Cyclosporiasis outbreak from salad

Cyclosporia cases, by state 7/30/13

Via CNN, and updated on the Center for Disease Control website, an alert about an outbreak of Cyclospora infections due to contaminated packaged salad.  Cyclospora is a parasitic infection, typically acquired via contaminated foods, and typically causes mild to severe gastrointestinal disease. Many patients may be infected without any signs or symptoms. According to the CDC, patients with active disease are not infectious and direct fecal to oral transmission does not occur with Cyclospora cayetanensis. Cases in the US are rare, as the pathogen is restricted to tropical and subtropical countries. Most outbreaks in the US have been attributed to various imported fruits and vegetables. The disease is diagnosed by the presence of oocysts in the stool, and is generally readily treatable using sulfa drugs. There are no useful treatments for patients allergic to sulfa drugs, however most patients with a healthy immune system will generally recover on their own. Patients who are immunocompromised in any way may have much more severe disease.

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Cyclosporia oocyst

As of the end of July 2013, a total of 378 cases of cyclosporiasis have been reported in 15 states, with the majority of the cases in the Midwest. The initial cases and the largest number to date have been from Iowa, with the first laboratory diagnosed illness occurring in mid-June. Reporting of epidemiological data to the CDC has implicated premixed bagged salads, however it is not clear at this time whether the individual state outbreaks are related to one another. The CDC has noted about ten previous outbreaks over the past 15 years, including one in Pennsylvania in 2004 associated with imported Guatemalan snow peas eating in a retirement facility. In that outbreak, approximately 45% of the people who came into contact with the contaminated produce developed symptoms.

Confirmed cases June-July 2013

With the current outbreak, the Centers for Disease Control and Prevention consider the investigation still ongoing, although the curve shown to the left would suggest that the outbreak is in its latter phases.  Fortunately, only about 10% of the total cases so far have required hospitalization, and no deaths have occurred. The YCPMicro recommendation from all of this? Make sure you wash your salad fixings before sitting down to dinner, or else be like me and stick to meat.  Vegetables are what the dinner eats!


About ycpmicro

My name is David Singleton, and I am an Associate Professor of Microbiology at York College of Pennsylvania. My main course is BIO230, a course taken by allied-health students at YCP. Views on this site are my own.

Posted on August 1, 2013, in Danger danger danger!, You are what you eat and tagged , . Bookmark the permalink. Comments Off on Cyclosporiasis outbreak from salad.

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