Since the beginning of May, a cyclospora outbreak has been affecting the United States, and it has now spread to six additional states, according to a source familiar with the situation, as reported by NBC News on Wednesday.
The newly impacted states are Arkansas, Iowa, Missouri, Nebraska, New Hampshire, and North Carolina. These join the previously confirmed states: Illinois, Indiana, Kansas, Kentucky, Michigan, Ohio, Oklahoma, Pennsylvania, and West Virginia.
As of Tuesday, the Centers for Disease Control and Prevention (CDC) reported over 22,000 confirmed or suspected cases of cyclospora infections, along with 517 hospitalizations due to this multi-state outbreak.
Michigan: The Epicenter of the Outbreak
Recently, the first two deaths linked to this outbreak in U.S. history were reported, both occurring in Michigan, the hardest-hit state with more than 11,000 cases. According to the Michigan Department of Health and Human Services, "both individuals had significant underlying health conditions that could have been exacerbated by cyclospora and dehydration."
Unexpected Surge in Missouri Cases
Missouri has seen an unusual spike in cases. The state's Department of Health reported 1,095 cases by Sunday, nearly double the approximately 595 cases recorded the previous week. Typically, the state sees only about a dozen cases of cyclospora each year.
Florida's Vigilant Monitoring
Although Florida is not among the states newly added to the CDC's list, it has been under health surveillance since July due to cyclospora cases. By mid-July, Florida's Department of Health had confirmed 50 cases across more than 20 counties, including Miami-Dade and Broward, without identifying the infection source.
Tracing the Source: Taylor Farms' Iceberg Lettuce
The leading source of the outbreak has been traced to shredded iceberg lettuce from Taylor Farms, processed in Guanajuato, Mexico, and distributed across 27 states between late June and mid-July. Taco Bell was one of the first points of concern, with nearly 1,947 individuals reporting they had eaten at its restaurants.
Taylor Farms voluntarily recalled all its iceberg lettuce from central Mexico. However, investigators are still determining whether all reported cases nationwide can be attributed to this source alone.
Insights from Experts: Understanding the Spread
The expansion to six more states doesn't necessarily imply that the outbreak is actively spreading, cautioned Dr. Stephen Ostroff, former acting commissioner of the Food and Drug Administration (FDA). He explained that many of these cases likely involve individuals who were infected weeks ago but were only recently diagnosed and reported, given the parasite's incubation period of up to two weeks.
"With an incubation period of up to two weeks, there shouldn't be new cases from that product. However, it takes time for people to seek medical attention, get tested, and be diagnosed, reported to state health departments, and then to the CDC," Ostroff noted.
The recalled product's expiration dates ended on August 3, meaning if cases are identified in individuals exposed after this date, investigators will need to seek an alternative source.
"We may have resolved the shredded lettuce issue with Taylor Farms, but it's unlikely that explains all we're observing," the expert warned.
Understanding Cyclosporiasis and Its Symptoms
Cyclosporiasis is an intestinal infection caused by the microscopic parasite Cyclospora cayetanensis, which spreads through consuming fresh produce or water contaminated with human feces. It is not transmitted from person to person.
Symptoms, including severe watery diarrhea, cramps, nausea, and fatigue, typically appear between two and 14 days after exposure, and the parasite is resistant to common disinfectants.
This outbreak is the largest recorded in U.S. history, far exceeding the previous record of 631 cases documented in 2013. The CDC anticipates that the case count will continue to rise as more data is collected from various states.
Common Questions about the Cyclospora Outbreak
What states are affected by the Cyclospora outbreak?
The outbreak has impacted 15 states, including Arkansas, Iowa, Missouri, Nebraska, New Hampshire, North Carolina, Illinois, Indiana, Kansas, Kentucky, Michigan, Ohio, Oklahoma, Pennsylvania, and West Virginia.
What is the main source of the Cyclospora outbreak?
The leading source of the outbreak is identified as shredded iceberg lettuce from Taylor Farms, processed in Guanajuato, Mexico, and distributed in 27 states.
How does Cyclosporiasis spread?
Cyclosporiasis spreads by ingesting food or water contaminated with the Cyclospora parasite, which originates from human feces. It is not spread directly from person to person.