Cases in Stomach Bug Outbreak Continue to Climb

Latest CDC statistics show 576 illnesses reported in 19 states, 36 people hospitalized

Friday, August 16, 2013

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FRIDAY, Aug. 16 (HealthDay News) -- As U.S. health officials continue to try to track down the source of a widespread stomach bug outbreak, the number of cases continues to climb, with 576 illnesses now reported in 19 states.
According to statistics released Friday from the U.S. Centers for Disease Control and Prevention, at least 36 people, or 9 percent, have been hospitalized with severe cases of cyclospora infection. No deaths have been reported.
Last week, the source of the outbreak in at least two states was traced to Taylor Farms, which supplied salad mix to Olive Garden and Red Lobster restaurants and is the Mexican branch of Taylor Farms of Salinas, Calif.
On Tuesday, Taylor Farms de Mexico "officially informed FDA that, as of Aug. 9, 2013, the company voluntarily suspended production and shipment of any salad mix, leafy green, or salad mix components from its operations in Mexico to the United States," according to the U.S. Food and Drug Administration.
"To date, only the salad mix has been implicated in the outbreak of cyclosporiasis in Iowa and Nebraska," the FDA said. The agency added it is still trying to determine whether the prepackaged salad mix was the source of infections in the other states.
States that have recorded cases of cyclospora infection include Texas (240), Iowa (153), Nebraska (86), Florida (29), Wisconsin (14), Illinois (11), Arkansas (10), New York (7), Georgia (4), Kansas (4), Missouri (4), Louisiana (3), Minnesota (2), New Jersey (2), Ohio (2), Virginia (2), California (1), Connecticut (1) and New Hampshire (1).
Meanwhile, U.S. health officials said the overall investigation continues.
Prior outbreaks of cyclospora infection have typically been caused by tainted produce, the CDC noted.
One expert said recently that while cyclospora can make people very ill, it is not usually life-threatening.
"On the infectious disease scale, this ranks well below the more notorious and dangerous ailments like E. coli and salmonella," said Dr. Lewis Marshall Jr., chairman of the outpatient services at Brookdale University Hospital and Medical Center in New York City.
"It is unlikely to be fatal, but certainly can make one's life miserable," he added. "Symptoms include crampy abdominal pain, watery diarrhea, loss of appetite, bloating, nausea, fatigue, fever, headache and body aches."
Cases of cyclosporiasis are caused by a single-celled parasite and cannot be spread from person to person. The parasite has to be ingested via contaminated water or foods such as fruit and vegetables, according to Dr. Monica Parise, chief of the parasitic diseases branch at the CDC.
"It can be pretty miserable, because it can give diarrhea that can last for days," Parise said.
It takes about a week for people who are infected to become sick.
Marshall said there may be more cases of cyclospora infection out there than people realize. It is possible "that most occurrences go unreported, as many people wouldn't recognize the symptoms as any different than a common stomach bug," he said.
Dr. Thomas Frieden, CDC director, has urged people who have suffered from diarrhea for longer than a couple of days to be tested for cyclospora.
Marshall agreed.
"If not treated, symptoms can last from a few days to a month or longer, go away and then return later," Marshall said. "Cyclospora can be treated with an antibiotic combination of trimethoprim-sulfamethoxazole [Bactrim]."
The best option, however, is to avoid the bug altogether.
"The safest way to protect oneself and one's family is to always rinse fresh produce under water, and even put vegetables in a cold water bath ahead of time to properly clean them," Marshall advised.
One expert stressed that the wash-your-produce rule includes prepackaged salads.
"Wash all your fruits and salads before ingesting," said Dr. Salvatore Pardo, vice chairman of the emergency department at Long Island Jewish Medical Center in New Hyde Park, N.Y. "My hunch is the public does not do this to 'prepackaged' salad, which is normally purchased for convenience and dumped into the bowl since it tends to be free from particles -- dirt, sand, critters -- one would normally find in locally picked ingredients."

SOURCES: Aug. 16, 2013, U.S. Centers for Disease Control and Prevention website; Aug. 12, 2013, U.S. Food and Drug Administration website; Monica Parise, M.D., chief, parasitic diseases branch, CDC; Thomas Frieden, M.D., director, CDC; Salvatore Pardo, M.D., vice chairman, Emergency Department, Long Island Jewish Medical Center, New Hyde Park, N.Y.; Lewis Marshall Jr., M.D., chairman, department of outpatient services, Brookdale University Hospital and Medical Center, New York City

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