Health officials in Iowa and Nebraska today said the number of patients sickened in a Cyclospora outbreak has grown to 80, and though the source has not been identified, Iowa's investigation points to fresh vegetables as likely culprits.
The infection total in the two states is more than double the 35 reported earlier this week. Other Midwestern states may have cases, but so far Iowa and Nebraska are the only two reporting them, according to earlier reports.
The parasitic disease, spread through contaminated food and water, can cause an unusually long bout of watery diarrhea that can last up to 57 days if untreated. The long list of symptoms can also include fatigue, anorexia, bloating, stomach cramps, vomiting, muscle aches, and a low-grade fever.
Iowa has identified 45 cases from 15 counties, though nearly half are from Linn County, according to a press release today from the Iowa Department of Public Health (IDPH). One patient has been hospitalized. Most of Iowa's patients got sick in mid to late June.
Meanwhile, Nebraska has identified 35 cases, Leah Bucco-White, a public information officer for the Nebraska Department of Health and Human Services (NDHHS), told CIDRAP News today.
She said, "We're currently investigating and trying to identify the source of infection."
The IDPH said epidemiologic interviews with patients who have been sick so far suggest vegetables, rather than fruit, as a likely source. In the past Cyclospora outbreaks have been linked mainly to imported produce items such as raspberries, basil, snow peas, and mesclun lettuce.
Earlier this week Patricia Quinlisk, MD, MPH, medical director for the IDPH, told CIDRAP News that investigators were conducting follow-up interviews with sick patients and conducting cluster analysis. The department has discussed case-control studies, but the sample size needed to identify a specific fruit or vegetable would need to be large, and so far the state has only a relatively small number of cases.
She said the US Centers for Disease Control and Prevention and other experts recommend focusing on cluster analysis when sample sizes are small.
See also:
Jul 12 IDPH news release
Jul 8 CIDRAP News scan "Cyclospora outbreak sickens 35 in Iowa, Nebraska"
