Texas reports Cyclospora cases as Midwest outbreak grows

Iowa and Nebraska health officials reported another 15 Cyclospora infections today, raising the combined total to 134 cases, and a media report said cases are now cropping up in Texas, though it was unclear if they are part of the same outbreak.

The Iowa Department of Public Health (IDPH) said its case total reached 81 today, 10 more than yesterday. In Nebraska, the count reached 53 cases, 5 more than yesterday. Health officials in both states said the number of new cases is dropping, suggesting that the unknown food causing the outbreak has all been consumed or discarded by now.

In Texas, an NBC-affiliated TV station in Dallas reported today that Dallas County has eight cyclosporiasis cases and that neighboring Tarrant County (Fort Worth) has seven. Investigators are trying to find the source of contamination and determine if the cases are connected to the outbreak in Iowa and Nebraska, said the story from 5NBCDFW.com.

Christine Mann of the Texas Department of State Health Services said the state has had 37 cyclosporiasis cases so far this year, compared with 44 in all of 2012 and 14 in 2011, according to the story.

Today's press release from the IDPH said illness-onset dates in Iowa suggest that the infected people ate contaminated food in mid June. "This is a very good indication the food which was the source of the outbreak has already been consumed or discarded, since fresh vegetables have a limited shelf life," the statement said.

Iowa's cases are scattered over 25 counties, with Linn County (Cedar Rapids area) leading the list at 31 cases. At least five people have been hospitalized, according to the IDPH.

In Nebraska, patients' symptoms started no later than the end of June, "which suggests the contaminated food source may have worked its way through the system since fresh produce has a limited shelf life," the Department of Health and Human Services (DHHS) said in a press release.

Interviews with patients in Nebraska suggest that vegetables are the cause of the outbreak and that locally grown produce is not involved, according to the release. Three people in Nebraska have been hospitalized for the illness and released.

Of the 53 cases in Nebraska, 36 have been in Douglas County (the Omaha area), officials said. The rest are sprinkled through eight other counties.

Symptoms of cyclosporiasis include diarrhea that can last from weeks to months, along with other gastrointestinal problems, fatigue, loss of appetite, weight loss, muscle aches, and low-grade fever, the Nebraska statement said.

Previous Cyclospora outbreaks have been linked mostly to imported produce, including such items as raspberries, basil, snow peas, and mesclun lettuce.

See also:

Jul 16 IDPH press release

Jul 16 Nebraska DHHS press release

Jul 16 5NBCDFW.com story

Related Jul 15 CIDRAP News story

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