Texas officials probe spike in Cyclospora cases

A spike in Cyclospora infections in Texas has triggered an investigation to see if there is a common source and an advisory for health professions to consider the parasitic illness in certain patients seeking treatment for diarrhea.

Over the last month the state's health officials have received 61 reports of Cyclospora infections from around the state, according to Chris Van Deusen, press officer for the Department of State Health Services (TDSHS). He said an advisory went out to health providers on Jul 18, urging them to promptly report cases.

At the time the advisory went out, the TDSHS had been informed of 34 cases.  So far it's not known if other states are seeing similar spikes.

In a separate statement, Tarrant County Public Health (TCPH), which covers Fort Worth, said yesterday that it has received reports of eight cases so far. Prior to the spike in cases, since the beginning of the year TCPH had learned of only 1 case and the TDSHS had been notified of 8 cases.

In a statement posted on the TCPH Facebook page yesterday, Russell Jones, MPH, the county's chief epidemiologist, said Cyclospora can be difficult to wash off all types of produce. "To reduce your risk, we recommend thoroughly washing all produce before consumption. Produce that is cooked is not a concern. It's the raw produce like cilantro and salads that can be a problem."

Though no common source has been identified, the TDSHS said past outbreaks in the United States have been linked to imported fresh produce, including fresh cilantro, prepackaged salad mix, raspberries, snow peas, basil, and mesclun salad mix.

Symptoms typically begin 2 to 14 days after ingesting oocytes in contaminated food and water, the TDSHS said. Symptoms include profuse diarrhea that can last weeks to months and may relapse. Others include anorexia, fatigue, weight loss, bloating, gas, nausea, vomiting and a low-grade fever.

Last summer, a Cyclospora outbreak sickened at least 631 patients in 25 states and New York City, with Texas as the hardest-hit state, according to information from the US Centers for Disease Control and Prevention (CDC). At least 49 people were hospitalized for their infections.

Investigations pointed to more than one Cyclospora outbreak, with health officials in Iowa and Nebraska concluding that their restaurant-related cases were likely linked to a bagged salad mix produced by a Taylor Farms facility in Mexico. Meanwhile, trace back investigation by Texas health officials and their partners suggested some of the Texas cases were linked to fresh cilantro from Puebla, Mexico.

See also:

Jul 21 TCPH Facebook post

Dec 2, 2013, CDC final outbreak update

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