Multistate outbreak tied to basil part of Cyclospora surge

Federal health officials are investigating a Cyclospora outbreak linked to fresh basil that has so far sickened 132 people in 11 states, part of a steep increase at the national level.

The past several summers have seen rises in domestically acquired infections from the parasite Cyclospora cayetanensis, which is spread by eating food or drinking water contaminated with feces. Profuse diarrhea that can last weeks to months is a hallmark of Cyclospora infection.

Outbreaks are typically linked to imported fresh produce, such as raspberries, basil, cilantro, and snow peas.

Multiple clusters fuel steep rise

In an update yesterday, the US Centers for Disease Control and Prevention (CDC) said that, as of Jul 23, officials have reported 580 lab-confirmed cases in 30 states, the District of Columbia, and New York City, up sharply from 23 cases in 10 states and New York City reported at the end of June.

Nationally, 38 people were hospitalized, and no deaths were reported.

"At this time, multiple clusters of cases associated with different restaurants or events are being investigated by state public health authorities, CDC, and FDA," the CDC said, referring to the Food and Drug Administration.

Many cases can't be directly linked to the multistate basil outbreak, partly because there is no validated molecular typing tool for C cayetanensis.

For comparison, in all of 2018 the CDC received reports of 2,299 Cyclospora cases from 33 states. About a third of the illnesses were linked to two large multistate outbreaks in the Midwest, one involving prepackage vegetable trays, and the other linked to salads sold at a fast food chain. Some illness clusters were also linked to fresh produce, including basil and cilantro.

Restaurant exposures in some states

The CDC said federal health officials and partners in several states are investigating Cyclospora infections linked to consuming fresh basil from Siga Logistics de LL de CV of Morelos, Mexico.

The hardest hit of the 11 states with cases linked to basil are New York (69), Minnesota (29), and Florida (22), with Connecticut, Iowa, Massachusetts, Ohio, Rhode Island, South Carolina, and Wisconsin reporting from 1 to 3 infections.

The CDC said exposures occurred at restaurants in Florida, Minnesota, New York, and Ohio.

Illness onsets range from Jun 14 to Jul 9, and patient ages range from 19 to 98. Of 96 people with available information, 74% were female. Four patients were hospitalized.

Epidemiologic evidence and early product distribution clues suggest that fresh basil from Siga Logistics is the source of the outbreak, the CDC said.

FDA working with company on recall

In a statement yesterday the Food and Drug Administration (FDA), which has been working on the trace-back investigation, said it is working with the company to facilitate a recall.

"As this outbreak investigation continues, the FDA will work with our Mexican food safety regulatory counterparts to better define the cause and source of this outbreak," the FDA said. The agency added that it will update its information when more information is available.

Federal health officials are urging restaurants, retailers, distributors, and importers not to sell, serve, or distribute Siga Logistics basil. It also warned consumers not to eat or serve uncooked items, such as pesto, that include fresh basil from Mexico, unless they are certain that it wasn't exported by Siga Logistics.

See also:

Jul 25 CDC Cyclospora case update

Jul 25 CDC multistate Cyclospora outbreak notice

Jul 25 FDA outbreak investigation notice

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