Memo: Spike in rare foodborne illness may be linked to outbreak in Midwest

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by MATT GOODMAN & JANET ST. JAMES

WFAA

Posted on July 16, 2013 at 12:10 PM

Updated Tuesday, Jul 16 at 5:18 PM

DALLAS –– Dallas County epidemiologists fear that an unusual spike in cases of the foodborne illness cyclosporiasis may be linked to an outbreak that has sickened more than 100 people in Nebraska and Iowa. 

According to a memo sent on Tuesday from the county’s Department of Health and Human Services to medical providers, eight cases of the rare cyclospora infection have been diagnosed within the past week in Dallas County. In the past 12 years, just 12 people have been diagnosed with it here. 

Statewide, the Texas Department of State Health Services report 35 cases from 2001 to 2010. As of Tuesday afternoon, the state reports 37 reports of cyclospora infection in the past week. 

Cyclospora is a parasite that can infect food and water. According to the Centers for Disease Control, symptoms usually begin after about a week of exposure and typically last for two days up to two weeks. In extreme cases, those who catch the illness can suffer symptoms for up two months.  

"In general, cyclospora infections can be mild and be a nuisance," said Dallas County Health & Human Services Chief Epidemiologist Dr. Wendy Chung. "They can cause prolonged bouts of diarreah for weeks.  Unfortunately, there may be more serious cases, especially in people with suppressed immune systems."

The CDC says common symptoms are diarrhea, loss of appetite, weight loss, cramping, bloating, increased gas, nausea and fatigue. Typically, the rare parasite is found on imported fresh fruits and vegetables that were not cleaned properly before being eaten. Cooking does kill the parasite, however.

Quoting from Dallas County’s memo, “DCHHS is encouraging medical providers to consider testing patients for Cyclospora if they have diarrheal illness lasting more than a couple days or diarrhea accompanied by severe anorexia or fatigue.”  

An outbreak in Iowa and Nebraska has sickened 124 people so far this year. Iowa’s Department of Health and Human Services issued a fact sheet Tuesday morning saying 71 residents have been diagnosed with the illness. Nebraska, meanwhile, has logged 53 cases

The cases are rapidly increasing, according to the Associated Press. Nebraska's cases have more than doubled in less than a week while those in Iowa have tripled. While Dallas County’s incidences have not been formally linked with the outbreak in the Midwest, the memo expresses concern that they are. 

“Increased numbers of Cyclospora cases are also currently being noted elsewhere in Texas and may possibly be related to an ongoing large multistate Cyclospora outbreak in Iowa and Nebraska,” it reads. 

Chung said she is investigating possible connections to food sources and grocery vendors.

"At this point, we do not know the exact food item which may be implicated," she said. "But in the past in the United States, these types of outbreaks have traditionally been associated with fresh imported produce items."

Residents suffering any of the symptoms are asked to visit their medical provider. Cyclosporiasis is typically treated with an antibiotic taken twice a day for seven to 10 days. 

“Thorough washing of fresh produce is recommended, but may not eliminate the risk of transmission since Cyclospora can be difficult to wash off all types of produce,” the county memo says. “Infection is generally not transmitted directly from person-to-person.”

According to the Lincoln Journal Star, other cases have also been reported in Kansas, Wisconsin and Illinois. 

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