Two people in Michigan who became ill with cyclosporiasis have died amid the ongoing outbreak of the parasite-caused infection, state health officials reported on August 3. They mark the first known fatalities linked to the outbreak, which spans nine states, although cases have been reported in 45 states
Cyclosporiasis, a gastrointestinal illness, is rarely life-threatening. The individuals who died both had “significant underlying health conditions that may have been impacted by cyclosporiasis and dehydration,” according to a statement from the Michigan Department of Health and Human Services
Still, “this is unprecedented,” says John Guzewich, a foodborne disease epidemiologist who retired from the Food and Drug Administration, to the New York Times’ Caroline Hopkins Legaspi. He isn’t aware of any past instances where the Centers for Disease Control and Prevention (CDC) had linked deaths in the United States to the illness
The sickness is caused by a microscopic parasite called Cyclospora cayetanensis that spreads through feces-contaminated food or water. Symptoms include watery diarrhea, frequent bowel movements, nausea, loss of appetite, bloating and other stomach problems. They can appear up to two weeks after becoming infected and last for several weeks. But sometimes, symptoms don’t show up. Most people recover with antibiotics, although cyclosporiasis can be hard to diagnose with standard stool sample tests.
The U.S. typically logs up to 1,000 cases of cyclosporiasis per year, most of which happen in the spring and summer. This year, however, the CDC is aware of more than 18,000 confirmed or suspected cases reported between May 1 and July 28, although national numbers have been lagging behind those reported by states. This is the largest cyclosporiasis outbreak ever recorded in the country
Michigan is at the epicenter of the multistate outbreak. It has documented more than 11,500 cases of cyclosporiasis, at least 193 of which involved hospitalizations, as of August 4. But that’s likely an undercount, because people with milder symptoms often don’t seek testing or treatment, says Anurag Malani, an infectious diseases doctor at Trinity Health Ann Arbor Hospital, to NPR’s Kristofor Husted and Maria Godoy
After a federal investigation, many cyclosporiasis cases have been linked to iceberg lettucet is served at Taco Bell and other establishments and has since been recalled
However, many experts suspect that’s not the whole story
“We have one clear implicated food, but it doesn’t explain everything,” says Susan Ringler Cerniglia, a spokesperson for the Washtenaw County Health Department in Michigan, to Siddhi Mahatole, Mrinalika Roy and Heather Schlitz at Reuters. The huge number of cases, gaps in reporting and people’s difficulty with remembering what they ate make it tough for investigators to pinpoint other foods that may have contributed to the outbreak, reports the outlet
Quick fact: Common
Past outbreaks around the world have most often been linked to raspberries, basil, cilantro and salad mixes
“I don’t want to come out and give one exact reason, but what this could point to is a mass contamination event, or it could just be that the conditions were right for this parasite at this time of year,” Wade Syers, a food safety specialist at the Michigan State University Extension, tells Anna Pope at Harvest Public Media
Regardless, things finally may be looking up for Michigan, as the number of new cyclosporiasis cases has been falling over the last few weeks
“We have growing confidence that the outbreak is declining,” Laina Stebbins, a spokesperson for Michigan’s health department, tells the Times. It’s still too early to tell if that trend applies to the rest of the country
Meanwhile, there are ways you can protect yourself against the disease. Stay up to date on food safety alerts and do not eat recalled food. Wash your hands with soap and water before and after handling raw fruits and vegetables. Wash your produce thoroughly before eating, cutting or cooking it—even if it’s labelled as prewashed. Scrub firm fruits and vegetables, like melons and cucumbers, with a clean brush. And if you want to be extremely safe, cooking produce to 158 degrees Fahrenheit will kill the parasite.
But don’t feel the need to stop eating all fruits and vegetables, Syers tells Harvest Public Media. “We don’t have to go all out on an avoidance,” he says. “We don’t have to be afraid of produce.”
