July 15, 2013
Cyclospora Parasite Outbreak Taking Place In Iowa And Nebraska
Lee Rannals for redOrbit.com - Your Universe Online
The outbreak has climbed from 35 people to 80 in just a week in Midwestern states. So far, Iowa and Nebraska are the only states reporting problems.
The parasitic disease spreads through contaminated food and water and can cause unusually long watery diarrhea, which could last up to 57 days if it goes untreated. According to the University of Minnesota, Cyclospora can also cause fatigue, anorexia, bloating, stomach cramps, vomiting, muscle aches, and a low-grade fever.
The Iowa Department of Public Health (IDPH) said that 45 cases of the parasite have been reported in 15 counties, so far. However, the IDPH said that nearly half of the cases have been reported in Linn County.
"Most people's illness began in mid to late June and at least one person has been hospitalized. Many people report still being ill with diarrhea and some have had relapses," the IDPH said. "Specific treatment is available (but it is not typically used for more common diarrheal illnesses). Also, very specific laboratory testing (not commonly ordered) must be done to detect Cyclospora."
According to Nebraska Department of Health and Human Services (NDHHS), Nebraska has identified 35 cases.
"We're currently investigating and trying to identify the source of infection," said Leah Brucco-White, a public information officer for NDHHS.
Although health officials haven't pinpointed the cause of the breakout yet, Iowa's investigation is pointing to fresh vegetables as the likely culprit. The IDPH said it conducted interviews with patients who have been sick for its investigation. Past Cyclospora outbreaks have been linked to imported produce items like raspberries, basil, snow peas, and mesclun lettuce.
Patricia Quinlisk, MD, MPH, medical director for the IDPH, said investigators were conducting follow-up interviews with sick patients. IDHS has discussed case-control studies, but the sample size needed to help identify a specific fruit or vegetable would need to be large.
Quinlisk said the US Centers for Disease Control and Prevention, as well as other experts, recommend that researchers focus on a cluster analysis when sample sizes are small.
The IDPH issued an epidemiologic alert to clinicians about the Cyclospora outbreak on July 3, when seven cases had been detected. The agency has advised clinicians to test patients for the parasite if they have diarrhea lasting more than a few days accompanied by anorexia and fatigue.
In the past 20 years, only 10 previous Cyclospora infections have been identified in Iowa.