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Food Poison Journal Food Poisoning Outbreaks and Litigation: Surveillance and Analysis

Iowa Cyclospora Outbreak 2013 Now 127 Cases

Iowa Outbreak Update 7.23.13

IDPH, CDC, the State Hygienic Laboratory and local public health agencies are investigating an outbreak caused by Cyclospora. o As of today, 127 cases of Cyclospora infections have been reported to IDPH. The next case count will be updated Wednesday, July 24 at approximately 10:00 a.m.

o The number of cases reported is decreasing.

o Cyclospora is a rare parasite.

o Previous outbreaks have been associated with fresh produce (fresh fruits and vegetables)

o People become infected with Cyclospora by consuming food or water contaminated with the parasite.

The source of this outbreak is unknown at this time. o The CDC has launched a web page focusing on the Cyclosporiasis outbreak, which includes Iowa and several other states. For CDC updates, visit www.cdc.gov/parasites/cyclosporiasis/outbreaks/investigation-2013.html.

o The Iowa Department of Public Health (IDPH) continues to receive reports of confirmed cases of Cyclospora infection and interview those who are ill, but numbers are decreasing. Now the investigation focuses primarily on determining the source of the contamination. This investigation is ongoing, and will be led by the Iowa Department of Inspections and Appeals (DIA). IDPH and DIA will continue to update the CDC as the Iowa epidemiologic investigation continues.

o Onset dates of the illness suggest the ill people had eaten the contaminated food in mid-June. This is a very good indication the food which was the source of the outbreak has already been consumed or discarded, since fresh vegetables have a limited shelf life.

o At no time was an Iowa-grown fruit or vegetable suspected to be the cause of the outbreak.

o IDPH encourages Iowans to make fruits and vegetables part of their daily diet. It is always a good idea to wash all fresh fruits and vegetables thoroughly before eating.

o Cyclospora illness is typically traced to consumption of fresh fruits and vegetables contaminated with the parasite; this investigation currently indicates fresh vegetables, not fruit, may be the source of illness.

o IDPH is working with local public health agencies to interview individuals who are ill to determine if there is a common food exposure that would indicate the source of illness.

o Cluster investigations continue, which ask questions of both the ill person and their family and friends who are not ill, to determine what the well people did not eat.

Cyclospora infection causes a watery diarrhea that lasts an average of 57 days, if untreated.

o Most of the illnesses in this outbreak began in mid to late June. Many people report still being ill and some have had relapses.

There is treatment (medicine) available to treat Cyclospora infection.

o Specific laboratory testing (not commonly ordered) must be done to detect Cyclospora.

o Specific treatment (not typically used to treat more common diarrheal illnesses) can be prescribed.

If you are experiencing diarrhea, or have recently had a long bout with diarrhea, you should contact your health care provider and see if you should be tested for Cyclospora infection.

o Additional symptoms of cyclosporiasis (the infection caused by Cyclospora) include:

Watery diarrhea

Fatigue (severe tiredness)

Loss of appetite

Weight loss

Bloating

Increased gas

Stomach cramps

Nausea

Vomiting

Muscle aches

Low-grade fever