IDPH, CDC, Iowa Department of Inspections and Appeals, the State Hygienic Laboratory and local public health agencies are investigating an outbreak caused by Cyclospora.

• The epidemiologic investigation completed by local public health departments in Iowa and IDPH has implicated a prepackaged salad mix as the source of the outbreak. The food trace back investigation performed by DIA determined that at least 80 percent of these cases had been exposed to the same prepackaged salad mix.

o The salad mix contained iceberg and romaine lettuce, carrots and red cabbage.

o This salad mix is no longer in Iowa’s food supply chain.

• 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.

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

o Bagged salads and all other vegetables are safe to eat.

o Public Health 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.

• As of today, 145 cases of Cyclospora infections have been reported to IDPH. Case counts with county breakdown are posted to the IDPH website every weekday at approximately 10:00 a.m. at www.idph.state.ia.us/EHI/Issue.aspx?issue=Cyclospora Outbreak Investigation&pg=Cyclospora Case Count Updates

o IDPH continues to receive reports of confirmed cases of Cyclospora infection and interview those who are ill, but numbers are decreasing.

o Cyclospora is a rare parasite.

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

• CDC updates on the Cyclosporiasis outbreak, which includes Iowa and several other states, can be found at www.cdc.gov/parasites/cyclosporiasis/outbreaks/investigation-2013.html.

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

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