Three more states report Cyclospora cases; total rises to 283

Cyclospora oocysts
Cyclospora oocysts

Oocysts of Cyclospora cayetanensis stained with safranin., CDC

Three more states are reporting Cyclospora infections, pushing the national total to 283, but it's not clear which of the newly reported cases are part of the national outbreak, the US Centers for Disease Control and Prevention (CDC) and individual states reported today.

In its update today, the CDC added Georgia, Connecticut, and New Jersey to its map of cyclosporiasis cases, which means nine states are now reporting cases. Georgia has two cases, and Connecticut and New Jersey each have one.

About half of the total cases are from Iowa, which reported its first cases in early July. In an update today the Iowa Department of Public Health (IDPH) said 134 cases have been reported in the state so far, which is seven more than reflected in the CDC total.

The Nebraska Department of Health and Human Services (NDHHS) also updated its case count today, adding one more case that isn't reflected in the CDC's total to bring its total to 69. The combined new cases in Iowa and Nebraska raise the total number of US cases to 283.

Texas is third in case numbers, with 65.

The CDC said totals in those three states may include some travel-associated cases and that interviews are pending. It also noted that the single cases reported from Illinois and Kansas probably involved infections acquired in neighboring outbreak states.

Wisconsin has confirmed four Cyclospora cases.

William Gerrish, director of communications for the Connecticut Department of Public Health, said both of the state's patients are women who got sick in June, and neither was hospitalized, NBC Connecticut reported today.

He said one of the patients likely acquired her infection during international travel, meaning it wouldn't be linked to the multistate outbreak. It's not clear if the other case is linked to the others, because the source of the outbreak has not been found.

The CDC said most patients have illness-onset dates ranging from the middle of June through early July. At least 10 patients from three states have been hospitalized.

Investigations are still under way in several states. So far no source of the parasite has been found, but Iowa health officials who have interviewed sick patients suggest that a vegetable rather than fruit could be the contaminated food vehicle. Past Cyclospora outbreaks have been linked to imported fruits and vegetables.

The CDC said more cases are under investigation that will be included in the illness total as states confirm them. The agency said it has confirmed five cases so far in CDC labs, one of them through telediagnosis, which allows for rapid lab confirmation. It urged other state labs to confirm cases using the remote method.

Cyclosporiasis is a rare parasitic disease, spread through contaminated food and water that can cause an unusually long bout of watery diarrhea that can last up to 57 days if untreated. The long list of symptoms can also include fatigue, anorexia, bloating, stomach cramps, vomiting, muscle aches, and a low-grade fever.

See also:

Jul 24 CDC outbreak update

Jul 24 IDPH update

Jul 24 NDHHS update

Jul 24 NBC Connecticut story

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