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Cyclospora continues to raise concerns in Dallas

QIANA JONES | 8/12/2013, 10:35 a.m.
Recently, a parasitic outbreak found in produce has caused a growing concern in the health community as well as the ...
Cyclosporiasis is an intestinal illness caused by the microscopic parasite Cyclospora cayetanensis. Infected people shed unsporulated (non-infective; immature) Cyclospora cayetanensis oocysts in their stool; immature oocysts usually require at least 1 week under favorable laboratory conditions to sporulate (become infective). An unsporulated oocyst, with undifferentiated cytoplasm, is shown (far left), (A) next to a sporulating oocyst that contains two immature sporocysts. (B) An oocyst that was mechanically ruptured has released one of its two sporocysts. (C) One free sporocyst is shown as well as two free sporozoites, the infective stage of the parasite. CDC/DPDM

The Dallas Examiner

Recently, a parasitic outbreak found in produce has caused a growing concern in the health community as well as the community at large.

As of Aug. 1, there have been 425 cases of Cyclosporiasis confirmed in 17 states, including Texas. On July 17, the Dallas County Health and Human Services Department reported nine cases of the infection. Since then, several additional cases were reported totaling 28 confirmed cases on Monday. Most of the cases were reported between mid-June through early July – 24 of which have been hospitalized.

Previously, only 12 cases have been identified in Dallas County in the preceding 12 years. The increase in cases being reported is possibly related to an ongoing Cyclospora outbreak in Iowa and Nebraska, according to DCHHS. The Food and Drug Administration conducted an investigation that identified the common source as a prepackaged salad mix imported from Taylor Farms in Mexico.

Cyclosporiasis is an intestinal illness caused by the microscopic parasite Cyclospora cayetanensis. Ingesting foods such as imported fruits, vegetables or water that has been contaminated with infected feces may cause a Cyclospora infection. While washing fruits and vegetables is recommended, it still may not prevent exposure to the infection because it can be difficult to wash off. Contamination is unlikely to occur through direct person-to-person contact because the parasite needs time – anywhere from a few days to weeks – to pass in a bowel movement in order to be actively infectious for another person. It is not known whether or not animals can be infected and pass it onto people.

Symptoms generally occur 14 days after the person becomes infected. Typical symptoms include profuse or watery diarrhea with frequent bowel movements, loss of appetite, substantial weight loss, stomach cramps/pain, bloating, increased gas, nausea and fatigue. Flu-like symptoms are also common such as vomiting, body aches, headache and fever. However, some people who are infected do not have any symptoms.

Untreated, the symptoms could last from a few days to a month or longer and it’s also common for relapses to occur. If symptoms are present and last more than a couple of days, consumers should contact their medical provider. Specific tests are available by a practitioner to detect the infection.

Diagnosis is made through one or more stool sample submissions from different days for analysis. Identification of the parasite requires specific laboratory tests that are not routinely performed and your health-care provider may have the submission tested for other organisms that may cause similar symptoms.

A combination of two antibiotics, trimethoprim-sulfamethoxazole – also known as Bactrim, Septra or Cotrim – sulfa drugs, is the suggested treatment for the infection. Infected people with diarrhea are being asked to rest, drink plenty of fluids, and should seek their physician’s advice before taking medicine to slow the diarrhea symptom. There is no vaccine to protect against Cyclospora infection.

Dr. Christopher Perkins, DCHHS medical director and health authority, advised consumers to thoroughly rinse fruits and vegetables several times before preparing them, in order to decrease the risk of infection – even if the vegetables are going to be cooked.

Usually, those most at risk have been people living or traveling abroad in tropical or subtropical regions because Cyclosporiasis is endemic in some countries in these zones. The food-borne outbreak in the United States has been linked to various imported produce from these regions. Also, people who have previously been infected may become infected again.

Some health experts have concluded that the Clyclospora outbreak has run its course and is over. Though other experts remain cautious. The Centers for Disease Control stated that it is unclear if contamination from the same imported produce has continued to infect consumers from state to state, or if recently reported infections are from another source.

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DCHHS Director Zachary Thompson stated that the DCHHS would continue to investigate the contamination and those who may have been exposed. The CDC also stated that, along with its public health partners, it would work to put an end to the outbreak and continue to update the public on its national investigation as information becomes available.