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(NEXSTAR) – Yet another outbreak of cyclosporiasis not linked to lettuce is now under investigation by the U.S. Food and Drug Administration. Meanwhile, the outbreak linked to recalled iceberg lettuce has expanded to more than a dozen states.
The FDA reported the new outbreak of the “explosive” diarrhea-causing parasite on Wednesday. Ten cases have been reported in the outbreak, and investigators are conducting traceback efforts to identify a common cause.
We may never know the cause of the outbreak. Because of how long it can take for people to experience symptoms, and the difficulties of sequencing cyclospora, investigations can “take a significant amount of time,” Gwen Biggerstaff, the deputy director of the CDC’s Division of Foodborne, Waterborne, and Environmental Diseases, said last month.
Domestically acquired cases in the U.S. are most commonly linked to produce. In addition to lettuce, other foods historically blamed for cyclosporiasis cases include raspberries, basil, cilantro, green onions, snow peas and mesclun. Blackberries, watercress, mango and vegetable trays may also have been implicated in outbreaks, according to a study.
Dr. Robert Redfield, who previously served as the CDC director, told Nexstar’s NewsNation that consumers should be cautious with produce. Instead, he urged a focus on buying and eating locally grown vegetables.
Authorities have not yet identified the cause of another cyclospora outbreak that was reported late last month. The case count in that outbreak has grown from 93 to 115, according to the FDA.
The agency now lists seven active cyclospora investigations, though some are believed to have ended already. Three – sickening 18, eight, and two people, respectively – are listed as ended. An additional outbreak, reported in early July, is considered ongoing, with 25 cases linked to it.
Only the lettuce-linked outbreak has an identified source.
US’s largest cyclosporiasis outbreak expands
Also on Wednesday, the FDA and the Centers for Disease Control and Prevention confirmed that six more states are linked to the outbreak.
The 15 states at the center of the investigation now include “at least” Arkansas, Iowa, Illinois, Indiana, Kansas, Kentucky, Michigan, Missouri, Nebraska, Ohio, Oklahoma, Pennsylvania and West Virginia.
While every state has reported at least one probable case of cyclosporiasis this year, not all are the result of the ongoing lettuce-linked outbreak. Only three states — Delaware, Hawaii, and Montana — have not reported any laboratory-confirmed cases of cyclosporiasis linked to the CDC’s investigation.
The U.S. this week also saw what appear to be its first deaths related to the ongoing outbreak. Two patients in Michigan died after becoming ill prior to the lettuce recall, though state health officials warned that “both individuals had significant underlying health conditions.”
The true number of people who have been infected by the cyclospora parasite this year may be higher than the aforementioned tallies suggest. Not everyone who becomes infected experiences symptoms, requires hospitalization or undergoes testing to confirm their diagnoses.
Healthcare experts encourage those experiencing symptoms, especially diarrhea that lasts more than a week or two, to seek medical care.
Left untreated, cyclosporiasis can stick around for a month or longer. Treatment can include antibiotics, antidiarrheal medications and hydration, according to the Cleveland Clinic.
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