US cyclosporiasis cases top 1,600 with more cases likely, health officials say

The U.S. Food and Drug Administration said on Tuesday it was conducting traceback investigations on multiple produce items, including lettuce, as officials try to identify the source of a cyclosporiasis outbreak as the number of lab-confirmed cases continues to rise. No deaths have been reported from the outbreak, but so far 141 people have been hospitalized, with 1,645 lab-confirmed cases reported across 34 states, according to the U.S. Centers for Disease Control and Prevention. The agency said it was aware of more than 5,100 additional reports that require more analysis and confirmation. Cyclosporiasis is an intestinal infection that can be contracted by consuming food — typically raw fruits and vegetables — or water contaminated with feces, according to the CDC. It causes diarrhea, nausea and other gastrointestinal symptoms. While the United States has experienced outbreaks of the gastrointestinal illness before, the scale and geographic spread of this year's outbreak are significantly larger, prompting concern among health officials, who have so far not pinpointed the source of the outbreak. "This is an active and evolving investigation," said Gwen Biggerstaff, a CDC foodborne disease expert. In traceback investigations, officials collect information from sick people on the foods they ate in the week before they got sick. The CDC expects that cases will continue to increase, potentially through the end of August, Biggerstaff told reporters. The agency cautioned that there is a roughly six-week lag between the onset of illness and the reporting of cases, which means more infections are likely to be identified as additional data is received. The current U.S. outbreak, which began on May 1, is centered in Michigan, with Ohio and New York State also reporting high numbers of cases. Michigan health officials on Tuesday reported 3,309 cases in the state, an increase of 669 cases since the last update on Monday. Biggerstaff told reporters that the evidence collected so far suggests that cases in Michigan, West Virginia, Kentucky and Ohio may be linked to one source, though that does not account for cases in several other states. "There are a number of other investigations that are going on, some single-state investigations as well as investigations for the cases that are not currently linked to a cluster or outbreak," Biggerstaff said. The Washington Post reported federal and state officials are investigating whether lettuce served at Yum Brands'-owned restaurant chain Taco Bell may have been associated with an outbreak. The company said it has removed certain ingredients at select restaurants for precautionary reasons, adding that U.S. health officials have not confirmed a link to the chain and the outbreak. Dr. Michael Osterholm, an infectious disease expert at the University of Minnesota, said it is possible that the outbreak centered on Michigan is already over given that many produce items only have a shelf life of about three weeks. Donald Prater, the FDA’s acting deputy commissioner for food, acknowledged that produce moves through the system quickly, but said the agency is looking at multiple clusters and sub-clusters, and it needs more information before it can determine whether the outbreak is already over.

US cyclosporiasis cases top 1,600 with more cases likely, health officials say

FDA and CDC trace outbreak as cases rise

Health officials say more cases are likely

Michigan cluster is largest, with other states also affected

Taco Bell ingredients reviewed as officials investigate produce

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