Fifth state linked to cyclosporiasis outbreak, investigation still focused on lettuce

(NEXSTAR) – Yet another state has been linked to the multistate outbreak of the parasite-linked sickness cyclosporiasis as investigators seek to positively identify the cause.

While the Food and Drug Administration has confirmed that a positive test result linked to samples of Taylor Farms-branded shredded lettuce sourced from central Mexico was instead a false positive, the investigation remains focused on the produce.

“FDA’s traceback investigation and outbreak data continue to converge on shredded iceberg lettuce from Taylor Farms locations in central Mexico,” the FDA said Monday. The agency added that it “will continue to work with federal and state partners to investigate this multistate outbreak and ensure products implicated in this outbreak have been removed from the market.”

Product samples are still being collected, but “there are no confirmed positive sample results” linked to the cyclospora outbreak, the FDA said.

The FDA is also still referring to the investigation as a five-state outbreak. That’s up from the four states the Centers for Disease Control and Prevention had linked to the outbreak last week.

Those four states — Michigan, Ohio, West Virginia, and Kentucky — comprise at least 1,500 cases of cyclosporiasis in the outbreak investigation. The newest state implicated, Indiana, has reported at least 47 outbreak-related cases.

Case counts could also be far higher than the tally the CDC has confirmed. As of Monday, Michigan health officials have reported 6,148 cases of cyclosporiasis alone. Of those, 102 required hospitalization.

Additional states could be included in the outbreak, too, the FDA warned.

While several states have seen a spike in cyclosporiasis cases this year, not all are linked to the outbreak. Health officials in Utah, for example, said earlier this month that a resident diagnosed with an infection has no connection to the ongoing outbreak.

Not everyone who becomes ill has symptoms, and among those who do, not all will require hospitalization or seek out testing. Cyclosporiasis is only diagnosed by a stool sample; the CDC last week urged medical professionals to “specifically request Cyclospora laboratory testing on stool specimens” because a regular examination may not detect the parasite.

In addition to “explosive” diarrhea, symptoms of cyclosporiasis include a loss of appetite, nausea, vomiting, stomach cramps, “bloating, including burping and farting,” low-grade fever, and extreme tiredness.

For some people, illness will “self-resolve after a few days,” Dr. Katie Theoktisto of Baylor Scott & White told Nexstar’s KXAN. If you continue experiencing diarrhea for more than a week or two, she recommends seeking medical care.

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