The Food and Drug Administration (FDA) and the Centers for Disease Control and Prevention (CDC) are investigating a multi-state outbreak of Cyclospora infections.  As of July 31, there have been 397 confirmed cases in 16 states: Arkansas, Connecticut, Florida, Georgia, Illinois, Iowa, Kansas, Louisiana, Minnesota, Missouri, Nebraska, New Jersey, New York, Ohio, Texas, and Wisconsin.

The CDC was first notified of two laboratory-confirmed cases of Cyclospora on June 28.  Both cases were Iowa residents that had not recently traveled abroad.  The majority of cases have been reported in Iowa, which is currently at 143.  The Iowa Department of Public Health and the Nebraska Department of Health and Human Services have both completed their investigations and concluded that the outbreak was related to a bagged salad mix.  The CDC and FDA are still investigating to determine if the cases in the other states are from the same source or are unrelated infections.  Past outbreaks of Cyclospora usually implicated fresh produce products.

A Cyclospora infection, also known as cyclosporiasis, comes from infection by a microscopic parasite.  This parasite can be found in contaminated food or water.  In some regions of the world, cyclosporiasis is more common.  As a result, travelers to these regions are susceptible to greater risk and should exercise caution in consuming local food and water.  However, most recent cases have been linked to food grown in the U.S. and Canada, rather than international sources.

Symptoms of an infection began two to 11 days after consuming a contaminated item.  The symptoms include watery diarrhea, frequent and possibly explosive bowel movements, alternating bouts of diarrhea and constipation, loss of appetite, weight loss, other common signs of abdominal distress and discomfort, muscle aches, low fever, and fatigue.  Cyclosporiasis can usually be treated at home, focusing on hydrating without drinking caffeinated beverages, fruit juices, or soda.  If medical treatment is sought, patients are usually prescribed a combination antibiotic.

Currently, of the 397 cases, 40 have been confirmed by laboratory tests.  In five states, there have been 22 reported hospitalizations and no fatalities have been reported.  At the FDA, there is a team at the central office as well as field officers working to investigate the outbreak, beginning with the connections to the bagged salad mix confirmed in Iowa and Nebraska.  Officials have not yet named the brand of bagged salad, though it was connected it to 80 percent of cases and removed it from distribution in its state.  Officials are not yet providing the name because there are laws to protect companies’ identities until investigators are certain.