Cyclospora Outbreak Rears its Ugly Head in the U.S., Again

August 1, 2013

As of this date, 397 cases of Cyclospora has been reported to the CDC from 16 states and the city of New York, resulting in 22 hospitalizations and thankfully no deaths. The majority of the illnesses had onset dates from mid-June through early July. However, what is troubling is that the last reported onset date was July 23 and given the incubation period of 2 to 10 days with an average of a week and the lag time between onset, clinical diagnosis, reporting to the CDC via state departments of health, there is no clear indication that the outbreak is totally over.

Two states have reported epidemiological association with salad mix, purportedly a mixture of romaine lettuce, iceberg lettuce, cabbage and carrotts. The origin of the produce domestic or foreign, is unknown, as is any implicated brand. There has not been a recall to date or a public notification of any specific brand.

There is even question that there might be more than one outbreak going on simultaneously.

Most interestingly, none of the individuals prior to the 14 days onset have had foreign travel outside of the United States or Canada. In the past, there have been several outbreaks of Cyclosporiasis associated with produce, with snow peas from Guatemala in 2004 and raspberries in 1997, also from Guatemala.

There is a seasonality, like many gastrointestinal illnesses, that clusters in the spring and summer months. In addition to raspberries and snow peas, mescaline lettuce and basil have also been attributed as vectors for Cyclosporiasis.

The five states that have the largest number of cases are:

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