Cyclosporiasis outbreak in Michigan: Latest case numbers near 1K mark

FOX 2 - Cyclosporiasis cases continue rising in Michigan, with the current reported number at 992 according to the state's Health and Human Services Wednesday.

Dig deeper:

The diarrheal illness is caused by infection with the parasite Cyclospora cayetanensis, which experts say is found in developing countries and is spread by food or water contaminated with feces.

The illness is described as having "a two-week case of diarrhea," said Doctor Joel Kammeyer from the Detroit Medical Center.

"We're clearly in an outbreak where we're above 700 cases for the past few weeks, really since the third week of June," he said. 

Michigan usually averages only about 50 cases per year, said Kammeyer, an infectious disease doctor. 

Cyclosporiasis outbreak in Michigan

By the numbers:

Although there are no updated county numbers reflecting the new 992 case total, in the most recent count from July 6, Monroe County led the state.

As of July 6th, Monroe (173), Washtenaw (95), Lenawee (86), Shiawasee (62), and Wayne (58) were the top five counties in cases.

As far as Metro Detroit is concerned, Oakland County ranks seventh (33) and Macomb boasts one of the fewest amounts in the state, with four cases. 

Outbreaks have occurred in the US as a result of eating contaminated fresh produce in hot weather.  It is not known to spread from person-to-person.

The biggest danger is dehydration which can occur, the doctor said, adding that just under 40 people have been hospitalized due to the outbreak. And of those 36, most were outpatient cases due to dehydration. 

No source has been identified as the cause yet, according to HHS.

Kammemeyer said that the food-borne illness is an intestinal parasite that doesn't reveal itself right away. 

"Oftentimes it takes more than a week after the initial exposure before symptoms start," he said. "And the symptoms can be more prolonged than typical diarrhea, sometimes as often as two weeks."

Cyclosporiasis symptoms

Timeline:

Symptoms occur two to 14 days after exposure and may include:

• Frequent watery diarrhea
• Loss of appetite and weight
• Abdominal cramps and bloating
• Nausea (vomiting is less common)
• Low-grade fever

Anyone infected who does not get treatment, health experts say the illness may last for a few days to over a month. Symptoms could go away and then return one or more times.

Cyclosporiasis food concerns

One of the ways to protect yourself is washing your lettuce, cutting out bruised areas, and washing your hands after handling it.

"It often begins with fresh produce, sometimes lettuce or salad products," said Kammemeyer. "There have been outbreaks associated with raspberries, basil, cilantro, et cetera. And so. If someone has lettuce from the store, we're really kind of emphasizing some of the food preparation strategies to try and prevent infection.

"We suspect that it's probably a vegetable source, but it's not known right now. So caution with preparation I think is the best bet at the moment."

Recommended Cyclosporiasis precautions

According to HHS these are the recommended precautions for restaurants, commercial kitchens, and other entities preparing or serving raw produce in Southeast Michigan:

• Lettuce and leafy greens: Purchase whole heads of lettuce rather than prewashed, bagged lettuce or salad mixes. Remove the outer two to three leaves and wash the remaining leaves under running water. Cook leafy greens when possible.
• Cilantro and basil: Separate the leaves and wash thoroughly under running water. Cooking is the safest option.
• Green onions: Trim the root end, remove the outer layer, and wash thoroughly under running water. Cooking is the safest option.
• Raspberries: Because their surface is difficult to clean, consider using cooked raspberries (such as in pies or jams) or frozen raspberries. Freezing may reduce, but does not eliminate, the parasite.
• Snow peas: Wash thoroughly under running water while rubbing the surface. Cooking is the safest option.

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