CDC reports 145 cyclosporiasis cases

The Centers for Disease Control and Prevention said on July 1 it had received reports of 145 U.S.-acquired cyclosporiasis cases in people who became sick between May 1 and June 16. The cases were reported across 17 states, and 20 people were hospitalized, the agency said. No deaths have been reported. The CDC said there is no evidence so far of a single multistate outbreak linking all of the illnesses, and investigations into possible clusters and sources are continuing. ### What exactly did the CDC report? The CDC’s July 1 surveillance update described the figure as a count of laboratory-confirmed cyclosporiasis cases acquired in the United States, not a single confirmed nationwide outbreak. The agency said the patients did not report travel during the 14 days before they became sick, which is one reason officials are treating the illnesses as domestically acquired. (cdc.gov) The 145 patients ranged in age from 5 to 86, with a median age of 42, and 61% were female, according to the CDC. The median illness onset date was May 13, with onset dates ranging from May 1 to June 6. ### Why isn’t the CDC calling this one nationwide outbreak? The CDC said there is “currently no evidence of a single, multistate Cyclospora outbreak linking all cases.” Instead, the agency said it and state and federal partners are investigating several clusters of cases in more than one state. (cdc.gov) The CDC’s foodborne outbreak page shows that Cyclospora investigations are tracked separately from the main table of active multistate investigations for pathogens such as E. coli, Listeria and Salmonella. (cdc.gov) The page says information on active outbreaks caused by Cyclospora can be found through its dedicated section. ### What is cyclosporiasis, and how do people get it? (cdc.gov) Cyclospora cayetanensis is a microscopic parasite that causes an intestinal illness called cyclosporiasis, according to the CDC. The agency says the disease is typically linked to contaminated food or water. Dr. Miriam Fischer of MedStar Health told WTOP that the parasite is “usually spread from infected produce or infected water” and is not typically spread from person to person. (cdc.gov) Fischer said symptoms usually begin about a week after exposure, though they can appear as soon as two days or as late as two weeks later. (cdc.gov) ### What do the Virginia and Maryland cases show? Virginia had 10 cases as of the Virginia Department of Health’s July 7 media update, WTOP reported. Maryland had one diagnosed case the same day at a MedStar urgent care facility, Fischer told the outlet. WTOP reported those state figures after the CDC’s July 1 update, which covered illnesses with onset dates through June 16. (wtop.com) That means local case counts can move ahead of the CDC’s national surveillance snapshot as additional reports are confirmed and compiled. That is an inference based on the dates in the CDC and WTOP reports. ### Why might the real number be higher than 145? Fischer told WTOP there may be more cases than those reported to state agencies and the CDC because confirmation usually requires a stool sample and many illnesses are mild. “People may not even have any symptoms at all,” she said. The CDC says cyclosporiasis is a nationally notifiable disease and that case counts are monitored year-round, with the season considered May 1 through Aug. 31 because reports rise in spring and summer. (cdc.gov) ### What happens next in the investigation? CDC said local, state and federal public health authorities, including the Food and Drug Administration, are investigating several clusters in more than one state. (wtop.com) The agency said the goal is to identify potential clusters and potential sources of illness. The next public signals are likely to come from updated CDC surveillance pages, state health department notices and any CDC or FDA outbreak postings if investigators tie illnesses to a specific food item or supplier. (cdc.gov) As of July 8, the CDC’s current outbreak page said only some multistate investigations result in online outbreak notices. (cdc.gov)