Texas traces Cyclospora outbreak to possible produce exposures as cases climb to 48

Texas health officials are investigating 48 Cyclospora cases reported since May 1, with no single food source yet identified and fresh produce among the leading exposure questions. The Texas Department of State Health Services said the cases, counted through July 6, match the U.S. Centers for Disease Control and Prevention’s outbreak case definition. State and federal investigators are reviewing where patients ate and what they bought as part of the search for a common link. Cyclospora infections in the United States have repeatedly been tied to produce, including herbs, salad mixes and berries, according to Texas DSHS and the CDC. ### Why are investigators focused on produce if they still do not know the source? Texas DSHS said the source remains unknown, but public health officials have pointed to fresh produce because that is the most common pattern in past U.S. outbreaks. The agency says cyclosporiasis is caused by consuming food or water contaminated with feces containing the Cyclospora parasite, and past domestic outbreaks have been associated with imported fresh produce including cilantro, salad mix, raspberries and basil. (nbcdfw.com) The CDC says foodborne outbreaks of cyclosporiasis in the United States have been linked to consumption of fresh produce, and surveillance is used to detect clusters tied to a common food source. That is why investigators typically ask patients about recent meals, grocery purchases and travel while trying to narrow down a traceback. ### What exactly is Cyclospora, and how do people get sick? Cyclospora cayetanensis is a microscopic parasite that causes an intestinal illness known as cyclosporiasis, the CDC says. (nbcdfw.com) People get infected after eating food or drinking water contaminated with the parasite. The illness is not generally thought to spread directly from one person to another, because the parasite usually needs time in the environment before it becomes infectious. (cdc.gov) CDC guidance says symptoms usually begin about one week after exposure, though the range can be from two days to two weeks or more. Common symptoms include watery diarrhea, loss of appetite, weight loss, stomach cramps, bloating, nausea, fatigue and sometimes a low-grade fever. ### Why does Texas see these cases in summer? Texas DSHS said in a May 15 health advisory that the state’s Cyclospora season typically runs from May through August. (cdc.gov) The agency told healthcare providers to consider Cyclospora in patients with diarrheal illness lasting more than a few days or diarrhea accompanied by severe loss of appetite or fatigue. (cdc.gov) The same advisory said Texas reported more than 400 cyclosporiasis cases in 2024, compared with 788 in 2023 and 636 in 2022, and that 97% of cases over that three-year period occurred from May to August. Those figures are one reason state, federal and local agencies prepare for annual summer investigations. ### What can consumers and restaurants do while the traceback continues? (dshs.texas.gov) The CDC says people should wash hands with soap and water before and after handling raw fruits and vegetables and wash produce thoroughly under running water before eating, cutting or cooking it. Produce labeled “prewashed” does not need to be washed again at home, the agency says. Texas officials have not named a supplier, farm or restaurant chain, which leaves general produce handling and recordkeeping as the main immediate controls. (dshs.texas.gov) For restaurants and retailers, traceback work usually depends on invoices, lot information and supplier records that can connect a patient’s meal to a shipment. That inference is consistent with how CDC and state surveillance investigations are structured. (cdc.gov) ### What happens next in the Texas investigation? As of July 6, Texas had 48 cases that matched the CDC outbreak definition, and that count could change as new illnesses are reported or ruled out. Texas DSHS says providers should report cases to local health departments, while the CDC says it works year-round with state and federal partners to identify common food sources and investigate outbreaks. (nbcdfw.com) (cdc.gov)