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Published Date: 2018-07-25 15:11:55
Subject: PRO/EDR> Cyclosporiasis - USA (07)
Archive Number: 20180725.5926980
CYCLOSPORIASIS - USA (07)
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Date: Thu 19 Jul 2018
Source: CDC [edited]
https://www.cdc.gov/parasites/cyclosporiasis/outbreaks/2018/b-071318/index.html


CDC [Centers for Disease Control and Prevention], public health and regulatory officials in several states, and the U.S. Food and Drug Administration are investigating a multistate outbreak of Cyclospora infections. At this time, there is no evidence to suggest that this cluster of illnesses is related to the ongoing Cyclospora outbreak linked to Del Monte fresh produce vegetable trays.

As of [Thu 19 Jul 2018] (12pm EDT), a total of 163 laboratory-confirmed cases of Cyclospora infection were reported in people who consumed salads from McDonald's restaurants; the cases were reported by 10 states. Note, the Florida case-patient purchased a salad while traveling in Kentucky. A list of the states and the number of cases reported from each state can be found on the Case Count Maps page.

Illnesses started on or after [Tue 1 May 2018]. The median illness onset date is [Thu 28 Jun 2018] (range: Sun 20 May to Tue 10 Jul 2018). Ill people range in age from 16 to 87 years old, with a median age of 53. Sixty-six percent (66 percent) are female. At least 3 people have been hospitalized; no deaths have been reported.

Illnesses that started after [Thu 7 Jun 2018] might not have been reported yet due to the time it takes between when a person becomes ill and when the illness is reported. For Cyclospora infections, this can take up to 6 weeks.

Investigation of the Outbreak
Epidemiologic evidence indicates that salads purchased from McDonald's restaurants are one likely source of these infections. The investigation is ongoing and FDA is working to determine the source of the ingredients used in the salads served at McDonald's. The investigation has not identified a single, common ingredient in the salads linked to illness.

State and local health departments are interviewing ill people to find out what foods they ate in the 2 weeks before they got sick. Many ill people reported eating salads from McDonald's restaurants located in the Midwest. People reported eating a variety of McDonald's salads.

As of [Thu 19 Jul 2018] (1pm EDT), a total of 237 laboratory-confirmed cases of Cyclospora infection were reported in people who consumed pre-packaged Del Monte Fresh Produce vegetable trays containing broccoli, cauliflower, carrots, and dill dip from 4 states. A list of the states and the number of cases reported from each state can be found on the Case Count Maps page.

The median illness onset date among patients is [Fri 1 Jun 2018] (range: Mon 14 May to Wed 13 Jun 2018). Ill people range in age from 13 to 79 years old, with a median age of 46. Fifty-three percent are female and 7 people have been hospitalized. No deaths have been reported.

Illnesses that began after [Thu 7 Jun 2018] might not have been reported yet due to the time it takes between when a person becomes ill and when the illness is reported.

--
Communicated by:
ProMED-mail
<promed@promedmail.org>

[Since the middle of June [2018] there have been several reports of outbreaks of infections with _Cyclospora cayetanensis_, which is usually spread by contaminated food (see earlier ProMED reports below). The previous outbreaks have been associated with vegetable trays manufactured by Del Monte Fresh Produce and McDonald's restaurants. It is still not clear if the 2 outbreaks are linked. - Mod.EP

HealthMap/ProMED map available at:
United States: http://healthmap.org/promed/p/106]

See Also

Cyclosporiasis - USA (06): (IL, IA): 20180713.5903938
Cyclosporiasis - USA (05): (TX) 20180704.5888094
Cyclosporiasis - USA (04): (WI, MN) vegetable tray, recall 20180623.5872047
Cyclosporiasis - USA (03): additional states 20180619.5863566
Cyclosporiasis - USA (02): (WI, MN) 20180618.5861210
Cyclosporiasis - USA: (WI, MN) 20180616.5859069
2017
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Cyclosporiasis - USA (06): nationwide increase 20170927.5344698
Cyclosporiasis - USA (05): nationwide increase 20170923.5335655
Cyclosporiasis - USA (04): background 20170817.5255726
Cyclosporiasis - USA (03): nationwide increase, alert 20170815.5250731
Cyclosporiasis - UK: ex Mexico 20170814.5249389
Cyclosporiasis - USA (02): (TX) 20170801.5219001
Cyclosporiasis - USA: (TX) 20170719.5189199
Cyclosporiasis - Canada (02): (ON, BC) 20170716.5177711
Cyclosporiasis - France ex Mexico: (QR) 20170714.5174986
Cyclosporiasis - Mexico: (GJ) RFI 20170708.5159937
Cyclosporiasis - Canada: (ON, BC) 20170703.5146527
2016
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Cyclosporiasis - USA: (TX) alert 20160807.4399338
Cyclosporiasis - UK (02): ex Mexico (Riviera Maya) alert 20160805.4396881
Cyclosporiasis - UK: ex Mexico 20160730.4381665
2015
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Cyclosporiasis - UK, Canada: ex Mexico, RFI 20151101.3759380
Cyclosporiasis - USA (05): ex Mexico 20150827.3606898
Cyclosporiasis - USA (04): ex Mexico 20150813.3576519
Cyclosporiasis - Canada 20150810.3569701
Cyclosporiasis - USA (03) 20150802.3553403
Cyclosporiasis - USA (02): (TX) 20150702.3479116
Cyclosporiasis - USA: (TX) increase in cases 20150624.3462421
2014
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Cyclosporiasis - USA (02): multistate 20140730.2646220
Cyclosporiasis - USA: (TX) 20140727.2638219
2013
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Cyclosporiasis - USA (14): 20130906.1926983
2011
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Cyclosporiasis - USA (02): background 20111002.2967
.................................................sh/ep/ec/lm

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