Learn about explosive diarrhea in Pennsylvania and how to prevent it.
Because thousands of people in the United States suffer from explosive diarrhea caused by the parasite Cyclospora, Pennsylvania did not have an unusually high number of cases of Cyclosporiasis.
- Infectious disease experts are unsure how long the current national Cyclospora outbreak will last.
- The source has not been determined, suggesting that multiple contaminated products may be present.
- This parasite often contaminates produce such as lettuce and berries and can be difficult to wash away.
- According to the CDC, no deaths have been reported among the 34 affected states.
Several infectious disease experts from around the country told USA TODAY they don’t know how long the current national Cyclospora outbreak will last.
“What’s different this year is the unusually high number of cases and the fact that investigators have not yet identified a specific source of infection,” Dr. Suraj Sagar, director of infectious diseases at Holy Name Medical Center in Teaneck, New Jersey, said on July 15.
Sugger said it’s still unclear whether this is one large outbreak in multiple states or multiple smaller outbreaks occurring at the same time, as 34 states have reported confirmed or suspected cases, according to the Centers for Disease Control and Prevention.
CDC officials said clusters in Michigan, Ohio, West Virginia and Kentucky are likely related. This parasite usually occurs during the summer.
Sugger, an expert on the parasite, has previously suggested there may be multiple clusters involving different sources of infection. For example, Michigan has 3,762 cases, 65 times the state’s annual average, according to the state health department’s website.
Sager said the parasite is typically found in lettuce, salad greens, spinach, and fruits such as blueberries and raspberries, but other foods can’t be ruled out.
“In many cases, public health officials can trace the source of an outbreak to a specific farm, producer, supplier, or contaminated water source and issue a targeted recall,” Sugger said. “Right now, they are unable to do that, suggesting that there may be multiple contaminated products or multiple unrelated outbreaks occurring at the same time.”
Fortunately, there have been no deaths from the cases reported to the CDC, Sugger said. His comments came as state and federal health officials confirmed 1,645 cases of cyclosporiasis as a cause of stomach-disturbing infections under investigation. Meanwhile, more than 5,100 additional cases are also under investigation, according to the CDC.
Dr. Amy Edwards, a professor of pediatrics at Case Western Reserve University School of Medicine in Cleveland, agrees.
“I don’t expect this situation to end anytime soon,” Edwards told USA TODAY. “We don’t see anything close to being over. Usually, most cases are small in scope and can be as short as a week or as long as three weeks. There can be multiple types of contamination, multiple foods, and in an outbreak like this, it becomes more difficult to eliminate the source and it becomes more difficult to control the outbreak.”
Difficult to control parasite spread
Given the scale of the outbreak, Edwards believes it may have started during food harvesting and production.
“Remember, this parasite comes from human feces, so typically we would probably think of farm workers who help with harvesting, or people who are sick, or people who work on food distribution,” Edwards said. “Somewhere along the way, certain foods that caused the outbreak, such as lettuce, parsley, and raspberries, became contaminated and unfortunately spread the infection.”
Dr. Norman Beatty, an associate professor of infectious diseases at the University of Florida College of Medicine, told USA TODAY that such outbreaks could also result from the use of contaminated preharvest or harvest water, or inadequate hygiene by infected food handlers.
Beattie said washing produce may not completely stop the spread. He said the Cyclospora parasite “has a tough outer shell and is difficult to eradicate.” That’s because, as the CDC suggests, cyclospora oocyst cell walls are “very resistant” to environmental pressures and traditional disinfectants, Beatty added.
“It is unclear how to safely remove these oocysts from produce if they contaminate soil or plants, but it is likely that simply washing with water will not remove the oocysts before consumption,” Beattie said. “Some people suggest using white vinegar, household soap, or even bleach to remove or kill Cyclospora oocysts, but this is unproven and will not remove the parasite from produce.”
Beattie added that other outbreaks may occur in other areas and people should contact their local health care provider if they have concerns.
Sager said vigilance is key as health officials continue their investigation.
“Due to the high number of cases, we are trying to find a definitive source of infection, but without a clearly identified source of infection, the inability to do specific contact tracing makes it more difficult than usual,” Sagar said.
