Michigan health officials reported that confirmed cyclosporiasis cases in the state had risen above 7,000, marking another increase in a large summer outbreak of the intestinal illness.
The Michigan Department of Health and Human Services reported 7,171 cases since June 22, according to WDIV’s account of the state update. The figure was up from 6,571 cases reported on July 21. As of July 16, 102 people with reported cases had been hospitalized.
The reported illnesses were still concentrated most heavily in Monroe, Lenawee, Washtenaw, Wayne, Shiawassee, Jackson, Oakland and Livingston counties. The Centers for Disease Control and Prevention had identified cases in 34 states and expected illnesses to keep rising through the end of August, the usual end of the Cyclospora season.
Cyclosporiasis is caused by Cyclospora, a parasite that affects the small intestine. Health care providers can diagnose the infection through testing of a stool sample. Symptoms can include watery diarrhea with frequent and sometimes forceful bowel movements, as well as fatigue, nausea, stomach cramps and loss of appetite.
The illness may last from several days to more than a month if untreated, and symptoms can return after appearing to improve. The period between infection and illness is usually about one week, though it can range from two days to two weeks or longer. People can be infected with Cyclospora more than once.
Michigan officials and local health departments were still trying to identify the direct source of the outbreak. Lettuce or salad greens remained under consideration as a possible source, based on early information from the investigation and past links between Cyclospora and pre-packaged salad greens.
Federal officials had stepped back from an earlier assertion involving a sample of Taylor Farms iceberg lettuce grown in central Mexico, describing the result as a false positive. The available evidence did not identify a confirmed source for the Michigan outbreak.
MDHHS urged people with gastrointestinal illness, including sudden and persistent diarrhea, to contact a health care provider and their local health department. Officials also issued produce-safety advice, including washing fresh produce under clean running water even when it will be peeled, and cooking food to 158 degrees or higher when cooking is possible.
The department said those precautions were especially important for people at greater risk from dehydration or weakened immune systems, including patients receiving chemotherapy, organ transplant recipients, infants, young children and elderly people. Health officials also provided guidance for restaurants and commercial kitchens on preparing, processing or serving raw produce.
In the United States, cyclosporiasis outbreaks have been associated with several kinds of fresh produce. Michigan’s July 22 case count showed the outbreak continuing to expand while investigators worked to narrow the possible exposure pathway.
