Courtesy CDCThe source of rare microscopic cyclospora parasites responsible for almost 200 illnesses in at least three states remains a mystery as federal, state and local health officials interview patients to determine a possible common denominator.About 200 people in three states are confirmed sick with infections from rare cyclospora parasites that state and federal officials say are usually found in imported fresh produce when outbreaks occur in the U.S.
However, those officials said they don’t have any hard evidence yet, and haven’t released what produce items the victims have in common.
Jim Gorny, vice president for food safety and technology for the Produce Marketing Association, said he doesn’t envy the investigators because “they are faced with a real conundrum.”
“I think it is a little premature to pass judgment,” Gorny said. “But I understand they are going on historical data from previous outbreaks.
“The facts will speak for themselves, but we just don’t have many of those yet.”
Gorny, who was senior advisor for the office at food safety at the Food and Drug Administration before joining PMA’s staff this summer, said FDA and the Centers for Disease control and Prevention have three tools during outbreak investigations: epidemiology, which involves asking patients what they ate; positive test samples from suspect sources, which no health officials have at this point; and traceback, which can’t happen until there is a suspected source.
Coral BeachJim Gorny, PMA vice president for food safety and technology, says health officials are in a tough spot with the cyclospora investigation because there is virtually no evidence to help them initiate a traceback.The PMA scientist agreed with what FDA, CDC and health officials at state and county levels are saying about the cyclospora parasite in general. He said it is rarely found in the U.S. because it prefers tropical and subtropical environments.
With few answers and 102 cyclospora illnesses confirmed as of July 18, officials in Iowa want federal agencies to take over the investigation. Nebraska has 53 confirmed cases and Texas has 42.
The CDC is maintaining an assist as necessary role, said spokeswoman Sharon Hoskins.
The Food and Drug Administration is taking a similar stand, said spokesman Douglas Karas, working with local and state officials as needed.
Officials in Iowa and Nebraska say fresh produce from their states is not suspect, partly because of the wide distribution of sick people and local growers’ limited distribution networks.
Dr. Patricia Quinlisk, Iowa’s health department medical director, and Dr. Joseph Acierno, Nebraska’s director of public health, both said they believe fresh vegetables, not fruit, is the source of the parasites, based on patient interviews.
Illnesses in the three states began in late June. Symptoms usually don’t appear for at least a week after exposure, according to the CDC.
The Texas Health Department advised healthcare providers July 16 to test patients for cyclospora if they have diarrhea lasting more than a couple days or diarrhea accompanied by severe anorexia or fatigue.
“It is too soon to tell if any of the cases are connected to a multi-state outbreak in Nebraska and Iowa,” said Texas health department spokeswoman Christine Mann. “Past outbreaks in the U.S. have been associated with consumption of imported fresh produce.”
The most recent widespread outbreak in North America was in 1996 when more than 850 cases, mostly in the U.S., were linked to imported raspberries from Guatemala, according to the CDC website. Fresh basil and lettuce have also been linked to U.S. outbreaks.