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Siga Logistics of RL de CV, exporter of fresh basil from Morelos, Mexico, under investigation Cyclospora infections, according to the Federal Centers for Disease Control and Prevention (CDC) in Atlanta. The Food and Drug Administration (FDA) and public health and regulatory officials from several states are also involved in the investigation.
As of August 15, 2019, a total of 205 people suffering from Cyclospora Infections associated with this outbreak have been reported in 11 states: CT (1), FL (50), GA (2), IA (2), MA (1), MN (33), NY (107), OH ( 3), RI (1), SC (1) and WI (4). Exposures have been reported in 5 states (Florida, Minnesota, New York, Ohio and Wisconsin).
Since the last report, an additional 73 cases have been added to the outbreak. The diseases started on dates from June 10, 2019 to July 18, 2019. The sick people were 15 to 98 years old, with a median age of 51 years and 70% were women. Five people (2%) were hospitalized. No deaths attributed to Cyclospora have been reported.
Diseases may not be reported yet because of the time that elapses between when a person falls ill and when the illness is reported. It takes on average 4-6 weeks.
There are usually several clusters of Cyclospora infections occurring during a given season. To date, it is not known if other cases of Cyclospora Infections in the United States this season are related to fresh basil. This investigation is ongoing.
Epidemiological data and initial information on product distribution indicate that fresh basil exported by Siga Logistics from RL de CV de Morelos, Mexico, is a likely source of this outbreak.
During the interviews, the sick people answered questions about the foods they ate and other exposures exposed during the week preceding their illness. A disease cluster is defined as two or more people who do not live in the same household and who report eating at the same restaurant, attending a joint event, or shopping at a grocery store within one week of their disease. Disease cluster surveys provide vital clues about the source of an outbreak. If several unrelated patients have eaten or shopped at the same location of a restaurant or store several days in advance, this suggests that the contaminated food has been served or sold on square. In this group associated with fresh basil, there were several situations in which people reported eating in the same restaurants.
The FDA and the regulators of several states are currently collecting data to determine the source of fresh basil consumed by sick people in the five affected states. The information available to date on product distribution indicates that the fresh basil that made him sick was exported by Siga Logistics of RL de CV of Morelos, Mexico. This traceback survey is underway to determine the source of contamination. Other disease groups are currently under investigation to determine if they are related to fresh basil exported by Siga Logistics of RL CV of Morelos, Mexico.
Consumers should not consume fresh basil exported by Siga Logistics from RL de CV Morelos, Mexico, until we know more about this outbreak. This survey is ongoing and the CDC will provide updates as more information becomes available.
What is Cyclospora?
Cyclospora is a parasite composed of a cell, too small to be seen without a microscope. The body was previously thought to be a blue-green alga or a large form of cryptosporidium. Cyclospora cayetanensis is the only species of this organism found in humans. The first known human cases of cyclospora disease (ie, cyclosporiosis) were first discovered in 1977. An increase in the number of reported cases began in the mid-1980s, part thanks to the availability of better diagnostic techniques. It is estimated that more than 15,000 cases occur each year in the United States. The first outbreak of cyclospora recorded in North America occurred in 1990 and was related to contaminated water. Since then, several outbreaks of cyclosporiosis have been reported in the United States and Canada, often associated with the consumption of fresh fruit or vegetables. Cyclosporiosis is common in some developing countries and travelers who go there are also contaminated.
Where does Cyclospora come from?
Cyclospora spreads when people ingest water or food contaminated with infected stool. For example, exposure to contaminated water among farm workers may have been the original source of the parasite during raspberry-associated outbreaks in North America. Cyclospora needs time (one to several weeks) after passing intestinal transit to become contagious. It is therefore unlikely that cyclospora is directly transmitted from one person to another. It is not known whether or not animals can become infected and transmit the infection to humans.
What are the typical symptoms of a Cyclospora infection?
Cyclospora infects the small intestine (gut) and usually causes watery diarrhea, bloating, increased gas, stomach cramps, loss of appetite, nausea, mild fever and fever. tiredness. In some cases, vomiting, explosive diarrhea, muscle aches, and significant weight loss may occur. Some people infected with cyclospora have no symptoms. The symptoms usually appear about a week after the infection. If it is not treated, the illness can last from a few days to six weeks. Symptoms can also happen one or more times. In addition, people who have already been infected with cyclospora may be re-infected.
What are the serious and long-term risks of Cyclospora infection?
Cyclospora has been associated with various chronic complications such as Guillain-Barre syndrome, reactive arthritis or Reiter's syndrome, biliary disease and acalculous cholecystitis. Because cyclospora infections tend to respond to the appropriate treatment, complications are more likely to occur in people who are not treated or who are not treated quickly. Extra-intestinal infection also appears to occur more frequently in people whose immune systems are compromised.
How is Cyclospora infection detected?
Your health care provider may ask you to submit a stool sample for analysis. Since it may be difficult to detect cyclospora infection, you may be asked to submit several stool samples over several days. The identification of this parasite in the stool requires special laboratory tests that are not performed routinely. Therefore, your health care provider should specifically request the cyclospora test if there is suspicion. Your health care provider may have your stool checked for other organisms that may cause similar symptoms.
How is Cyclospora infection treated?
The recommended treatment in case of cyclospora infection is the combination of two antibiotics, trimethoprim-sulfamethoxazole, also called Bactrim, Septra or Cotrim. People with diarrhea should rest and drink plenty of fluids. No alternative medicine has yet been identified for people with cyclospora infection who are unable to take sulfonamides. Some experimental studies, however, have suggested that ciprofloxacin or nitazoxanide may be effective, but to a lesser extent than trimethoprim-sulfamethoxazole. Consult your health care provider to discuss alternative treatment options.
How to prevent Cyclospora infection?
It is advisable to avoid drinking water or contaminated food during a trip. Drinking bottled or boiled water and avoiding fresh ready-to-eat products should help reduce the risk of infection in areas with high infection rates. Improved health conditions in developing regions with adverse environmental and economic conditions are likely to reduce exposure. Washing fresh fruits and vegetables at home can help eliminate some of the organisms, but cyclospora can stay on the products even after washing.
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