Iowa Dept. of Health Investigates Intestinal Illness (July 8 2013): Cyclospora

[Giuseppe]

Re: Iowa Dept. of Health Investigates Intestinal Illness (July 8 2013): Cyclospora

[Source: Iowa Department of Public Health, full PDF document: (LINK). Edited.]


Iowa Cyclospora Outbreak 2013

Outbreak Update 8.1.13


IDPH, CDC, Iowa Department of Inspections and Appeals, the State Hygienic Laboratory and local public health agencies are investigating an outbreak caused by Cyclospora.

The epidemiologic investigation completed by local public health departments in Iowa and IDPH has implicated a prepackaged salad mix as the source of the outbreak. The food trace back investigation performed by DIA determined that at least 80 percent of these cases had been exposed to the same prepackaged salad mix.

• As an example of the complexity of this investigation, over 100 restaurants and 80 grocery stores were patronized by cases during the time they could have been exposed to Cyclospora. Exposures to pre-packaged salad mix could have occurred at more than 50 possible sites (including more than 15 restaurants, more than 30 grocery stores and other possible sites).
• The salad mix contained iceberg and romaine lettuce, carrots and red cabbage.
• This salad mix is no longer in Iowa?s food supply chain.

Onset dates of the illness suggest the ill people had eaten the contaminated food in mid-June. This is a very good indication the food which was the source of the outbreak has already been consumed or discarded, since fresh vegetables have a limited shelf life.

At no time was an Iowa-grown fruit or vegetable suspected to be the cause of the outbreak.

• Bagged salads and all other vegetables are safe to eat.
• Public Health encourages Iowans to make fruits and vegetables part of their daily diet. It is always a good idea to wash all fresh fruits and vegetables thoroughly before eating.

As of today, 146 cases of Cyclospora infections have been reported to IDPH. Because the number of new cases identified has declined dramatically, IDPH will discontinue daily case count updates as of today, August 1. Weekly case counts will be posted each Thursday at 10:00 a.m at https://www.idph.state.ia.us/EHI/Iss...sue=Cyclospora Outbreak Investigation&pg=Cyclospora Case Count Updates.

Daily status updates will also be discontinued; but will be posted as needed.

• IDPH continues to receive reports of confirmed cases of Cyclospora infection and interview those who are ill, but numbers are decreasing.
• Cyclospora is a rare parasite.
• People become infected with Cyclospora by consuming food or water contaminated with the parasite.

IDPH has not released the name of the salad mixture brand, or locations where it was purchased or eaten because of confidentiality mandated by Iowa state law.

• Iowa Code Section 139A.3(2)?c? requires IDPH to prevent the identification of any business involved in a disease outbreak, and authorizes release of the identity of a business to the public only ?when the state epidemiologist or director of public health determines such a release of information is necessary for the protection of the public.?
• Because the vast majority of illnesses occurred in mid-June and the limited shelf life of fresh produce, IDPH and DIA determined the implicated salad mix was no longer in the Iowa food supply chain.
• Thus, there is no ongoing threat to the public health which would require the identification of a particular brand, store, or restaurant where the salad mixture was available. In addition, these sites could not have taken any action to prevent contamination of the mixture since it came pre-packaged and ready-to-eat.
• If it had been determined the source of the outbreak was still in the food supply chain, or that a business was refusing to take some action necessary to protect the public?s health, IDPH would inform Iowans about the exact product or source in order to protect their health. In such a case, a recall of the item would be facilitated by the FDA. Neither action was necessary in this outbreak.

CDC updates on the Cyclosporiasis outbreak, which includes Iowa and several other states, can be found at www.cdc.gov/parasites/cyclosporiasis/outbreaks/investigation-2013.html.

Cyclospora infection causes a watery diarrhea that lasts an average of 57 days, if untreated.

• Specific laboratory testing (not commonly ordered) must be done to detect Cyclospora.
• Specific treatment (not typically used to treat more common diarrheal illnesses) can be prescribed.

If you are experiencing diarrhea, or have recently had a long bout with diarrhea, you should contact your health care provider and see if you should be tested for Cyclospora infection.

• Additional symptoms of cyclosporiasis (the infection caused by Cyclospora) include:
  • Watery diarrhea
  • Fatigue (severe tiredness)
  • Loss of appetite
  • Weight loss
  • Bloating
  • Increased gas
  • Stomach cramps
  • Nausea
  • Vomiting
  • Muscle aches
  • Low-grade fever

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------

[Giuseppe]

Re: Iowa Dept. of Health Investigates Intestinal Illness (July 8 2013): Cyclospora

[Source: Iowa Department of Public Health, full page: (LINK). Edited.]


Posted: Wed, 31 Jul 2013 12:50 CDT / Category: Food Safety

Cyclospora Outbreak Slows in Iowa


The Iowa Department of Public Health (IDPH), in cooperation with the Iowa Department of Inspections and Appeals (DIA), local public health officials and the CDC and FDA, has been investigating what has become a national Cyclospora outbreak for several weeks. Iowa continues to have the most cases reported in the multi-state outbreak, with 145 cases reported as of today. The number of new cases being reported continues to decline.

Interviews with ill individuals and food trace back investigations have led to the identification of a pre-packaged salad mixture as the source of Iowa?s outbreak. More than 80 percent of Iowa?s cases reported eating the same pre-packaged salad mix that contained iceberg and romaine lettuce, red cabbage, and carrots. The mixture came into Iowa already packaged and already contaminated. ?The process that led to the implication of the pre-packaged salad mixture as the outbreak source is a good illustration of how public health investigations work,? said IDPH Medical Director, Dr. Patricia Quinlisk.

As cases began to be reported to IDPH in early July, epidemiologists interviewed those who were ill to determine what and where they had eaten. As an example of the complexity of this investigation, over 100 different restaurants were patronized by cases during the time they could have been exposed to Cyclospora. It was determined exposures occurred at more than 50 possible sites (including more than 15 restaurants, more than 30 grocery stores and other possible sites).

Since Cyclospora has historically been associated with contaminated fresh fruits and vegetables, these exposures were looked at very closely. It was quickly determined there were no fruit or fruit products in common and IDPH informed the public a vegetable was likely the source. As the public health investigation progressed, detailed interviews were performed where clusters of cases occurred. These cluster investigations further implicated a specific type of prepackaged salad mixture (that included iceberg lettuce, romaine lettuce, red cabbage, and carrots). The DIA investigation continued in parallel and began to point to a specific prepackaged salad mix. Further investigation determined the salad mixture came from the same origin, even though exposures occurred at various locations. DIA was instrumental in determining that 80 percent of Iowa cases had been exposed to the specific pre-packaged salad mix. Once it was determined this was an interstate, and possibly international food product, FDA became involved.

IDPH has not released the name of the salad mixture brand, or locations where it was purchased or eaten because of confidentiality mandated by Iowa state law. Iowa Code Section 139A.3(2)?c? requires IDPH to prevent the identification of any business involved in a disease outbreak, and authorizes release of the identity of a business to the public only ?when the state epidemiologist or director of public health determines such a release of information is necessary for the protection of the public.?

Because the vast majority of illnesses occurred in mid-June and the limited shelf life of fresh produce, IDPH and DIA determined the implicated salad mix was no longer in the Iowa food supply chain. Thus, there is no ongoing threat to the public health which would require the identification of a particular brand, store, or restaurant where the salad mixture was available. In addition, these sites could not have taken any action to prevent contamination of the mixture since it came pre-packaged and ready-to-eat.

If it had been determined the source of the outbreak was still in the food supply chain, or that a business was refusing to take some action necessary to protect the public?s health, IDPH would inform Iowans about the exact product or source in order to protect their health.

In such a case, a recall of the item would be facilitated by the FDA. Neither action was necessary in this outbreak.


Contact Information: Polly Carver-Kimm at (515) 281-6693


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[Giuseppe]

Re: Iowa Dept. of Health Investigates Intestinal Illness (July 8 2013): Cyclospora

[Source: Iowa Department of Public Health, full PDF document: (LINK). Edited.]


Iowa Cyclospora Outbreak 2013

Outbreak Update 7.31.13


IDPH, CDC, Iowa Department of Inspections and Appeals, the State Hygienic Laboratory and local public health agencies are investigating an outbreak caused by Cyclospora.

The epidemiologic investigation completed by local public health departments in Iowa and IDPH has implicated a prepackaged salad mix as the source of the outbreak. The food trace back investigation performed by DIA determined that at least 80 percent of these cases had been exposed to the same prepackaged salad mix.

• The salad mix contained iceberg and romaine lettuce, carrots and red cabbage.
• This salad mix is no longer in Iowa?s food supply chain.

Onset dates of the illness suggest the ill people had eaten the contaminated food in mid-June. This is a very good indication the food which was the source of the outbreak has already been consumed or discarded, since fresh vegetables have a limited shelf life.

At no time was an Iowa-grown fruit or vegetable suspected to be the cause of the outbreak.

• Bagged salads and all other vegetables are safe to eat.
• Public Health encourages Iowans to make fruits and vegetables part of their daily diet. It is always a good idea to wash all fresh fruits and vegetables thoroughly before eating.

As of today, 145 cases of Cyclospora infections have been reported to IDPH. Case counts with county breakdown are posted to the IDPH website every weekday at approximately 10:00 a.m. at https://www.idph.state.ia.us/EHI/Iss...sue=Cyclospora Outbreak Investigation&pg=Cyclospora Case Count Updates

• IDPH continues to receive reports of confirmed cases of Cyclospora infection and interview those who are ill, but numbers are decreasing.
• Cyclospora is a rare parasite.
• People become infected with Cyclospora by consuming food or water contaminated with the parasite.

CDC updates on the Cyclosporiasis outbreak, which includes Iowa and several other states, can be found at www.cdc.gov/parasites/cyclosporiasis/outbreaks/investigation-2013.html.

Cyclospora infection causes a watery diarrhea that lasts an average of 57 days, if untreated.

• Specific laboratory testing (not commonly ordered) must be done to detect Cyclospora.
• Specific treatment (not typically used to treat more common diarrheal illnesses) can be prescribed.

If you are experiencing diarrhea, or have recently had a long bout with diarrhea, you should contact your health care provider and see if you should be tested for Cyclospora infection.

• Additional symptoms of cyclosporiasis (the infection caused by Cyclospora) include:
  • Watery diarrhea
  • Fatigue (severe tiredness)
  • Loss of appetite
  • Weight loss
  • Bloating
  • Increased gas
  • Stomach cramps
  • Nausea
  • Vomiting
  • Muscle aches
  • Low-grade fever

-
------

[Giuseppe]

Re: Iowa Dept. of Health Investigates Intestinal Illness (July 8 2013): Cyclospora

[Source: Iowa Department of Public Health, full PDF document: (LINK). Edited.]


Iowa Cyclospora Outbreak 2013

Outbreak Update 7.30.13


IDPH, CDC, Iowa Department of Inspections and Appeals, the State Hygienic Laboratory and local public health agencies are investigating an outbreak caused by Cyclospora.

The epidemiologic investigation completed by local public health departments in Iowa and IDPH has implicated a prepackaged salad mix as the source of the outbreak. The food trace back investigation performed by DIA determined that at least 80 percent of these cases had been exposed to the same prepackaged salad mix.

• The salad mix contained iceberg and romaine lettuce, carrots and red cabbage.
• This salad mix is no longer in Iowa?s food supply chain. 

Onset dates of the illness suggest the ill people had eaten the contaminated food in mid-June. This is a very good indication the food which was the source of the outbreak has already been consumed or discarded, since fresh vegetables have a limited shelf life. 

At no time was an Iowa-grown fruit or vegetable suspected to be the cause of the outbreak.

• Bagged salads and all other vegetables are safe to eat.
• Public Health encourages Iowans to make fruits and vegetables part of their daily diet. It is always a good idea to wash all fresh fruits and vegetables thoroughly before eating.

As of today, 143 cases of Cyclospora infections have been reported to IDPH. Case counts with county breakdown are posted to the IDPH website every weekday at approximately 10:00 a.m. at https://www.idph.state.ia.us/EHI/Iss...sue=Cyclospora Outbreak Investigation&pg=Cyclospora Case Count Updates

• IDPH continues to receive reports of confirmed cases of Cyclospora infection and interview those who are ill, but numbers are decreasing.
• Cyclospora is a rare parasite.
• People become infected with Cyclospora by consuming food or water contaminated with the parasite.

CDC updates on the Cyclosporiasis outbreak, which includes Iowa and several other states, can be found at www.cdc.gov/parasites/cyclosporiasis/outbreaks/investigation-2013.html.

Cyclospora infection causes a watery diarrhea that lasts an average of 57 days, if untreated.

• Specific laboratory testing (not commonly ordered) must be done to detect Cyclospora.
• Specific treatment (not typically used to treat more common diarrheal illnesses) can be prescribed.

If you are experiencing diarrhea, or have recently had a long bout with diarrhea, you should contact your health care provider and see if you should be tested for Cyclospora infection.

• Additional symptoms of cyclosporiasis (the infection caused by Cyclospora) include:
  • Watery diarrhea
  • Fatigue (severe tiredness)
  • Loss of appetite
  • Weight loss
  • Bloating
  • Increased gas
  • Stomach cramps
  • Nausea
  • Vomiting
  • Muscle aches
  • Low-grade fever

-
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[Giuseppe]

Re: Iowa Dept. of Health Investigates Intestinal Illness (July 8 2013): Cyclospora

[Source: Iowa Department of Public Health, full page: (LINK).]


Posted: Tue, 30 Jul 2013 13:58 CDT, Category: Food Safety

Update on Iowa Cyclospora Illness Outbreak

For Information, Contact: David Werning, 515-281-7386


DES MOINES, IA (July 30, 2013) - A prepackaged salad mix has been implicated as the source of the cyclospora outbreak that sickened more than 100 Iowans last month, the State?s top food inspector said today.

Steven Mandernach, chief of the Food and Consumer Safety Bureau of the Iowa Department of Inspections and Appeals (DIA), said epidemiological data and food history interviews conducted with ill Iowans links a bagged salad mix with the foodborne illness.

?The evidence points to a salad mix containing iceberg and romaine lettuce, as well as carrots and red cabbage as the source of the outbreak reported in Iowa and Nebraska,? Mandernach said, adding: ?Iowans should continue eating salads as the implicated prepackaged mix is no longer in the state?s food supply chain.?

Once epidemiological results from the Iowa Department of Public Health (IDPH) was provided to DIA, the Department?s food inspection staff traced potential products through the food distribution and production system.

DIA?s investigation found an exposure to a common prepackaged salad mix from a single source in approximately 80 percent of the cases.

?Additionally, food histories are challenging as individuals do not always remember the foods eaten during the past several weeks,? Mandernach added.

Compounding the State?s investigation was the fact that by the time the parasitic-induced illness was identified, most if not all of the suspect product was no longer on the shelves. ?Because it can take more than a week for the first symptoms to appear after ingesting the contaminated food, there wasn?t a product on the shelf to be examined for the parasite.

As a result, most of the foodborne illness investigation focused on trying to trace-back suspected food products through the food chain,? Mandernach explained.

The statewide investigation was conducted jointly by DIA, IDPH, the State Hygienic Laboratory (SHL), local health departments, and officials in Nebraska who were investigating a related outbreak. Despite the challenges of the investigation, Mandernach said a number of successes were also recognized, including the initial detection of the cyclospora by the SHL technicians. ?Additionally, the investigation was helped by the excellent communication and collaboration between the involved local, state, and federal agencies, and the cooperation of the public, medical providers, and the food industry,? he added.

Iowa?s public health and regulatory agencies have been working for several years on improving the investigation process for foodborne illness. ?We saw those efforts pay off during this investigation, as all the players worked together seamlessly to the betterment of the public,? the food inspector said.

Mandernach noted that Iowa received a three-year cooperative grant in 2012 from the FDA to establish a Food and Feed Rapid Response Team.

The Team includes not only those agencies involved in the cyclospora investigation, but integrates the Iowa Department of Agriculture and Land Stewardship (IDALS) and the FDA into the State?s investigative and response process.

?Our goal, when investigating a foodborne illness, is to as quickly as possible identify the source of the outbreak and stop the spread. The Rapid Response Team assists in this effort by promoting coordination and communication among the various agencies, and making available dedicated staff that are focused on the early detection of potential foodborne illness,? he added.

The State will continue to work closely with local health departments, other states, and the Centers for Disease Control and prevention (CDC) and FDA as the investigation moves forward. For the latest cyclospora outbreak information, go to http://www.idph.state.ia.us/EHI/Issue.aspx?issue=Cyclospora Outbreak Investigation&pg=Investigation Home.

Contact Information: Polly Carver-Kimm at (515) 281-6693


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[Giuseppe]

Re: Iowa Dept. of Health Investigates Intestinal Illness (July 8 2013): Cyclospora

[Source: Iowa Department of Public Health, full PDF document: (LINK). Edited.]


Iowa Cyclospora Outbreak 2013

Outbreak Update 7.29.13

IDPH, CDC, the State Hygienic Laboratory and local public health agencies are investigating an outbreak caused by Cyclospora.

• As of today, 145 cases of Cyclospora infections have been reported to IDPH. The next case count will be updated Tuesday, July 30 at approximately 10:00 a.m.
• The number of cases reported is decreasing.
• Cyclospora is a rare parasite.
• Previous outbreaks have been associated with fresh produce (fresh fruits and vegetables)
• People become infected with Cyclospora by consuming food or water contaminated with the parasite.

The source of this outbreak is unknown at this time.

• The CDC has launched a web page focusing on the Cyclosporiasis outbreak, which includes Iowa and several other states. For CDC updates, visit www.cdc.gov/parasites/cyclosporiasis/outbreaks/investigation-2013.html.
• The Iowa Department of Public Health (IDPH) continues to receive reports of confirmed cases of Cyclospora infection and interview those who are ill, but numbers are decreasing. Now the investigation focuses primarily on determining the source of the contamination. This investigation is ongoing, and will be led by the Iowa Department of Inspections and Appeals (DIA). IDPH and DIA will continue to update the CDC as the Iowa epidemiologic investigation continues.
• Onset dates of the illness suggest the ill people had eaten the contaminated food in mid-June. This is a very good indication the food which was the source of the outbreak has already been consumed or discarded, since fresh vegetables have a limited shelf life.
• At no time was an Iowa-grown fruit or vegetable suspected to be the cause of the outbreak.
• IDPH encourages Iowans to make fruits and vegetables part of their daily diet. It is always a good idea to wash all fresh fruits and vegetables thoroughly before eating.
• Cyclospora illness is typically traced to consumption of fresh fruits and vegetables contaminated with the parasite; this investigation currently indicates fresh vegetables, not fruit, may be the source of illness.
• IDPH is working with local public health agencies to interview individuals who are ill to determine if there is a common food exposure that would indicate the source of illness.
• Cluster investigations continue, which ask questions of both the ill person and their family and friends who are not ill, to determine what the well people did not eat.

Cyclospora infection causes a watery diarrhea that lasts an average of 57 days, if untreated.

• Most of the illnesses in this outbreak began in mid to late June. Many people report still being ill and some have had relapses.

There is treatment (medicine) available to treat Cyclospora infection.

• Specific laboratory testing (not commonly ordered) must be done to detect Cyclospora.
• Specific treatment (not typically used to treat more common diarrheal illnesses) can be prescribed.

If you are experiencing diarrhea, or have recently had a long bout with diarrhea, you should contact your health care provider and see if you should be tested for Cyclospora infection.

• Additional symptoms of cyclosporiasis (the infection caused by Cyclospora) include:
  • Watery diarrhea
  • Fatigue (severe tiredness)
  • Loss of appetite
  • Weight loss
  • Bloating
  • Increased gas
  • Stomach cramps
  • Nausea
  • Vomiting
  • Muscle aches
  • Low-grade fever

-
------

[Giuseppe]

Re: Iowa Dept. of Health Investigates Intestinal Illness (July 8 2013): Cyclospora

[Source: Iowa Department of Public Health, full PDF document: (LINK). Edited.]


Iowa Cyclospora Outbreak 2013

Outbreak Update 7.26.13


IDPH, CDC, the State Hygienic Laboratory and local public health agencies are investigating an outbreak caused by Cyclospora.

• As of today, 140 cases of Cyclospora infections have been reported to IDPH. The next case count will be updated Monday, July 29 at approximately 10:00 a.m.
• The number of cases reported is decreasing.
• Cyclospora is a rare parasite.
• Previous outbreaks have been associated with fresh produce (fresh fruits and vegetables)
• People become infected with Cyclospora by consuming food or water contaminated with the parasite.

The source of this outbreak is unknown at this time.

• The CDC has launched a web page focusing on the Cyclosporiasis outbreak, which includes Iowa and several other states. For CDC updates, visit www.cdc.gov/parasites/cyclosporiasis/outbreaks/investigation-2013.html.
• The Iowa Department of Public Health (IDPH) continues to receive reports of confirmed cases of Cyclospora infection and interview those who are ill, but numbers are decreasing. Now the investigation focuses primarily on determining the source of the contamination. This investigation is ongoing, and will be led by the Iowa Department of Inspections and Appeals (DIA). IDPH and DIA will continue to update the CDC as the Iowa epidemiologic investigation continues.
• Onset dates of the illness suggest the ill people had eaten the contaminated food in mid-June. This is a very good indication the food which was the source of the outbreak has already been consumed or discarded, since fresh vegetables have a limited shelf life.
• At no time was an Iowa-grown fruit or vegetable suspected to be the cause of the outbreak.
• IDPH encourages Iowans to make fruits and vegetables part of their daily diet. It is always a good idea to wash all fresh fruits and vegetables thoroughly before eating.
• Cyclospora illness is typically traced to consumption of fresh fruits and vegetables contaminated with the parasite; this investigation currently indicates fresh vegetables, not fruit, may be the source of illness.
• IDPH is working with local public health agencies to interview individuals who are ill to determine if there is a common food exposure that would indicate the source of illness.
• Cluster investigations continue, which ask questions of both the ill person and their family and friends who are not ill, to determine what the well people did not eat.

Cyclospora infection causes a watery diarrhea that lasts an average of 57 days, if untreated.

• Most of the illnesses in this outbreak began in mid to late June. Many people report still being ill and some have had relapses.

There is treatment (medicine) available to treat Cyclospora infection.

• Specific laboratory testing (not commonly ordered) must be done to detect Cyclospora.
• Specific treatment (not typically used to treat more common diarrheal illnesses) can be prescribed.

If you are experiencing diarrhea, or have recently had a long bout with diarrhea, you should contact your health care provider and see if you should be tested for Cyclospora infection.

• Additional symptoms of cyclosporiasis (the infection caused by Cyclospora) include:
  • Watery diarrhea
  • Fatigue (severe tiredness)
  • Loss of appetite
  • Weight loss
  • Bloating
  • Increased gas
  • Stomach cramps
  • Nausea
  • Vomiting
  • Muscle aches
  • Low-grade fever

-
-------

[Giuseppe]

Re: Iowa Dept. of Health Investigates Intestinal Illness (July 8 2013): Cyclospora

[Source: Iowa Department of Public Health, full PDF document: (LINK). Edited.]


Iowa Cyclospora Outbreak 2013

Outbreak Update 7.25.13


IDPH, CDC, the State Hygienic Laboratory and local public health agencies are investigating an outbreak caused by Cyclospora.

• As of today, 138 cases of Cyclospora infections have been reported to IDPH. The next case count will be updated Friday, July 26 at approximately 10:00 a.m.
• The number of cases reported is decreasing.
• Cyclospora is a rare parasite.
• Previous outbreaks have been associated with fresh produce (fresh fruits and vegetables)
• People become infected with Cyclospora by consuming food or water contaminated with the parasite.

The source of this outbreak is unknown at this time.

• The CDC has launched a web page focusing on the Cyclosporiasis outbreak, which includes Iowa and several other states. For CDC updates, visit www.cdc.gov/parasites/cyclosporiasis/outbreaks/investigation-2013.html.
• The Iowa Department of Public Health (IDPH) continues to receive reports of confirmed cases of Cyclospora infection and interview those who are ill, but numbers are decreasing. Now the investigation focuses primarily on determining the source of the contamination. This investigation is ongoing, and will be led by the Iowa Department of Inspections and Appeals (DIA). IDPH and DIA will continue to update the CDC as the Iowa epidemiologic investigation continues.
• Onset dates of the illness suggest the ill people had eaten the contaminated food in mid-June. This is a very good indication the food which was the source of the outbreak has already been consumed or discarded, since fresh vegetables have a limited shelf life.
• At no time was an Iowa-grown fruit or vegetable suspected to be the cause of the outbreak.
• IDPH encourages Iowans to make fruits and vegetables part of their daily diet. It is always a good idea to wash all fresh fruits and vegetables thoroughly before eating.
• Cyclospora illness is typically traced to consumption of fresh fruits and vegetables contaminated with the parasite; this investigation currently indicates fresh vegetables, not fruit, may be the source of illness.
• IDPH is working with local public health agencies to interview individuals who are ill to determine if there is a common food exposure that would indicate the source of illness.
• Cluster investigations continue, which ask questions of both the ill person and their family and friends who are not ill, to determine what the well people did not eat.

Cyclospora infection causes a watery diarrhea that lasts an average of 57 days, if untreated.

• Most of the illnesses in this outbreak began in mid to late June. Many people report still being ill and some have had relapses.

There is treatment (medicine) available to treat Cyclospora infection.

• Specific laboratory testing (not commonly ordered) must be done to detect Cyclospora.
• Specific treatment (not typically used to treat more common diarrheal illnesses) can be prescribed.

If you are experiencing diarrhea, or have recently had a long bout with diarrhea, you should contact your health care provider and see if you should be tested for Cyclospora infection.

• Additional symptoms of cyclosporiasis (the infection caused by Cyclospora) include:
  • Watery diarrhea
  • Fatigue (severe tiredness)
  • Loss of appetite
  • Weight loss
  • Bloating
  • Increased gas
  • Stomach cramps
  • Nausea
  • Vomiting
  • Muscle aches
  • Low-grade fever

-
------

[Giuseppe]

Re: Iowa Dept. of Health Investigates Intestinal Illness (July 8 2013): Cyclospora

[Source: Iowa Department of Public Health, full PDF document: (LINK). Edited.]


Iowa Cyclospora Outbreak 2013

Outbreak Update 7.24.13


IDPH, CDC, the State Hygienic Laboratory and local public health agencies are investigating an outbreak caused by Cyclospora.

• As of today, 134 cases of Cyclospora infections have been reported to IDPH. The next case count will be updated Thursday, July 25 at approximately 10:00 a.m.
• The number of cases reported is decreasing.
• Cyclospora is a rare parasite.
• Previous outbreaks have been associated with fresh produce (fresh fruits and vegetables)
• People become infected with Cyclospora by consuming food or water contaminated with the parasite.

The source of this outbreak is unknown at this time.

• The CDC has launched a web page focusing on the Cyclosporiasis outbreak, which includes Iowa and several other states. For CDC updates, visit www.cdc.gov/parasites/cyclosporiasis/outbreaks/investigation-2013.html.
• The Iowa Department of Public Health (IDPH) continues to receive reports of confirmed cases of Cyclospora infection and interview those who are ill, but numbers are decreasing. Now the investigation focuses primarily on determining the source of the contamination. This investigation is ongoing, and will be led by the Iowa Department of Inspections and Appeals (DIA). IDPH and DIA will continue to update the CDC as the Iowa epidemiologic investigation continues.
• Onset dates of the illness suggest the ill people had eaten the contaminated food in mid-June. This is a very good indication the food which was the source of the outbreak has already been consumed or discarded, since fresh vegetables have a limited shelf life.
• At no time was an Iowa-grown fruit or vegetable suspected to be the cause of the outbreak.
• IDPH encourages Iowans to make fruits and vegetables part of their daily diet. It is always a good idea to wash all fresh fruits and vegetables thoroughly before eating.
• Cyclospora illness is typically traced to consumption of fresh fruits and vegetables contaminated with the parasite; this investigation currently indicates fresh vegetables, not fruit, may be the source of illness.
• IDPH is working with local public health agencies to interview individuals who are ill to determine if there is a common food exposure that would indicate the source of illness.
• Cluster investigations continue, which ask questions of both the ill person and their family and friends who are not ill, to determine what the well people did not eat.

Cyclospora infection causes a watery diarrhea that lasts an average of 57 days, if untreated.

• Most of the illnesses in this outbreak began in mid to late June. Many people report still being ill and some have had relapses.

There is treatment (medicine) available to treat Cyclospora infection.

• Specific laboratory testing (not commonly ordered) must be done to detect Cyclospora.
• Specific treatment (not typically used to treat more common diarrheal illnesses) can be prescribed.

If you are experiencing diarrhea, or have recently had a long bout with diarrhea, you should contact your health care provider and see if you should be tested for Cyclospora infection.

• Additional symptoms of cyclosporiasis (the infection caused by Cyclospora) include:
  • Watery diarrhea
  • Fatigue (severe tiredness)
  • Loss of appetite
  • Weight loss
  • Bloating
  • Increased gas
  • Stomach cramps
  • Nausea
  • Vomiting
  • Muscle aches
  • Low-grade fever

-
------

[Giuseppe]

Re: Iowa Dept. of Health Investigates Intestinal Illness (July 8 2013): Cyclospora

[Source: Iowa Department of Public Health, full PDF document: (LINK). Edited.]


Iowa Cyclospora Outbreak 2013

Outbreak Update 7.23.13 (new information is highlighted)


IDPH, CDC, the State Hygienic Laboratory and local public health agencies are investigating an outbreak caused by Cyclospora.

• As of today, 127 cases of Cyclospora infections have been reported to IDPH. The next case count will be updated Wednesday, July 24 at approximately 10:00 a.m.
• The number of cases reported is decreasing.
• Cyclospora is a rare parasite.
• Previous outbreaks have been associated with fresh produce (fresh fruits and vegetables)
• People become infected with Cyclospora by consuming food or water contaminated with the parasite.

The source of this outbreak is unknown at this time.

• The CDC has launched a web page focusing on the Cyclosporiasis outbreak, which includes Iowa and several other states. For CDC updates, visit www.cdc.gov/parasites/cyclosporiasis/outbreaks/investigation-2013.html.
• The Iowa Department of Public Health (IDPH) continues to receive reports of confirmed cases of Cyclospora infection and interview hose who are ill, but numbers are decreasing. Now the investigation focuses primarily on determining the source of the contamination. This investigation is ongoing, and will be led by the Iowa Department of Inspections and Appeals (DIA). IDPH and DIA will continue to update the CDC as the Iowa epidemiologic investigation continues.
• Onset dates of the illness suggest the ill people had eaten the contaminated food in mid-June. This is a very good indication the food which was the source of the outbreak has already been consumed or discarded, since fresh vegetables have a limited shelf life.
• At no time was an Iowa-grown fruit or vegetable suspected to be the cause of the outbreak.
• IDPH encourages Iowans to make fruits and vegetables part of their daily diet. It is always a good idea to wash all fresh fruits and vegetables thoroughly before eating.
• Cyclospora illness is typically traced to consumption of fresh fruits and vegetables contaminated with the parasite; this investigation currently indicates fresh vegetables, not fruit, may be the source of illness.
• IDPH is working with local public health agencies to interview individuals who are ill to determine if there is a common food exposure that would indicate the source of illness.
• Cluster investigations continue, which ask questions of both the ill person and their family and friends who are not ill, to determine what the well people did not eat.

Cyclospora infection causes a watery diarrhea that lasts an average of 57 days, if untreated.

• Most of the illnesses in this outbreak began in mid to late June. Many people report still being ill and some have had relapses.

There is treatment (medicine) available to treat Cyclospora infection.

• Specific laboratory testing (not commonly ordered) must be done to detect Cyclospora.
• Specific treatment (not typically used to treat more common diarrheal illnesses) can be prescribed.

If you are experiencing diarrhea, or have recently had a long bout with diarrhea, you should contact your health care provider and see if you should be tested for Cyclospora infection.

• Additional symptoms of cyclosporiasis (the infection caused by Cyclospora) include:
  • Watery diarrhea
  • Fatigue (severe tiredness)
  • Loss of appetite
  • Weight loss
  • Bloating
  • Increased gas
  • Stomach cramps
  • Nausea
  • Vomiting
  • Muscle aches
  • Low-grade fever

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[Giuseppe]

Re: Iowa Dept. of Health Investigates Intestinal Illness (July 8 2013): Cyclospora

[Source: Iowa Department of Public Health, full PDF document: (LINK). Edited.]


Iowa Cyclospora Outbreak 2013

Outbreak Update 7.19.13 (new information is highlighted)


IDPH, CDC, the State Hygienic Laboratory and local public health agencies are investigating an outbreak caused by Cyclospora.

• As of today, 118 cases of Cyclospora infections have been reported to IDPH. The next case count will be updated Tuesday, July 23 at approximately 10:00 a.m.
• The number of cases reported is decreasing.
• Cyclospora is a rare parasite.
• Previous outbreaks have been associated with fresh produce (fresh fruits and vegetables)
• People become infected with Cyclospora by consuming food or water contaminated with the parasite.

The source of this outbreak is unknown at this time.

• The Iowa Department of Public Health (IDPH) continues to receive reports of confirmed cases of Cyclospora infection and interview those who are ill, but numbers are decreasing. Now the investigation focuses primarily on determining the source of the contamination. This investigation is ongoing, and will be led by the Iowa Department of Inspections and Appeals (DIA). IDPH and DIA will continue to update the CDC as the Iowa epidemiologic investigation continues.
• Onset dates of the illness suggest the ill people had eaten the contaminated food in mid-June. This is a very good indication the food which was the source of the outbreak has already been consumed or discarded, since fresh vegetables have a limited shelf life.
• At no time was an Iowa-grown fruit or vegetable suspected to be the cause of the outbreak.
• IDPH encourages Iowans to make fruits and vegetables part of their daily diet. It is always a good idea to wash all fresh fruits and vegetables thoroughly before eating.
• Cyclospora illness is typically traced to consumption of fresh fruits and vegetables contaminated with the parasite; this investigation currently indicates fresh vegetables, not fruit, may be the source of illness.
• IDPH is working with local public health agencies to interview individuals who are ill to determine if there is a common food exposure that would indicate the source of illness.
• Cluster investigations continue, which ask questions of both the ill person and their family and friends who are not ill, to determine what the well people did not eat.

Cyclospora infection causes a watery diarrhea that lasts an average of 57 days, if untreated.

• Most of the illnesses in this outbreak began in mid to late June. Many people report still being ill and some have had relapses.

There is treatment (medicine) available to treat Cyclospora infection.

• Specific laboratory testing (not commonly ordered) must be done to detect Cyclospora.
• Specific treatment (not typically used to treat more common diarrheal illnesses) can be prescribed.

If you are experiencing diarrhea, or have recently had a long bout with diarrhea, you should contact your health care provider and see if you should be tested for Cyclospora infection.

• Additional symptoms of cyclosporiasis (the infection caused by Cyclospora) include:
  • Watery diarrhea
  • Fatigue (severe tiredness)
  • Loss of appetite
  • Weight loss
  • Bloating
  • Increased gas
  • Stomach cramps
  • Nausea
  • Vomiting
  • Muscle aches
  • Low-grade fever

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------

[Giuseppe]

Re: Iowa Dept. of Health Investigates Intestinal Illness (July 8 2013): Cyclospora

[Source: Iowa Department of Public Health, full PDF document: (LINK). Edited.]


Iowa Cyclospora Outbreak 2013

Outbreak Update 7.19.13


IDPH, CDC, the State Hygienic Laboratory and local public health agencies are investigating an outbreak caused by Cyclospora.

• As of today, 109 cases of Cyclospora infections have been reported to IDPH. The next case count will be updated Monday, July 22 at approximately 10:00 a.m. o The number of cases reported is decreasing.
• Cyclospora is a rare parasite.
• Previous outbreaks have been associated with fresh produce (fresh fruits and vegetables)
• People become infected with Cyclospora by consuming food or water contaminated with the parasite.

The source of this outbreak is unknown at this time. o The Iowa Department of Public Health (IDPH) continues to receive reports of confirmed cases of Cyclospora infection and interview those who are ill, but numbers are decreasing. Now the investigation focuses primarily on determining the source of the contamination. This investigation is ongoing, and will be led by the Iowa Department of Inspections and Appeals (DIA).

IDPH and DIA will continue to update the CDC as the Iowa epidemiologic investigation continues.

• Onset dates of the illness suggest the ill people had eaten the contaminated food in mid-June. This is a very good indication the food which was the source of the outbreak has already been consumed or discarded, since fresh vegetables have a limited shelf life.
• At no time was an Iowa-grown fruit or vegetable suspected to be the cause of the outbreak.
• IDPH encourages Iowans to make fruits and vegetables part of their daily diet. It is always a good idea to wash all fresh fruits and vegetables thoroughly before eating.
• Cyclospora illness is typically traced to consumption of fresh fruits and vegetables contaminated with the parasite; this investigation currently indicates fresh vegetables, not fruit, may be the source of illness.
• IDPH is working with local public health agencies to interview individuals who are ill to determine if there is a common food exposure that would indicate the source of illness.
• Cluster investigations continue, which ask questions of both the ill person and their family and friends who are not ill, to determine what the well people did not eat.

Cyclospora infection causes a watery diarrhea that lasts an average of 57 days, if untreated.

• Most of the illnesses in this outbreak began in mid to late June. Many people report still being ill and some have had relapses.

There is treatment (medicine) available to treat Cyclospora infection.

• Specific laboratory testing (not commonly ordered) must be done to detect Cyclospora.
• Specific treatment (not typically used to treat more common diarrheal illnesses) can be prescribed.

If you are experiencing diarrhea, or have recently had a long bout with diarrhea, you should contact your health care provider and see if you should be tested for Cyclospora infection.

• Additional symptoms of cyclosporiasis (the infection caused by Cyclospora) include:
  • Watery diarrhea
  • Fatigue (severe tiredness)
  • Loss of appetite
  • Weight loss
  • Bloating
  • Increased gas
  • Stomach cramps
  • Nausea
  • Vomiting
  • Muscle aches
  • Low-grade fever

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------

[Giuseppe]

Re: Iowa Dept. of Health Investigates Intestinal Illness (July 8 2013): Cyclospora

[Source: Iowa Department of Public Health, full page: (LINK).]


Posted: Thu, 18 Jul 2013 10:41 CDT / Category: Infectious Disease Prevention

Cyclospora Outbreak Investigation Focuses on Finding Source


The Iowa Department of Public Health (IDPH) continues to receive reports of confirmed cases of Cyclospora infection and interview those who are ill, but numbers are decreasing.

Now the investigation focuses primarily on determining the source of the contamination. The Iowa Department of Inspections and Appeals (DIA) is leading the Iowa investigation. IDPH and DIA will continue to update their federal partners as the Iowa epidemiologic investigation continues. Daily case counts will continue to be posted to the IDPH web site.

?Through interviews with those who have been ill and by mapping the onset of illness (mid-June), we have a very good indication the source of contamination was most likely a vegetable that has probably already been consumed or discarded (because of the limited shelf life of fresh produce),? said IDPH Medical Director, Dr. Patricia Quinlisk. At no time was an Iowa-grown fruit or vegetable suspected to be the cause of the outbreak and IDPH continues to encourage Iowans to include fresh fruits and vegetables as part of their daily diet.

As of today, 102 cases of Cyclospora infections have been reported to IDPH; almost all have been identified through testing at the State Hygienic Lab (SHL), including:

• Linn County - 34 cases
• Polk County - 9 cases
• Pottawattamie County - 8 cases
• Dallas County - 5 cases
• Black Hawk County - 4 cases
• Woodbury County - 4 cases
• Boone County - 4 cases
• Fayette County - 3 cases
• O?Brien County - 3 cases
• Buchanan - 3 cases
• Webster County - 3 cases
• Dubuque - 3 cases
• Mills County - 2 cases
• Des Moines County - 2 cases
• Benton County - 1 case
• Keokuk County - 1 case
• Monona County - 1 case
• Butler County - 1 case
• Lucas County - 1 case
• Poweshiek County - 1 case
• Winneshiek County - 1 case
• Johnson County - 1 case
• Montgomery County - 1 case
• Iowa County - 1 case
• Van Buren County - 1 case
• Story County - 1 case
• Cedar County - 1 case
• Dickinson County - 1 case
• Plymouth County - 1 case
• Total - 102 cases

At least six people have been hospitalized. Many people report still being ill with diarrhea and some have had relapses. Specific treatment is available (but it is not typically used for more common diarrheal illnesses).

Also, very specific laboratory testing (not commonly ordered) must be done to detect Cyclospora.

People become infected with Cyclospora by consuming food or water contaminated with the parasite, which causes a watery diarrhea that lasts an average of 57 days if untreated. Symptoms of cyclosporiasis include:

• Watery diarrhea
• Fatigue (severe tiredness)
• Loss of appetite
• Weight loss
• Bloating
• Increased gas
• Stomach cramps
• Nausea
• Vomiting
• Muscle aches
• Low-grade fever

For more information, visit www.idph.state.ia.us/EHI/Issue.aspx?issue=Cyclospora Outbreak Investigation.

Contact Information: Polly Carver-Kimm at (515) 281-6693


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[Giuseppe]

Re: Iowa Dept. of Health Investigates Intestinal Illness (July 8 2013): Cyclospora

[Source: Iowa Department of Public Health, full page: (LINK).]


Posted: Wed, 17 Jul 2013 10:21 CDT / Category: Infectious Disease Prevention

IDPH Cyclospora Case Count Update

________

• Linn County - 31 cases
• Polk County - 7 cases
• Pottawattamie County - 6 cases
• Black Hawk County - 4 cases
• Boone County - 4 cases
• Fayette County - 3 cases
• O?Brien County - 3 cases
• Dallas County - 3 cases
• Buchanan - 3 cases
• Webster County - 3 cases
• Mills County - 2 cases
• Des Moines County - 2 cases
• Dubuque - 2 cases
• Benton County - 1 case
• Keokuk - 1 case
• Monona - 1 case
• Butler - 1 case
• Lucas - 1 case
• Poweshiek - 1 case
• Winneshiek - 1 case
• Johnson County - 1 case
• Montgomery - 1 case
• Iowa - 1 case
• Van Buren County - 1 case
• Story County - 1 case
• Cedar County - 1 case
• Woodbury County - 1 case
• Total ? 87

Almost all cases have been identified through testing at the State Hygienic Lab (SHL).

Most people?s illness began in mid to late June, and at least five persons have been hospitalized. Many people report still being ill with diarrhea and some have had relapses.

For more information about the Cyclospora outbreak in Iowa, visit www.idph.state.ia.us/EHI/Issue.aspx?issue=Cyclospora Outbreak Investigation&pg=Investigation Home.

Case counts are current as of 4:30PM on July 16, 2013.

Contact Information: Polly Carver-Kimm at (515) 281-6693


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[Giuseppe]

Re: Iowa Dept. of Health Investigates Intestinal Illness (July 8 2013): Cyclospora

[Source: Iowa Department of Public Health, full page: (LINK).]


IDPH Cyclospora Outbreak Investigation Update


The Iowa Department of Public Health (IDPH) continues to receive reports of confirmed cases of Cyclospora infection, but numbers are decreasing.

In addition, the onset dates of the illness suggest the ill people had eaten the contaminated food in mid-June. This is a very good indication the food which was the source of the outbreak has already been consumed or discarded, since fresh vegetables have a limited shelf life. At no time was an Iowa-grown fruit or vegetable suspected to be the cause of the outbreak.

IDPH encourages Iowans to make fruits and vegetables part of their daily diet. It is always a good idea to wash all fresh fruits and vegetables thoroughly before eating.

?We know fresh produce (fruits and vegetables) has been implicated in previous Cyclospora outbreaks, and interviews with those who have been ill indicate vegetables were probably the source of this outbreak,? said IDPH Medical Director, Dr. Patricia Quinlisk. ?The illness onset dates, coupled with the shelf life of fresh produce, make it very likely the vegetable that was the source of the outbreak has already been eaten or thrown away, and will not cause anyone else to become ill.?

IDPH continues to work with the CDC, other states, other Iowa state agencies and local public health agencies in the investigation of the Cyclospora outbreak to ensure there is no continuing exposure to contaminated food, and to try to understand how the food became contaminated in the first place.

As of today, 81 cases of Cyclospora infections have been reported to IDPH; almost all have been identified through testing at the State Hygienic Lab (SHL), including:

• Linn County - 31 cases
• Polk County - 5 cases
• Pottawattamie County - 5 cases
• Black Hawk County - 4 cases
• Fayette County - 3 cases
• O?Brien County - 3 cases
• Dallas County - 3 cases
• Buchanan County - 3 cases
• Webster County - 3 cases
• Boone County - 3 cases
• Mills County - 2 cases
• Des Moines County - 2 cases
• Dubuque County - 2 cases
• Benton County - 1 case
• Keokuk County - 1 case
• Monona County - 1 case
• Butler County - 1 case
• Winneshiek County - 1 case
• Johnson County - 1 case
• Montgomery County - 1 case
• Iowa County - 1 case
• Van Buren County - 1 case
• Story County - 1 case
• Cedar County - 1 case
• Woodbury County - 1 case

At least five people have been hospitalized. Many people report still being ill with diarrhea and some have had relapses. Specific treatment is available (but it is not typically used for more common diarrheal illnesses).

Also, very specific laboratory testing (not commonly ordered) must be done to detect Cyclospora.

People become infected with Cyclospora by consuming food or water contaminated with the parasite, which causes a watery diarrhea that lasts an average of 57 days if untreated. Symptoms of cyclosporiasis include:

• Watery diarrhea
• Fatigue (severe tiredness)
• Loss of appetite
• Weight loss
• Bloating
• Increased gas
• Stomach cramps
• Nausea
• Vomiting
• Muscle aches
• Low-grade fever

For more information, visit www.idph.state.ia.us/EHI/Issue.aspx?issue=Cyclospora Outbreak Investigation.

Contact Information: Polly Carver-Kimm at (515) 281-6693


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