Michigan cyclosporiasis outbreak tops 13,900 cases; 35 additional hospitalizations in past week

An additional 35 Michigan residents have required hospital care for cyclosporiasis as an outbreak continues to be tracked, state health officials said on Thursday.

The Michigan Department of Health and Human Services says it has counted 13,909 cases and 314 hospitalizations, as of Aug. 13. 

Tracking of an outbreak of the intestinal ailment began in the state on June 22.   

Michigan health officials said on Aug. 6 that people can resume routine recommendations for preparing and eating lettuce and salad greens as a recent cyclosporiasis outbreak appears to be fading.

This mirrors the latest news from federal officials on the matter.

The Centers for Disease Control said on Aug. 5 in a joint statement with the U.S. Food and Drug Administration that the "FDA remains confident that all iceberg lettuce related to this specific Cyclospora outbreak is off the market." 

The CDC also said that it can take as long as six weeks from when someone eats contaminated produce to when they become ill to confirm if the patient's ailment can be linked to this summer's outbreak.

Michigan cases

Michigan was the most affected state in the outbreak that erupted this summer, though the rate of increase per day is slowing compared to a couple of weeks ago.

Health officials say 314 Michigan residents received hospital treatment as of Aug. 13, up 35 from the 279 counted as of Aug. 6.

Michigan health officials report case numbers, hospitalization status and detailed outbreak data weekly on Thursdays by 11 a.m. ET. 

There were also two deaths among patients whom state officials said on Aug. 3 had "significant underlying health conditions." Those two patients had illness onset before July 17, the Centers for Disease Control and Prevention said.

There could still be additional cases confirmed to state and national tallies as the public health investigation continues. MDHHS says its tracking showed that most of the exposures happened in late June or early July, adding that, "the majority of the contaminated produce is likely no longer available for consumption.  

Cases across the country

The Michigan case numbers are different from the CDC's tally. The CDC says its surveillance updates do not include probable cases, only laboratory-confirmed cases. The CDC works with state officials to update the counts as additional information becomes available. 

Tracking the disease in Michigan

Tracking of the outbreak of the intestinal ailment began in Michigan on June 22, with a sudden spike quickly catching the state's attention. Normally, Michigan sees around 50 cases of cyclosporiasis per year, according to MDHHS.    

The ailment was first detected in Monroe County in late June and spread to 70 counties, with Southeast Michigan bearing the heaviest burden. 

During the past few weeks, Oakland and Wayne counties each have reported more than 1,000 cases. Eaton, Genesee, Ingham, Lenawee, Macomb, Monroe, Muskegon, Oakland, Shiawassee, Washtenaw and Wayne counties are all reporting more than 300 cases each.  

What federal agencies say

Last month, the Centers for Disease Control said a lettuce supplier to fast-food giant Taco Bell had been linked to the outbreak. Taylor Farms voluntarily pulled all of its iceberg lettuce grown in central Mexico from the market. However, federal officials said there are multiple clusters of the ailment active in the United States, and the FDA said a previous positive test result for the parasite in a Taylor Farms lettuce sample was later withdrawn.

The Centers for Disease Control and Prevention said that as of Aug. 5, it has confirmed cases linked to exposure to the Taylor Farms de Mexico iceberg lettuce in 15 states, including Michigan.

Symptoms of cyclosporiasis 

Cyclospora cayetanensis is a parasite that causes the diarrheal illness cyclosporiasis. The Centers for Disease Control and Prevention says the most common symptoms associated with the illness are frequent watery diarrhea, loss of appetite, bloating, nausea and fatigue. Some people may also experience body aches, headache or vomiting.   

Symptoms typically begin about a week after infection, and remain from about two days to two weeks or longer.  

"Without treatment, illness can last for weeks and may come and go," Wayne County health officials said. 

Tips to prevent cyclosporiasis

Health officials are encouraging residents to continue eating fresh produce while taking steps to reduce their risk of illness. 

Michigan health officials shared the following tips for avoiding the illness:

• Wash all fruits and vegetables thoroughly, under running water, before cutting, cooking or eating.
• Scrub firm fruits and vegetables, such as melons and cucumbers, with a produce brush when cleaning.
• Cut away any damaged or bruised areas of produce before preparing and eating.
• Refrigerate any cut, peeled or cooked produce within two hours of preparing it.
• Purchase lettuce or salad greens whole, remove the outer leaves and then wash the produce thoroughly before eating.