Austin-Travis County Cyclospora Outbreak

Posted in Our Blog,Outbreaks & Recalls,Salmonella on August 7, 2020

Residents of Texas, be aware. Austin Public Health (APH) has announced it is investigating an outbreak of cyclosporiasis, an intestinal illness caused by a parasite, after at least 82 cases were reported. A source us not yet identified in this Austin-Travis County Cyclospora Outbreak. APH said the earliest symptom onset was reported on June 1.

About the Austin-Travis County Cyclospora Outbreak

“While we may be in COVID-19 season, we cannot forget the other diseases and infections that are commonly present in our community,” said Janet Pichette, APH chief epidemiologist. “And as we have said time and time again, there are ways to prevent many of these diseases and infections, including cyclosporiasis – thoroughly wash fresh produce, wash your hands after handling fruits and vegetables, and separate produce from raw meat and seafood.”

APH urges residents to wash their hands with soap and warm water before and after handling or preparing fruits and vegetables. It is also advised to wash cutting boards, utensils and counter tops with soap and hot water between the preparation of raw meat products and the preparation of fruits and vegetables.

What are the Symptoms of Cyclospora?

Cyclospora is a parasite that causes food poisoning-like symptoms. Those sickened by the bug can expect a laundry list of gastrointestinal distress: bloating, stomach cramps, flatulence, nausea, and watery diarrhea are all common. They may feel faint. In serious cases, the illness can progress to vomiting or a moderate fever.

If not treated, the illness may last from a few days to a month or longer. Symptoms may seem to go away and then return one or more times (relapse). It’s common to feel very tired.

How is Cyclospora Diagnosed?

Cyclospora infection is diagnosed by examining stool specimens. Diagnosis can be difficult in part because even patients who are symptomatic might not shed enough oocysts in their stool to be readily detectable by laboratory examinations. Therefore, patients might need to submit several specimens collected on different days. Identification of the parasite requires special laboratory tests that are not routinely done when stool is tested for parasites. Therefore, if indicated, health care providers should specifically request testing for Cyclospora.

How Do You Treat Cyclospora?

Cyclospora infections can sometimes clear up after causing moderate illness. The illness caused by cyclospora can last for up to a month or more, although certain symptoms, like fatigue, have been known to persist after the rest of the illness has subsided.

There are some antibiotics that can be used as treatment in more serious cases. Trimethoprim/sulfamethoxazole (TMP/SMX), sold under the trade names Bactrim, Septra, and Cotrim, is the usual therapy for Cyclospora infection. No highly effective alternative antibiotic regimen has been identified yet for patients who do not respond to the standard treatment or have a sulfa allergy.

How Do You Catch Cyclospora?

Cyclospora is spread by people ingesting something—such as food or water—that was contaminated with feces (stool). Much of its life is spent as a hardened little egg-like ball called an oocyst. Once it’s made its way into your digestive system, cyclospora oocysts attach themselves to the walls of your intestine and go through the rest of their life cycle, eventually passing out of the body and looking for another host to infect.

Cyclospora needs time (typically, at least 1–2 weeks) after being passed in a bowel movement to become infectious for another person. Therefore, it is unlikely that Cyclospora is passed directly from one person to another.

Does Cyclospora Have a Season?

Cyclospora illnesses tend to be more common during the summer months. They’re also more common in tropical and subtropical regions. McAllen, which is located at the southern tip of Texas, is a subtropical climate. Most of the region’s precipitation happens during the hot summer months, with August and September being the wettest.

For cyclospora, precipitation is a boon. The parasite prefers wet, hot environments. It’s often spread through animal feces, but that’s only part of the story: often, it needs something to disperse those leavings further.

Rain is one of the ways that this dispersal happens. When it rains, the cyclospora spores in animal feces are carried through runoff past their point of origin. Sometimes, they flow into streams or rivers. Sometimes, they end up in fields where other livestock are being raised or where crops are being grown.

What Foods Carry Cyclospora?

Raspberries, basil, cilantro and snow peas have all been vehicles for the spread of cyclospora in the past. More recently, however, we’ve seen outbreaks of the parasite associated with prepackaged trays of fresh-cut fruits and vegetables sold at convenience stores and gas stations.

How Can I Prevent Catching Cyclospora?

Understanding how Cyclospora infection is transmitted, a person can take control of the life cycle and successfully avoid becoming infected.

• Use caution when traveling to areas where Cyclospora are endemic. In some tropical locations, the bacteria live in the environment and transmission is at a much higher rate than in other parts of the world.  Refer to the CDC’s travel notices page for updated information on risks associated with your destination.
• Use a clean water source. Most public water supply is safe for consumption.  Always pay attention for advisories to boil water in the event of known contamination from the water source.  Water from rivers, lakes, and streams should be treated with an appropriate sterilization method.  When traveling to higher risk areas
• Always wash fresh produce with clean water thoroughly before consuming. Produce consumed fresh is not killed by heat, so bacteria may be present on the surface from growing near an infected water source. Be sure to use safe, clean water to clean produce.
• Protect yourself by washing your hands prior to preparing, serving, and/or eating food. This will help reduce the spread of infection if you have come in contact with the bacteria in daily contact.

The FDA also recommends:

• Wash the inside walls and shelves of the refrigerator, cutting boards and countertops, and utensils that may have contacted contaminated foods; then sanitize them with a solution of one tablespoon of chlorine bleach to one gallon of hot water; dry with a clean cloth or paper towel that has not been previously used.
• Wash and sanitize surfaces used to serve or store potentially contaminated products.
• Wash hands with warm water and soap following the cleaning and sanitation process.
• Produce items should be rinsed in clean, running water without the use of cleaners or soaps. After washing, dry produce with a clean cloth towel or paper towel to further reduce bacteria that may be present on the surface.

All of this is to say that you can’t easily wash away or disinfect cyclospora from produce. The oocysts can be destroyed through boiling, but some produce, like salads, typically involve fresh ingredients that haven’t been put through a kill step where they’re exposed to high heat. In short: throw out any salad you might have that fits the description of the recalled products above. Don’t try to disinfect the salads yourself. And watch this space for more updates about this or other foodborne illness outbreaks.

Are There Future Complications of Cyclospora Infections?

Potentially. Although Cyclosporiasis usually is not life threatening, some more severe cases have reported complications during and after the infection. These complications include: malabsorption (inability for intestines to absorb nutrients), ongoing bowel issues, cholecystitis (inflammation of the gallbladder), and Reiter’s Syndrome or Reactive Arthritis (inflammation and pain in joints). Those who are elderly, very young, or have compromised immune systems are the most likely to develop reoccurrence of the infection and/or complications.

The Lange Law Firm Helps People with Cyclospora

Our mission is to help families who have been harmed by contaminated food or water.  When corporations cause Cyclospora food poisoning outbreaks or Legionnaires’ disease outbreaks, we use the law to hold them accountable.  The Lange Law Firm, PLLC is the only law firm in the nation solely focused on representing families in food poisoning lawsuits and Legionnaires disease lawsuits.

If you or your child was infected with Cyclospora, Austin-Travis County Cyclospora Outbreak, or any other parasite and are interested in making a legal claim for compensation, we have a Cyclospora lawyer ready to help you.  Call us for a free no obligation legal consultation at (833) 330-3663 or send us an e-mail here.

By: Candess Zona-Mendola