Cyclosporiasis outbreak: Cases rise to over 700 in Michigan, 36 reported hospitalizations

A parasite outbreak continues to rapidly rise in Michigan, with state health officials reporting more than 700 cases.

As of 4:30 p.m. on July 6, the Michigan Department of Health and Human Services (MDHHS) has received more than 700 reports of cyclosporiasis since June 22. There were also 36 reports of hospitalizations connected to the outbreak.

“Anyone experiencing gastrointestinal illness, such as sudden and ongoing diarrhea, should contact their health care provider and their local health department,” MDHHS said in a statement on Tuesday.

The cases remain the highest in Monroe, Lenawee, Washtenaw, Wayne, Shiawassee, Jackson, Oakland and Livingston counties. MDHHS is working on finding a direct cause.

Previous coverage --> Cyclosporiasis outbreak: Michigan health officials provide more tips on prevention as cases rise

What is cyclosporiasis?

Cyclosporiasis is an intestinal illness caused by a parasite and infects the small intestine.

Healthcare providers can diagnose the illness by testing a stool sample.

If infected with cyclosporiasis, people may experience watery diarrhea with frequent and sometimes explosive bowel movements.

The illness can last from a few days to over a month if the illness is not treated. Symptoms could relapse.

The timeframe from becoming infected to becoming sick usually takes about one week but can range from two days to two weeks or more.

In the US, outbreaks of cyclosporiasis have been linked to various types of fresh produce. People can get infected with Cyclospora more than once.

Anyone who experiences symptoms of cyclosporiasis should see their healthcare provider.

Read more --> What is cyclosporiasis? Know the signs, prevention as Michigan health officials investigate outbreak

Number of cases by county

MDHHS provided a list of cyclosporiasis cases by county in Michigan reported since June 22. Here’s a breakdown by county:

Produce linked to previous outbreaks

Health officials said the following foods have been previously linked to Cyclospora outbreaks in the United States and Canada:

• Bagged salad mixes and kits (pre-cut lettuce blends with romaine, iceberg, red cabbage, carrots)
• Fresh cilantro (coriander leaves)
• Fresh basil
• Raspberries
• Snow peas
• Green onions (scallions)

Produce recommendations

MDHHS provided a list of recommendations on July 6 on preparing, processing or serving raw produce, including restaurants and other commercial kitchens.

Health officials said to take the following steps to reduce risk of exposure:

• Lettuce/leafy greens: Buy whole heads of lettuce (rather than prewashed, bagged lettuce or salad mixes), throw away the outer 2–3 layers of leaves and wash the inner leaves under running water. For leafy greens that can be cooked, cooking is the safest option.
• Cilantro, basil: Wash thoroughly under running water, separating the leaves. Safest when cooked.
• Green onions: Trim the root end and remove the outer layer, wash thoroughly under running water. Safest when cooked.
• Raspberries: Their bumpy surface makes them especially hard to clean; the parasite can hide in the tiny crevices. Safest when cooked (pies, jams etc.). Consider frozen raspberries as an alternative (freezing may reduce but does not guarantee elimination of the parasite).
• Snow peas: Wash under running water and rub the surface. Safest when cooked.

MDHHS said the recommendations are essential for people who have a higher risk of dehydration or weakened immune systems, such as patients on chemotherapy, organ transplant recipients, infants and young children and elderly people.

General rules, routine food practices

Health officials said general rules of thumb to reduce the risk of getting the illness are to cook food -- when you can -- to 158 degrees or higher to kill cyclospora, and wash all fresh produce under clean running water, even if you plan to peel it.

Food safety reminders

Here are some reminders on food safety practices, according to the MDHHS:

• Wash hands with soap and water before and after handling or preparing food.
• Scrub firm fruits and vegetables, such as melons and cucumbers, with a clean produce brush.
• Cut away any damaged or bruised areas on fruits and vegetables before preparing and eating.
• Wash and sanitize utensils and surfaces before and after handling food. Wash and sanitize display cases and refrigerators where fresh produce is stored.
• Wash and sanitize cutting boards, surfaces and utensils used to prepare, serve or store fresh produce.
• Refrigerate cut, peeled or cooked fruits and vegetables as soon as possible.