Investigation of an Outbreak of Cyclosporiasis in the United States
On June 28, 2013, CDC was notified of 2 laboratory-confirmed cases of Cyclospora infection in Iowa residents who had become ill in June and did not have a history of international travel during the 14 days before the onset of illness. Since that date, CDC has been collaborating with public health officials in multiple states and the US Food and Drug Administration (FDA) to investigate an outbreak of cyclosporiasis. Preliminary details of the ongoing investigation are highlighted below.
- As of July 30, 2013 (5pm EDT), CDC has been notified of 378 cases of Cyclospora infection from the following 16 health departments: Iowa, Texas, Nebraska, Florida, Wisconsin, Illinois, New York City, Georgia, Missouri, Arkansas, Connecticut, Kansas, Minnesota, New Jersey, New York, and Ohio.
- Most of the illness onset dates have ranged from mid-June through early July.
- At least 21 persons reportedly have been hospitalized in three states.
- Nebraska and Iowa have performed investigations within their states and have shared the results of those investigations with CDC. Based on their analysis, Cyclospora infections in their states are linked to a salad mix. CDC will continue to work with federal, state, and local partners in the investigation to determine whether this conclusion applies to the increase in cases of cyclosporiasis in other states.
- It is not yet clear whether the cases from all of the states are part of the same outbreak.
- Additional cases are currently under investigation and will be included on this page as states confirm them. Cases in this outbreak are defined as laboratory-confirmed Cyclospora infection in a person who became ill in June or July, 2013, and had no history of travel outside of the United States or Canada during the 14 days prior to onset of illness.
- Previous outbreak investigations have implicated various types of fresh produce.
- To date, CDC has confirmed 34 cases of Cyclospora infection in CDC laboratories. One of the cases was confirmed via telediagnosis.
- CDC encourages laboratories to obtain confirmation of cases using telediagnosis. Telediagnosis allows for rapid laboratory confirmation. State health laboratories may submit images showing suspected Cyclospora oocysts to CDC. Images may be captured from modified acid-fast stained smears or from wet mounts examined by UV fluorescence microscopy. Both techniques require concentrated stool specimens. Instructions for submitting images for telediagnosis are found on the DPDx site.