TUESDAY, July 30 (HealthDay News) -- The ongoing outbreak of
stomach illness linked to the cyclospora parasite has now spread to
14 states and New York City, with 353 cases reported, the U.S.
Centers for Disease Control and Prevention reported Monday.
While no one has died from cyclosporiasis, "at least 21 persons
reportedly have been hospitalized in three states," the CDC said in
a posting on its website. Most people got sick from between
mid-June through early July.
U.S. health officials are still trying to determine the source
of the outbreak. "No food items have been implicated to date, but
public health authorities are pursuing all leads," the CDC said.
Prior outbreaks of cyclospora infection have typically been caused
by tainted produce, the agency noted.
Cases have now been reported from Arkansas, Connecticut,
Florida, Georgia, Illinois, Iowa, Kansas, Minnesota, Missouri,
Nebraska, New Jersey, New York City, Ohio, Texas and Wisconsin. The
CDC stresses that it's not clear that cases spread across these
states are all part of the same outbreak.
Cases of cyclosporiasis, which is caused by a single-celled
parasite and can trigger diarrhea and stomach cramps, have been
mounting through the month of July, said Dr. Monica Parise, chief
of the parasitic diseases branch of the U.S. Centers for Disease
Control and Prevention. The cyclospora parasite cannot be spread
from person to person; it has to be ingested via contaminated water
or foods such as fruit and vegetables.
"It can be pretty miserable, because it can give diarrhea that
can last for days," Parise said.
Cyclospora is a tiny parasite but is devastatingly effective,
added Dr. Bruce Hirsch, an attending physician in the division of
infectious diseases at North Shore University Hospital in
"You can ingest as few as 10 of these little critters and get
sick," Hirsch said.
Officials have not yet been able to determine the source of the
"We're doing the investigation," said Dr. Thomas Frieden,
director of the CDC, said Thursday. "We do anticipate being able to
identify the source, but we have not been able to do so yet."
No common events have been identified among the people infected
by cyclospora, and officials have no leads on the source of
infection, Parise said.
The first reported cases occurred in Iowa, which has been
hardest hit with at least 140 people falling ill, Parise said. The
first cases came in late June, with more infections reported
Other states reporting large numbers of infections are Nebraska,
with 71 cases, and Texas, with 92 cases.
It takes about a week for people who are infected to become
Frieden urged people who have suffered from diarrhea longer than
a couple of days to be tested for cyclospora. Antibiotics can be
used to treat severe cases of infection.
Earlier outbreaks of cyclospora have been traced back to fruits
and vegetables imported from tropical regions like Latin America
and Southeast Asia, where the parasite is common, Parise and Hirsch
"Our food supply system is large, complex and centralized. We
get foods from all over the world, and they are packaged together
and sent very, very quickly," Hirsch said. "I look at large
outbreaks like this, and it makes me wonder if more locally grown
foods would be safer."
People who want to avoid infection should thoroughly wash all
their fruits and vegetables, Hirsh said. They also should wash
cooking surfaces and utensils with hot, soapy water.
"For the most part, it's a miserable nuisance, but the concern I
have as a doctor is for patients whose immune systems are weakened
[and] have a real hard time with this infection," Hirsh said. He
urged extra caution for people undergoing cancer treatment,
recovering from an organ transplant or dealing with HIV
For more information on cyclospora, visit
the U.S. Centers for Disease Control and