Alabama Department of Public Health reports 28 cases of cyclosporiasis
Alabama reports 28 cyclosporiasis cases as officials investigate a nationwide outbreak potentially linked to contaminated iceberg lettuce distributed across multiple states.
Alabama has reported 28 cases of cyclosporiasis this year as state and federal health officials investigate a nationwide outbreak linked to potentially contaminated iceberg lettuce distributed to restaurants and retailers across the country.
The Alabama Department of Public Health said Monday that 22 of the state’s cases, or 78.6 percent, were reported in the Northern District. The Southwestern District reported two cases, while the Mobile, Northeastern, Southeastern and West Central districts each reported one.
Two Alabama patients have been hospitalized. No deaths have been reported.
The investigation has focused on shredded iceberg lettuce supplied by Taylor Fresh Foods and sourced from central Mexico. The lettuce was distributed to several states, including Alabama, from late June through mid-July.
The Food and Drug Administration said the investigation remains ongoing and that officials could identify additional restaurants, retailers or distribution channels as they continue tracing the product.
Alabama health officials said none of the state’s 28 cases have been directly linked to the Taco Bell restaurants identified in the federal investigation. Eight Alabama cases, however, have been associated with two separate foodborne outbreaks at Mexican-style restaurants, according to ADPH. Four cases were associated with international travel.
The potential link between the national outbreak and iceberg lettuce prompted Taylor Farms de Mexico and Taylor Fresh Foods to voluntarily remove iceberg lettuce sourced from central Mexico from the U.S. market.
The action includes products distributed to major restaurant and retail companies, including KFC, Pizza Hut, Subway, Trader Joe’s, Walmart, Sysco, Cross Valley Farms and Peak Fresh Produce.
The FDA advised consumers not to eat recalled lettuce and urged restaurants and retailers to determine whether they received affected products. The agency also said it is increasing border screening for products connected to the investigation.
The Alabama outbreak comes during the time of year when cyclosporiasis cases typically increase. The illness is caused by Cyclospora cayetanensis, a parasite that can contaminate food or water.
Cases in the United States generally increase during the spring and summer. May through August is considered the typical season for domestically acquired infections.
Cyclospora can be difficult to identify because tests for the parasite are not routinely included in many standard stool tests. The Centers for Disease Control and Prevention recommends that health care providers specifically request Cyclospora testing when patients experience prolonged or recurring watery diarrhea, particularly during the summer.
Symptoms generally begin about one week after infection but can appear as soon as two days after exposure or more than two weeks later.
Watery diarrhea is the most common symptom. Patients may also experience fatigue, loss of appetite, weight loss, stomach cramps, bloating, nausea and increased gas.
The illness is generally treatable with antibiotics, but prolonged diarrhea can lead to dehydration and, in some cases, hospitalization.
ADPH is urging Alabamians who develop symptoms consistent with cyclosporiasis to contact a health care provider and ask about testing for the parasite. Public health officials may also contact patients and ask for information about foods they consumed during the two weeks before becoming ill.
The agency is advising consumers to follow standard food safety practices, including washing fresh fruits and vegetables under running water and washing their hands before preparing or eating food.
Health officials noted, however, that washing produce does not necessarily eliminate Cyclospora. Cooking produce to at least 158 degrees Fahrenheit can kill the parasite.
The investigation presents a complicated food safety picture for Alabama because recalled lettuce was distributed in the state, but health officials have not directly linked the product to any of Alabama’s reported cases.
The FDA said the investigation remains active and that it will update its public advisories as officials receive new information about the outbreak, product testing and potential recalls.