Michigan health officials have reported two deaths associated with the state’s Cyclospora outbreak, the first deaths reported during the nationwide surge.
Michigan has recorded 11,234 cases and 193 hospitalizations; both people who died had significant underlying health conditions.
Federal officials have linked one portion of the nationwide outbreak to recalled iceberg lettuce from Taylor Farms de Mexico, but other clusters remain under investigation.
The Cyclospora outbreak has taken a deadly turn. Two Michigan residents have died from illnesses caused by the parasite, marking the first reported deaths during this year’s nationwide increase in infections.
The Michigan Department of Health and Human Services reported the deaths Monday. Medical records indicated that both individuals had significant underlying health conditions that may have been affected by cyclosporiasis and the dehydration it caused. The state did not release their names, ages, or other details.
Deaths from cyclosporiasis are uncommon in the United States, and the illness is generally not considered life-threatening. However, prolonged diarrhea can cause serious dehydration, particularly among older adults and people with weakened immune systems or other medical conditions.
Michigan had recorded 11,234 cases as of Aug. 3. At least 193 patients had been hospitalized as of July 30, according to the state health department. It is not immediately clear why Michigan accounts for the majority of U.S. cases.
The Centers for Disease Control and Prevention (CDC) said it was aware of the two deaths and would update its national figures to include them.
More than 18,000 confirmed or suspected cases
The CDC had received reports of 6,707 laboratory-confirmed, domestically acquired cases in 45 states between May 1 and July 27. At least 423 patients had been hospitalized.
In addition, the agency was reviewing more than 11,500 suspected cases that had not been laboratory-confirmed or still required further investigation. Many of those reports came from Michigan and Ohio, bringing the combined number of confirmed and suspected cases nationwide to more than 18,000.
The CDC warned that case numbers are likely to continue rising because it can take about six weeks for an illness to be reported, investigated, and added to federal totals. Some patients also recover without seeking medical care or being tested.
The nationwide figures include several clusters that may not share the same source.
Iceberg lettuce linked to one outbreak
Federal investigators have connected at least 1,947 illnesses in nine states to iceberg lettuce sourced from central Mexico. Those cases involved people who reported eating at Taco Bell restaurants before becoming ill. At least 98 patients in that cluster were hospitalized.
The affected states are Illinois, Indiana, Kansas, Kentucky, Michigan, Ohio, Oklahoma, Pennsylvania, and West Virginia.
Taylor Farms de Mexico recalled all iceberg lettuce from central Mexico on July 17. The recall included certain Marketside iceberg salad and shredded lettuce products sold at Walmart, along with products supplied to restaurants and other food-service customers.
The recalled lettuce was distributed to consumers, restaurants, or retailers in at least 27 states. Taco Bell said it stopped using lettuce from the supplier on July 17.
The CDC advises consumers not to eat recalled lettuce. It should be discarded or returned to the place of purchase. Containers, countertops, and other surfaces that touched it should be washed with hot, soapy water.
However, the lettuce-related outbreak represents only part of the nationwide increase. Michigan officials say lettuce or salad greens may be a source of illnesses in the state, but other foods have not been ruled out.
Symptoms can last for weeks
Cyclospora is a microscopic parasite commonly spread through food or water contaminated with feces. It is not generally transmitted directly from one person to another because the parasite must spend time in the environment before becoming infectious.
The most common symptom is frequent, watery diarrhea. Other symptoms can include:
Loss of appetite and weight loss
Stomach cramps and bloating
Increased gas
Nausea
Fatigue
Headache, fever or body aches
Symptoms usually begin about one week after exposure but can appear anywhere from two days to two weeks or longer. Without treatment, the illness may last for weeks and can appear to improve before returning.
People with persistent diarrhea should contact a healthcare provider and ask about Cyclospora testing because routine stool tests do not always check for the parasite. Patients should also drink fluids to reduce the risk of dehydration. Cyclosporiasis is commonly treated with the antibiotic combination trimethoprim-sulfamethoxazole.