Kansas cyclospora cases more than double this week, as illness spreads nationally

Kansas cases of cyclosporiasis, an illness caused by eating fruits and vegetables contaminated with a Cyclospora cayetanensis, doubled in Kansas in the past week. Health officials say lettuces and salad greens are emerging as a likely source in the nationwide cyclosporiasis outbreak, which has sickened hundreds of people across 31 states. (Photo by Jon King/Michigan Advance)

By Morgan Chilson

Kansas Reflector

TOPEKA — Kansas cases of a foodborne illness that causes explosive diarrhea doubled this week to 55, and a national health agency said cases exceeded 7,000 nationwide.  

Dana Hawkinson, medical director of infection prevention and control for the University of Kansas Health System, said Monday that Kansas cases of illness caused by the parasite Cyclospora cayetanensis are currently within the range the state experiences annually. 

The Kansas Department of Health and Environment’s infectious disease portal showed a jump in cyclosporiasis, the intestinal disease caused by cyclospora organisms, from 22 infections last week to 55. 

Hawkinson said some years the state has reported more than 60 cases. 

On Tuesday, the Centers for Disease Control and Prevention announced it has received reports of 1,645 confirmed domestic cases of cyclosporiasis but that it is aware of an additional 5,100 cases that require further analysis. 

The CDC’s website said cyclospora infections are often underreported and underdiagnosed, making it difficult to track the spread. 

Hawkinson said cyclosporiasis spreads through contact with fecal or body fluids, but is also found in the environment on fresh produce. The Food and Drug Administration is working along with state health departments to trace what products might be causing the national outbreaks, but there is little definitive information. 

Michigan’s Health and Human Services Department announced this week that salad greens might be the cause but didn’t rule out other factors. The state has not linked the outbreak to specific brands or items being sold. 

In Michigan, as of Wednesday, there are 3,762 cases, with 44 people hospitalized, the state’s website said. 

Hawkinson said the elderly, very young and people who are immunosuppressed are more likely to have a severe case of cyclosporiasis. Because the illness typically causes explosive diarrhea, it can lead to severe dehydration, he said. 

There is a wide variance in how long people are ill, with some a few days and others ill for more than a week, Hawkinson said. Cyclosporiasis also can sometimes recur after it seems to have gone away, he said. 

Hawkinson said cyclosporiasis isn’t as concerning from a public health standpoint as diseases such as COVID-19. But those who are liable to develop severe symptoms should be cautious. 

“We want to find the source of the outbreak, control it, and reduce those cases,” he said.

Treatment for the illness typically is an older antibiotic called Bactrim, Hawkinson said. 

The CDC said routine chemical disinfection or sanitization of food or water is unlikely to kill cyclospora in areas where it is often found, such as the sub-tropics and tropics. To reduce the likelihood of getting the illness from raw fruit and vegetables:

• Wash hands thoroughly with soap and water after handling produce.

• Wash fruits and vegetables thoroughly under running water before eating, cutting or cooking. 

• Scrub firm fruits and vegetables such as melons with a clean produce brush.

• Cut away damaged or bruised areas on produce before preparing and eating. 

• Refrigerate fruits and vegetables as soon as possible, preferably within two hours. 

Significant cyclosporiasis outbreaks in the past were linked to salad mixes, basil, cilantro, raspberries, blackberries and other fresh produce, according to a 2020 study of the disease.  

This article was republished with permission from the Kansas Reflector. The Kansas Reflector is a non-profit online news organization serving Kansas. For more information on the organization, go to its website at www.kansasreflector.com.