The Centers for Disease Control and Prevention offices in Atlanta are seen in 2022. The agency is investigating a rise in cyclosporiasis cases. Ron Harris/AP hide title toggle title Ron Harris/AP According to federal health authorities, a large number of cases of intestinal diseases causing diarrhea, nausea and fatigue have been detected in 34 states,
The Centers for Disease Control and Prevention offices in Atlanta are seen in 2022. The agency is investigating a rise in cyclosporiasis cases.
Ron Harris/AP
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Ron Harris/AP
According to federal health authorities, a large number of cases of intestinal diseases causing diarrhea, nausea and fatigue have been detected in 34 states, but the source is still under investigation.
As of Tuesday, the Centers for Disease Control and Prevention saying had received reports of 1,645 confirmed cases of cyclosporiasis, the gastrointestinal disease caused by the parasite cyclospora.
But the actual number of infections is likely much higher, because that figure only represents cases reported by states directly to the CDC. There is also a lag between the onset of symptoms and their reporting, and many people recover from the disease without medical treatment. Michigan alone reported 3,309 cases of cyclosporiasis as of Tuesday.
As of Thursday, there have been 141 hospitalizations nationwide and no deaths, according to the CDC.

Health officials are also investigating several clusters of cases that may be epidemiologically linked, including a multistate outbreak which includes at least four states: Michigan, Ohio, West Virginia and Kentucky
People can get the disease by eating food or drinking water contaminated with the parasite. Previous outbreaks have been linked to fresh produce. In 2018, Salads removed from McDonald’s of restaurants in 14 states after federal health officials linked them to dozens of cases of cyclosporiasis, and contaminated lettuce imported from Mexico was it is suspected that he has fallen ill 400 people in the US in 2013.
the disease does not No It spreads from person to person, Gwen Biggerstaff, deputy director of the CDC’s Division of Foodborne, Waterborne and Environmental Diseases, said at a news conference Tuesday: “The source of this outbreak is what we eat or drink, not casual contact with someone who is sick.”
It is typical for cyclosporiasis infections to increase in the spring and summer, but the CDC said Friday that several states had reported a larger increase in cases during the previous two weeks than during the same period last year. At this time last year, only 249 cases had been reported nationally.
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Where do cyclosporiasis infections occur?
Health officials from California to Texas and Florida have reported cases of cyclosporiasis since early May.
Some of the hardest hit areas appear to be in the Midwest and Northeast, including Michigan and New York.
Ohio Department of Health reported 177 cases of cyclosporiasis as of July 2, most of which occurred in June. Dr. Bruce Vanderhoff, director of the Ohio Department of Health, said cyclosporiasis is a “serious illness that can cause dehydration and requires people to seek emergency medical care, and should be taken seriously.”
According to the CDC, people who suffer from the disease range in age from 5 to 88 years.
The total number of cases nationwide is expected to increase, due to the estimated six-week gap between the onset of illnesses and the time they are reported to federal health authorities.
What is causing the outbreak?
That is still not clear. The CDC says it continues to try to identify the source or sources of the recent increase in cyclosporiasis infections.
Researchers do this in part by interviewing those who have gotten sick to find out what they ate. But since Symptoms may appear. Between two days and two weeks or more after a person was infected, they may not remember everything they ate during that period.
Previous outbreaks in the US of cyclosporiasis have been associated with raspberries, basil, cilantro, peas and lettuce, according to the Food and Drug Administration.
Federal health officials are urging doctors to test for the condition and specifically request laboratory testing on stool samples.

How to prevent cyclosporiasis
Cooking produce is an effective way to avoid infection, as heating food to 158 degrees Fahrenheit or higher kills cyclospora.
Public health officials recommend thoroughly rinsing all fresh produce under running water, even those that say they are pre-washed. Do this before eating (if eating raw) or cooking.
It is also important that home cooks respect the rules food safety rulesand that includes washing your hands with soap and water before and after handling fresh produce.
Public health officials do not yet know what foods may be the sources of the recent cases and stress the importance of washing any fresh produce you want to eat.
What to do if you have symptoms
The CDC encourages people to seek medical care if they have symptoms of cyclosporiasis, especially if they develop prolonged watery diarrhea along with fatigue or loss of appetite.
Dr. Kawsar Talaat, a physician at Johns Hopkins Hospital board-certified in pediatrics, internal medicine and infectious diseases, says cyclosporiasis can present in different ways. “If your diarrhea persists for more than a couple of days, see your doctor,” says Talaat.
Some patients may experience a waxing and waning pattern. “If the diarrhea goes away and comes back, it’s another sign of a possible cyclospora infection,” he says. “And again, go see your doctor.”
Talaat says reporting also has epidemiological importance. She says getting tested could help officials understand where the outbreak is coming from and how it is transmitted.
Talaat also explains that standard diarrhea tests cannot diagnose cyclosporiasis. She echoes the CDC’s recommendation that doctors should order specific testing for cyclosporiasis if it is suspected. It’s a stool test, Talaat explains, but it can miss cyclospora if the sample is small or taken at the wrong time in the organism’s life cycle. You may need to submit more than one stool sample to confirm that you have the parasite, he says.
For those suffering from cyclosporiasis, Talaat says there is an effective treatment: the antibiotic trimethoprim/sulfamethoxazole, brand name Bactrim or Septra, taken for seven to 10 days. Although cyclospora is a parasite, not a bacteria, the antibiotic is effective against it.
Talaat says many don’t even realize they have cyclosporiasis. “For most healthy adults, it is usually an infection that goes away on its own,” he says.
But for those who are older, young or immunocompromised, Talaat says they should be proactive and get tested and treated sooner to avoid the risk of hospitalization.
Carmel Wroth contributed to this report.
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