Cyclospora Parasite Outbreak in Texas

Washing vegetables - CDC-James Gathany
Photo: Gathany

A parasite races through Texas with such velocity that health officials warn shoppers to exercise extra caution and thoroughly wash store-bought fruits and vegetables.

The microscopic organism making the rounds is called cyclospora. It has swept through the Lone Star state before and those outbreaks were linked to imported fresh produce contaminated with fecal matter.

Health officials have not yet identified the source of the current outbreak but so far there have been 90 cases—72 of them just in the past two weeks. Travis County has been hit the hardest, with 50 of those 90 confirmed cases, KXAN-TV reported. Dallas County has had five cases, Harris County three, and Williamson County had one, according to KEYE-TV.

Several theories about the outbreak’s root cause have emerged. City of Austin Health & Human Services Epidemiologist Jeff Taylor told KXAN-TV that this has only been “hitting adults,” leading Travis County to investigate weddings and receptions held sometime in the last week of May and into early June in search of a common thread.

Chief medical officer at St. David’s South in Austin, Albert Gross, attributed the Austin area’s healthier lifestyle to the higher numbers of those infected, meaning they eat more fresh fruits and vegetables in Travis County.

Other health workers suspect that the transport and distribution of the produce has something to do with why Travis County has been so affected.

Gross also suggested that this may also be acquired through contaminated water.

“I suppose, with all the rain and flooding we’ve had around here it could be connected to that too,” he told KEYE-TV.

In Galveston County, high levels of fecal bacteria were reported at some beaches. Health department officials blamed it on the rains from tropical storm Bill and the Memorial Day floods which carried waste that eventually dumped into the Gulf of Mexico, KHOU-TV reported.

The most likely culprits in the cyclospora outbreak, however, are imported fresh fruits and leafy green vegetables, including raspberries, snow peas, and mesclun lettuce, which is a mix of greens. They have all been blamed for outbreaks in the U.S. since the 1990s.

In 2014, Texas reported 133 cases of cyclospora, the highest in the nation. In 2013, cilantro and raspberries imported from the Puebla region of Mexico erupted into 277 cases, according to KXAN-TV. In both years, Texas investigators linked Mexican-grown cilantro to the outbreaks.

The Centers for Disease Control and Prevention (CDC) say that people become infected with cyclospora by ingesting sporulated oocysts, an infective form of the parasite. This most commonly occurs when food or water tainted with feces is consumed. Once infected, the resulting intestinal infection is called cyclosporiasis. The incubation period before experiencing symptoms is approximately 7-10 days.

Since the parasite infects the small intestine, it often causes watery stools, with frequent, sometimes explosive diarrhea. Other common symptoms include loss of appetite, weight loss, dehydration, stomach cramps/pain, bloating, increased gas, nausea, and fatigue. Vomiting, body aches, headache, fever, and other flu-like symptoms may be noted. Some people who are infected show no symptoms, according to the CDC.

Because of the way the parasite is consumed, direct person-to-person transmission is unlikely. The cyclosporiasis infection can last several days, several weeks or even longer. Symptoms can come and go, too. Relapses are common as is feeling very tired.

Taylor said that diarrhea is the main symptom and can last about a week. He told KXAN-TV: “A person can start to feel better and then get another series of diarrheal episodes.”

Although indigenous to tropical and subtropical regions, foodborne outbreaks of cyclosporiasis in the U.S. have been traced to imported fresh produce. Commercially frozen and canned produce have never been sources.

For now, officials emphasize rinsing off produce thoroughly, even though it will not remove all the spores. The good news is that cyclospora is not life threatening.

Taylor cautioned, it may still be early in the outbreak.

Follow Merrill Hope on Twitter @OutOfTheBoxMom.