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Packaged Salad: The Culprit for the Cyclospora Outbreak In Iowa and Nebraska

Update Date: Jul 31, 2013 10:59 AM EDT
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Over the past month, people from the Midwest have been suffering from a massive outbreak of cyclospora, a rare parasite that causes severe bowel movements. Officials had investigated the cases in order to get to the bottom of this widespread infection believing that fresh produce was the source of the parasite. Finally, health officials from Iowa and Nebraska where the infections appeared to have started are reporting that a prepackaged salad mix caused the outbreak. Officials from the other affected states are not sure if the prepackaged salad mix is the source of contamination within their communities.

The cyclospora infection was initially reported in Iowa and Nebraska with 145 and 78 reported cases respectively. It quickly spread to 13 other states and has infected 372 people according to the U.S. Centers for Disease Control and Prevention (CDC). The parasite is expelled from the body through bowel movements, and thus, symptoms of an infection include explosive and watery diarrhea. Other symptoms are increased gas, loss of appetite, stomach cramps, bloating, nausea and fatigue.

"Our goal is to protect Nebraskans, pinpoint the source of the illness and make sure the risk is eliminated," the department's chief of medical officer and director of public health, Dr. Joseph Acierno said according to the Denver Post.  

In order to stop the outbreak from expanding, finding the source of contamination was the key in the investigations that ensued. According to Nebraska officials, the infected salad mix that caused the outbreak involved iceberg lettuce, romaine lettuce, red cabbage and carrots. The officials have not identified the specific brands but are working with the U.S. Food and Drug Administration (FDA) to get a better picture. In Iowa, the officials believe that the same prepackaged salad mix was responsible for the outbreak. However, Iowan officials are optimistic that the threat no longer exists within the state.

In the meantime, officials from other states are not sure if their cases are tied to this same source of produce. The CDC is currently investigating with the FDA to determine if other fresh produce was involved. There have been at least 21 hospitalizations and no fatalities from this outbreak.

"CDC is still actively pursuing all leads and hasn't implicated any single food item as the cause of the outbreak in all states," Sharon Hoskins, the CDC spokeswoman said. "We're still not sure if the cases in all of the states are linked to the same outbreak."

In order to determine the source or sources, the agencies will have to carefully outline the foods that the infected people ate. With almost 400 confirmed cases, this process will be extremely labor intensive. The FDA has created a seven-person team based in Maryland to work with specialists from 10 field offices to get to the bottom of the outbreak.

The states that have been infected include Texas, Wisconsin, Arkansas, Connecticut, Florida, Georgia, Illinois, Kansas, Minnesota, Missouri, New Jersey, New York and Ohio. 

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