November 23, 2014

States working together to find cause of cyclospora outbreak

While the number of new cyclospora cases being confirmed is slowing, the effort to find the source of the parasite that’s caused all the trouble is not. Iowa Health Department Medical Director, Patricia Quinlisk, says Iowa had over 100 cases as of Thursday and Nebraska and Texas are also seeing large numbers of cases with some scattered cases in other states.

Quinlisk says Iowa is working with the other states to try and nail down the source. “In fact we’re having daily conference calls with all the states that’re involved, the Centers for Disease Control and the Food and Drug Administration. Because when you get something with multiple states and thinking that it’s a food that hit the basic markets across the states, you have to get all of the federal as well as the state people involved,” Quinlisk says.

It’s believed the parasite that caused the cyclospora cases was spread through contaminated fruit or vegetables. Dr. Quinlisk says having multiple states involved is a mixed blessing.

“Sometimes it makes it a little bit harder because it’s more complex and there are more people involved,” according to Quinlisk. “But on the other hand, sometimes it can make it easier because the same kind of foods for example that Iowans are eating might be different that Texans are eating. And therefore you find out what food they have in common — which might be easier to see across different states and slightly different cultures.”

Those who have been confirmed with cyclospora get a 15-page questionnaire from health officials. “We go through everything that they might have eaten — that they put in their mouths during that incubation period which is two weeks long. And then we also ask them things like: what grocery stores do you go to, what restaurants have you gone to, do you travel, have you been out of the country, did you go to other states, have you been to any conferences, what about church suppers,” Quinlisk explains.

“All of those questions we ask to try and find out what the possible common exposure that all these people who got sick may’ve had. The two week lag in the incubation of the disease and then the delay in people seeking out treatment means investigators may find people who can’t pull up the answers right away.

“We’re actually having to go back to people and ask them what they ate in early June. I would never be able to remember that,” Quinlisk says. “So, we often will then say ‘what would you have been likely to do?’ What’s the, for example, grocery store that you go out to most often? Do you go out to a certain restaurant routinely?”

Quinlisk says there’s no evidence to tie the problem to any fresh fruit or vegetables grown in Iowa. At least six people have been hospitalized in Iowa and some are still reporting the diarrhea that is one of the main symptoms of the disease.

Quinlisk says they believe they have discovered most of the cases in Iowa at this point, and the fact that there are not any new cases developing indicates the parasite was introduced by something that is now no longer here.