The outbreak of the protozoan parasite, Cyclospora, continues to affect more people in more states in the Midwest. There are scores of people infected in Nebraska and Texas, and other states in this part of the country are beginning to report cases.

In Iowa alone, 109 cases have been confirmed as of July 19.

On the Saturday, July 20 broadcast of Dispatch Radio, I had the opportunity to learn a little more about the outbreak in the Hawkeye State with Iowa Dept. of Public Health (IDPH) Medical Director and State Epidemiologist, Dr. Patricia Quinlisk. Listen to the podcast here (interview starts at the 26:30 mark).

Concerning the source of the outbreak, the Iowa Medical Director said the reason they believe it’s probably a vegetable and not a fruit, is based on lengthy and extensive interviews with people that have been affected.

“Basically we’re finding that people did not have fruits in common, but they did have some vegetables and vegetable products in common. So now we’re focusing on these vegetables.

“There’s about a handful of vegetables that we’re looking at, but we haven’t narrowed it down any farther. These are vegetables that get on the market for everybody. So there on the market for an individual citizen, a restaurant, a group of people, so at this point, the people that do the food investigations are trying to figure out what got onto our markets.”

Dr. Quinlisk said she is optimistic that investigators will be able to figure out the source of the outbreak, at least at a certain level. However, will they may not be able to pinpoint the exact farm where the tainted veggies came from.

Anyone is at risk for getting this infection, Quinlisk points out; however, the very young, very old and the immunocompromised have the greatest risk for serious infection.

Concerning the treatment of Cyclospora, she says the treatment is effective; however, it’s not really the medication you might expect. “It’s sort of unusual, you’d think with a parasitic infection, you would give an antiparasitic medicine, but in fact for some reason that we don’t understand, we give an antibacterial antibiotic called trimethoprim-sulfamethoxazole, a relatively common antibiotic.”

With outbreaks in Nebraska and Texas, I asked Dr. Quinlisk if they were able to establish any connection between the outbreaks.

She said when the IDPH first saw the cases, they put out alerts to the public, health care providers in Iowa and health departments in neighboring states and the CDC.

“We heard back from Nebraska very quickly that they were seeing something too. Almost from the very beginning we’ve been working with Nebraska. We seemed to have the problem at about the same time.

“We know that a lot of the food distribution systems for Iowa and Nebraska are the same, we believe ours are related. Whether or not Texas is related or not, they are still investigating that.”

Since, according to Dr. Quinlisk, the likely source is fresh vegetables, she believe the outbreak is coming to an end. “Even though we’re getting cases everyday still being reported to us, the people who are being reported to us are unfortunately, people who have been sick for a month or so, and are now just hearing about it in the media, they go to their doctor , get tested and gets reported to us.

“These are still people who started getting ill back in June, we’ve had almost nobody who got sick in July. So we do believe since it’s from a fresh vegetable, these people were eating it in early to mid June and that means it’s going to be off our market by now because fresh vegetables just don’t last this long.”

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