In the 52 days since the federal Centers for Disease Control and Prevention (CDC) in Atlanta first announced an outbreak of the single-celled parasite known as Cyclospora cayetanesis, here’s what’s has occurred:

• Confirmed cases have nearly tripled to 600
• Official case counts have required 18 updates
• States in the outbreak have quadrupled to 20
• In two investigative updates, one from state epidemiologists in Iowa and Nebraska and one from the U.S. Food and Drug Administrative (FDA), a salad mix from Taylor Farms de Mexico was linked to the outbreak in those two states, reaching consumers through Olive Garden and Red Lobster restaurants.

But the question that remains unanswered in 8th week of the outbreak asked by the CDC itself is:  “…whether this conclusion applies to, or helps explain, the increase in ill persons with cyclosporiasis in other states.”   In other words, CDC and the states involved are officially stumped, but the investigation continues and so do the case count updates.  It is not yet clear whether health officials are dealing with one big outbreak or several smaller ones. As of August 16, 2013 (5pm EDT), CDC Monday reported 600 cases identified located in: Texas (258), Iowa (155), Nebraska (86), Florida (29), Wisconsin (16), Illinois (11), Arkansas (10), New York (7), Georgia (4), Kansas (4), Missouri (4), Louisiana (3), Connecticut (2), Minnesota (2), New Jersey (2), New York (2), Ohio (2), Virginia (1), California (1), New Hampshire (1), and Tennessee (1). With the latest report, Tennessee became the 20th state in the outbreak. In a handful of the cases, the parasites were acquired outside the state where the ill person is being treated. Most of the illness onset dates have ranged from mid-June through mid-July, but over 250 cases have been added to the count during August. CDC has collected medical information for 440 of the confirmed cases, and 8 percent of those (36 individuals) have required hospitalization. Illnesses involve people from 1 to 92 years of age, with 55 percent being female. The median age is 51 years of age. No deaths have been reported. Food Safety News Friday reported a national case count that exceeds the CDC’s by ten cases. It is based on information from both state and federal sources.