This summer’s surge in reports of illnesses due to the parasite Cyclospora in Texas has prompted health officials in the Lone Star State to go looking for a common source. The Texas Department of State Health Services (DSHS) has received reports of 182 Cyclosporiasis cases from around the state this year. Last year, 200 Cyclospora cases in Texas were found by DSHS to be associated with cilantro from the Puebla region in Mexico. This year, DSHS on June 22 began encouraging healthcare providers to test patients for Cyclospora if they have diarrheal illness lasting more than a few days or diarrhea accompanied by severe anorexia or fatigue. The illnesses have been reported in 35 of the 254 Texas counties, with the largest concentration being 77 cases in Travis County where the city of Austin located. Health officials have been unable to assign 15 illnesses to a specific county. Cyclosporiasis is an intestinal illness caused by consuming food or water contaminated with the Cyclospora parasite. The major symptom is watery diarrhea lasting a few days to a few months. Additional symptoms may include loss of appetite, fatigue, weight loss, abdominal cramps, bloating, increased gas, nausea, vomiting and a low fever. People who think they may have a Cyclospora infection should contact their health care provider. Diagnosis of cyclosporiasis requires submission of stool specimens for “Ova and Parasite” testing with additional specific orders for Cyclospora identification. A single negative stool specimen does not exclude the diagnosis; three specimens are optimal. DSHS recommends thoroughly washing fresh produce, but that may not entirely eliminate the risk because Cyclospora can be difficult to wash off. Cooking will kill the parasite. Although no common exposure source for this increase in cases has yet been identified, past outbreaks in the U.S. have been associated with consumption of imported fresh produce, including fresh cilantro, pre-packaged salad mix, raspberries, basil, snow peas, and mesclun lettuce. It was two years ago that a Cyclosporiasis outbreak linked to imported salad mix and fresh cilantro sickened 631 people in 25 states.
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