According to an update posted Tuesday, August 4, 2015, as of August 3, the U.S. Centers for Disease Control and Prevention (CDC) had been notified of 384 ill persons with confirmed Cyclospora infection from 26 states so far this year. Most of them (226 people, or 59 percent) experienced the onset of illness on or after May 1, 2015, and did not report international travel prior to developing symptoms. Clusters of illness linked to restaurants or events have been identified in Texas (212 cases), Wisconsin (8 cases), and Georgia, CDC stated. The CDC update also noted the following:

• Cluster investigations are ongoing in Texas and Georgia.
• Cluster investigations in Wisconsin and Texas have preliminarily identified cilantro as a suspect vehicle.
• Investigations are ongoing to identify specific food items(s) linked to the cases that are not part of the identified clusters.
• Previous U.S. outbreaks of cyclosporiasis have been linked to imported fresh produce, including cilantro from the Puebla region of Mexico. Read the related FDA Import Alert issued July 27, 2015.
• Consumers and retailers should always follow safe produce handling recommendations.
• More information about Cyclospora can be found on CDC’s Cyclospora pages.

The U.S. Food and Drug Administration issued an Import Alert on July 28 for cilantro imported from the Mexican state of Puebla, citing fecal contamination in certain fields and processing and packing facilities which American and Mexican public health investigators had inspected. “Conditions observed at multiple such firms in the state of Puebla included human feces and toilet paper found in growing fields and around facilities; inadequately maintained and supplied toilet and hand washing facilities (no soap, no toilet paper, no running water, no paper towels) or a complete lack of toilet and hand washing facilities; food-contact surfaces (such as plastic crates used to transport cilantro or tables where cilantro was cut and bundled) visibly dirty and not washed; and water used for purposes such as washing cilantro vulnerable to contamination from sewage/septic systems,” the alert stated. According to FDA, CDC and state public health officials have identified annually recurring outbreaks (in 2012, 2013, and 2014) of cyclosporiasis in the U.S. associated with fresh cilantro from the state of Puebla. CDC has reported that, as of last August, 304 people were sickened in the 2014 outbreak. And, in 2013, a cyclosporiasis outbreak linked to imported salad mix and fresh cilantro sickened 631 people in 25 states.

(To sign up for a free subscription to Food Safety News, click here.)