Cyclosporiasis continues to rise as state says most lettuce, salad greens safe to eat

A total of 279 people have been hospitalized with cyclosporiasis, up from 193 reported last Thursday.

Earlier in the week, the department reported that two individuals had died from cyclosporiasis.

“Both individuals had significant underlying health conditions that may have been impacted by cyclosporiasis and dehydration,” the department said, noting that the parasitic infection is not typically life threatening.

Cyclosporiasis has been detected in 72 counties. Wayne, Oakland, Washtenaw, Ingham and Genesee counties have the highest number of reported cases.

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The state health department announced on July 1 that it was investigating the outbreak, which is caused by the microscopic Cyclospora parasite and spreads through contaminated food or water. Symptoms can emerge two days to two weeks after exposure and include watery diarrhea, loss of appetite, weight loss, cramping, bloating, increased gas, nausea and fatigue.

On Thursday, the state dropped its recommendations for residents to purchase whole heads of lettuce rather than bagged salad greens, and to remove their outer layers, wash the inner leaves and cook them when possible. 

As new case reports slow and emergency department visits decline, the state is returning to its recommendation that residents observe basic food safety practices such as handwashing, separating foods that could contain harmful germs like raw meat or unwashed fruits and vegetables during preparation, and cooking food to the proper temperature to kill germs.

On July 17, Taylor Farms de Mexico issued a voluntary recall of iceberg lettuce products sourced from central Mexico. On July 24, the U.S. Food and Drug Administration said it is continuing its investigation into infections linked to iceberg lettuce from the region along with the Centers for Disease Control and Prevention and state and local health departments.

The Michigan Department of Health and Human Services says its data suggests that the majority of contaminated produce is likely no longer available for consumption, though it advises residents to continue to avoid recalled lettuce.

The CDC is issuing weekly updates on cyclosporiasis cases, documenting 10,468 cases as of Aug. 4, with 12,255 cases – mostly from Michigan – yet to be confirmed through laboratory testing.

The federal agency notes its reports do not include probable cases, which may result in lower case counts than those reported by state health departments. 

The CDC is investigating multiple clusters of Cyclospora cases including a multistate outbreak tied to iceberg lettuce affecting 15 states: Arkansas,  Illinois, Indiana, Iowa, Kansas, Kentucky, Michigan, Missouri, Nebraska, New Hampshire, North Carolina, Ohio, Oklahoma, Pennsylvania and West Virginia.

Michigan remains the hardest hit state, with the CDC recording more than 4,000 cases.