Michigan reports first US deaths in cyclosporiasis outbreak

Michigan reports first US deaths in cyclosporiasis outbreak A cyclosporiasis outbreak that has grown into the largest on record in the United States has caused its first known deaths, two people in Michigan, the state's health department said on Monday (Aug 3). Cyclosporiasis, an intestinal illness caused by the Cyclospora parasite, is generally not life-threatening. Michigan, citing medical records, said the two who died had significant underlying health conditions that may have been affected by the disease and related dehydration. An FDA investigation linked the outbreak, now in nine states, to iceberg lettuce sourced from privately held Taylor Farms operations in central Mexico and served at Yum Brands-owned Taco Bell. The lettuce has been recalled, but authorities are still seeking other potential sources. Epidemiologists suspect multiple outbreaks, and it was not immediately clear whether the people who died were sickened from Taylor Farms iceberg lettuce served at Taco Bell restaurants, or from another yet to be identified source. US cyclosporiasis cases have climbed to record levels this year, with the current outbreak among the largest caused by foodborne illness in recent US history. It has also hurt consumer confidence, lowering lettuce sales and visits to restaurant chains such as Sweetgreen and Chipotle. The US Centers for Disease Control and Prevention (CDC), whose surveillance lags state reporting by several weeks, has recorded 6,707 laboratory-confirmed cases nationwide as of Jul 28, along with more than 11,500 suspected cases not yet confirmed through laboratory testing. State counts run higher because the CDC excludes probable cases. MICHIGAN HARDEST HIT Michigan, the hardest-hit state, has recorded 11,234 cases as of Monday, up 461 from Friday, with 193 hospitalised, health department data shows. The large number of cases, gaps in reporting and people's difficulty recalling what they ate have made it harder for investigators to determine which foods, beyond Taylor Farms lettuce, may have contributed to the outbreak, local Michigan health officials said. "We have one clear implicated food, but it doesn't explain everything," said Susan Ringler Cerniglia, spokesperson for the Washtenaw County Health Department, where 875 cases have been reported. Mixed messaging from the US Department of Health and Human Services had also complicated the response, she said. Health Secretary Robert F Kennedy Jr has said the outbreak is under control. "Leadership is saying things that don't really fit with what the data is telling us, and that's very, very problematic," Ringler Cerniglia said. "The secretary is saying this is under control and it's all good while you have case counts exploding." HHS said on Monday it was aware of the deaths. Michigan's Wayne County, which includes Detroit, has the highest number of cases at 1,379, state data showed. Cases have been rising steadily across the US in recent weeks, according to the CDC. Symptoms include severe diarrhoea, which can lead to dehydration, nausea and other gastrointestinal issues. HEALTH AGENCY CUTS MAY HAMPER RESPONSE Former CDC officials and food safety experts say cuts across federal health agencies have complicated the government's ability to respond to foodborne outbreaks. Cyclospora is harder to track than many foodborne pathogens because, unlike bacteria, it cannot be grown in the lab or easily genome-mapped to trace an outbreak, said Dr Paul Bollyky, a professor of infectious disease at Stanford Medicine. That makes standard epidemiology and contact tracing more difficult and labour-intensive, he said, work not made any easier with understaffing at public health departments. "It certainly doesn't help matters to have underfunded or understaffed public health departments," Bollyky said, adding that budget cuts and turnover at the CDC would make outbreaks like this harder to trace and control. The scale of the outbreak raises broader questions about the safety of the US food supply, he said. "Anytime you have over 10,000 people infected with a foodborne pathogen, you do have to wonder whether this is a canary in the coal mine."