Authorities Identify Food That May Be Causing the “Explosive Diarrhea” Outbreak as Cases Top 2,600

• Food linked to Cyclospora outbreak under investigation.
• Cases surpass 2,600.
• Learn how to prevent infection.

Cases of a parasitic infection commonly associated with so-called «explosive diarrhea» continue to rise in Michigan, with more than 2,600 confirmed infections. Health officials are focusing their investigation on a possible source: lettuce and other leafy salad greens.

The Michigan Department of Health and Human Services (MDHHS) reported Monday that 2,642 people have been diagnosed with cyclosporiasis since June 22, an unprecedented number for a state that typically records only 40 to 50 cases annually.

At least 44 people have been hospitalized, although investigators have not yet identified a specific product, grower, or supplier responsible for the outbreak.

Cyclospora Outbreak in Michigan: Causes, Symptoms, and Prevention

Lettuce Emerges as the Leading Clue

Health officials said the investigation remains ongoing, but evidence gathered so far points to lettuce and leafy salad greens as the most likely source of contamination.

However, they emphasized that other foods have not yet been ruled out.

«Although we have not identified a specific product as the source of the outbreak, we want to share what we’ve learned so far so Michigan residents can take steps to protect themselves and their families,» said Dr. Natasha Bagdasarian, chief medical executive for the MDHHS, in a statement.

«Preliminary information has shown that lettuce is a common food item repeatedly identified during the investigation. We will continue to provide updates as we learn more.»

The outbreak was first detected on June 29, when the Monroe County Health Department reported an unusual cluster of illnesses.

Since then, investigators have completed more than 1,000 epidemiological interviews to determine what foods patients consumed before becoming ill.

What Is Cyclosporiasis and How Is It Spread?

Cyclosporiasis is an intestinal infection caused by the parasite Cyclospora cayetanensis, which is typically transmitted through food or water contaminated with human fecal matter.

According to the Centers for Disease Control and Prevention (CDC), the illness is not generally spread from person to person.

In previous outbreaks across the United States and Canada, the parasite has been linked to several fresh produce items, including:

• Salad mixes and salad kits
• Lettuce
• Fresh cilantro
• Basil
• Raspberries
• Snow peas
• Green onions

Michigan officials also said there is currently no evidence linking the outbreak to recreational exposure to contaminated water.

Symptoms May Take Up to Two Weeks to Appear

Although the illness has become widely known for causing «explosive diarrhea,» health experts stress that it can produce a variety of other symptoms.

«The diarrhea can be very frequent and quite severe. People often describe it as explosive diarrhea,» said Dr. Kiran Joshi of the Cook County Department of Public Health.

«There can also be many other abdominal symptoms, including loss of appetite, nausea, vomiting, and sometimes a mild fever. These symptoms can certainly cause significant discomfort. The good news is that it’s generally not life-threatening, but if left untreated, it can last for a month or longer, so it’s very important to seek treatment.»

Common symptoms include:

• Persistent watery diarrhea
• Abdominal cramps and pain
• Bloating
• Nausea and vomiting
• Loss of appetite
• Fatigue
• Mild fever in some cases

Experts note that one characteristic of cyclosporiasis is that symptoms may not appear for several days to as long as two weeks after exposure, unlike many other foodborne illnesses.

«The first symptoms are explosive diarrhea, bloating, cramping, and loss of appetite,» said Dr. Sharon Welbel, chief of infectious diseases at Cook County Health.

«Some people experience a mild fever, but that’s fairly uncommon.»

Dr. Irfan Hafiz, an infectious disease specialist with Northwestern Medicine, said the illness also tends to last longer than many other gastrointestinal infections.

«The symptoms are somewhat milder, but they last longer. Norovirus hits you hard and then it’s over. This just lingers for a much longer period,» he told NBC Chicago.

Officials Urge Extra Caution With Salad Greens

As the investigation continues, health authorities recommend strengthening food safety practices, particularly when consuming leafy vegetables.

Recommendations include:

• Buy whole heads of lettuce instead of prepackaged salad mixes.
• Remove the outer two or three leaves.
• Thoroughly rinse the inner leaves under running water.
• Cook vegetables to at least 70°C (158°F) whenever possible.
• Peel fruits and vegetables with removable skins.
• Wash your hands thoroughly before handling food.

Officials also cautioned that washing alone does not guarantee removal of the parasite, as Cyclospora can resist many common chemical disinfectants.

What to Do If You Develop Symptoms

The MDHHS recommends that anyone experiencing persistent watery diarrhea consult a healthcare provider and specifically request testing for Cyclospora, since routine stool tests may not detect the parasite.

According to the CDC, the recommended treatment is the antibiotic trimethoprim-sulfamethoxazole (TMP-SMX), sold under brand names including Bactrim, Septra, and Cotrim, typically taken for about 10 days.

In addition to medical treatment, healthcare professionals recommend staying well hydrated and getting adequate rest to support recovery.

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SOURCE: ABC News / Telemundo