A parasite that causes bouts of “explosive diarrhea” has surfaced in California as a fast-growing outbreak sweeps across the US — with health officials warning the state’s official case count likely captures only a fraction of the true number of infections.
State data show between that between 1 and 10 California cases have been linked to a broader statewide outbreak as authorities continue tracking the spread.
But officials say many infections are never confirmed because some people recover without seeking medical care or getting tested, the parasite requires specialized laboratory testing to detect, and confirmed cases can take about six weeks to be reported.
Most of California’s infections have been tied to international travel rather than the expanding multistate outbreak.
Across the country, at least 2,944 people in 32 states have been sickened, with Michigan bearing the brunt of the outbreak.
The state has reported 1,562 infections, roughly 31 times the approximately 50 cases it typically records in a year, and at least 44 people have been hospitalized.
Investigators are examining whether contaminated food is driving the spike, but they have not identified a specific produce item, supplier or grower responsible for the outbreak.
Cyclospora, the parasite behind the illness known as cyclosporiasis, is typically spread through food or water contaminated with feces.
Previous outbreaks have been traced to imported fresh produce, including raspberries, basil, snow peas, mesclun lettuce and cilantro.
According to the CDC, the illness can cause severe gastrointestinal symptoms, including watery diarrhea “with frequent and sometimes explosive bowel movements.”
Other symptoms include nausea, vomiting, abdominal pain, bloating, fatigue, loss of appetite and weight loss.
Symptoms usually begin about one week after infection, although they can appear anywhere from two days to two weeks later, making it more difficult for investigators to determine where someone was exposed.
The CDC recommends treating cyclosporiasis with the antibiotic trimethoprim-sulfamethoxazole, commonly sold as Bactrim, Septra and Cotrim, over a 10-day course.
As investigators continue searching for the source of the outbreak, some Taco Bell restaurants have temporarily removed fresh ingredients from their menus as a precaution.
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Locations, including some in Metro Detroit, posted notices telling customers they were temporarily unable to serve lettuce, cilantro, onions, pico de gallo and guacamole because of a nationwide recall while health officials respond to the increase in cyclosporiasis cases.
Restaurants in outbreak hot spots, including Michigan and Ohio, have also pulled raw lettuce, onions, cilantro-onion mix, pico de gallo and guacamole from their menus.
However, neither the CDC nor the Food and Drug Administration has linked Taco Bell to any reported illnesses.
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