Indiana’s neighboring states see cases of infection linked to fresh produce

A stomach bug outbreak in some Midwest states has been linked to fresh fruits and vegetables.

Posted on July 30, 2013 at 1:00 a.m. | Updated on July 30, 2013 at 10:56 a.m.

ELKHART — A parasite that could be on fresh produce has infected 358 people nationwide as of Monday, July 29, according to the Centers for Disease Control and Prevention. Four cases of cyclospora infection caused by the parasite have been reported in Illinois and one case in Ohio as of Monday.

Past outbreaks of cyclospora infection in the United States, most recently in 2004, were caused by eating raw fruits and vegetables contaminated by feces. The source of the current outbreak has not yet been identified. The most common symptom of the infection is persistent diarrhea. Other symptoms include a loss of appetite, weight loss, cramping, bloating, increased gas, nausea and fatigue.

A CDC spokesperson said Monday that there is no way to predict whether the parasite will reach Indiana residents.

Dr. Daniel Nafziger, health officer at the Elkhart County Health Department, said he does not recommend that people stop eating fresh produce. Instead, he said, wash all produce carefully.

“If you look at the public impact of not eating fresh vegetables and fruit, that’s going to be worse for people than the small chance of contracting those parasites,” Nafziger said Monday.

The best thing to do to avoid sickness, Nafziger continued, is to rinse fresh produce with water before eating it. Fruits and vegetables from a home garden are probably safer, he added, because the grower has more control over substances touching the food.

“The most important thing for folks in our community to know (about cyclospora infection) would be, if you develop very bad diarrhea, be sure to see your physician,” Nafziger said. “Make sure your physician knows that this could be a possible cause.”

Nafziger said diagnosing the infection could be challenging since it’s not cost-effective for physicians to test everyone experiencing diarrhea.

“The most common treatment for diarrhea would be supportive care,” Nafziger said. “By and large, physicians don’t test for parasites unless the person has a travel history. For the average person living in Indiana, physicians may not be testing for parasites.”

If the infection is found, it can be treated with antibiotics, according to the CDC. Twenty-one people with the infection have been hospitalized as of Monday. Those who have other health conditions or a weak immune system are more likely to be hospitalized.

Thomas Duszynski of the Indiana State Department of Health said Monday that cyclospora infection is a reportable case in Indiana, meaning that physicians are required to report cases to the local health department. The local health department will then work with the state health department and the CDC to monitor the case.

Duszynski said he doesn’t want to speculate on the risk for Indiana residents, but added that the state is watching for potential cases.

“This time of year there are more enteric diseases like salmonella and E. coli reported,” Duszynski said Monday. “People are eating more produce, they are swimming in water that could be contaminated.”

He said that if cases were found in Indiana, the state would be on active surveillance, collecting and distributing updated information to local health care providers.

The CDC has a map of confirmed cases on its website, www.cdc.gov/ /parasites/cyclosporiasis/outbreaks/investigation-2013-maps.html.

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