Hamilton County has 23 confirmed cases of cyclosporiasis, up from 17 a week earlier, as Ohio's outbreak doubles and the CDC deploys disease detectives to the state.
The Ohio Department of Health reported 2,650 cyclosporiasis cases statewide on Thursday, through its infectious disease dashboard. That figure doubled from 1,320 the previous Thursday. Ohio is now among the hardest-hit states in the country, trailing only Michigan, according to WLWT.
The Centers for Disease Control and Prevention is sending Epidemic Intelligence Service officers to Ohio for roughly three weeks. The state requested the help through Epi-Aid, a CDC program that supports local health departments during investigations, an Ohio Department of Health spokesperson confirmed.
According to the CDC, the investigators will interview people who tested positive, analyze exposure data to identify common locations and foods and coordinate with federal teams tracing the multi-state outbreak.
Dr. Stephen Feagins, medical director of Hamilton County Public Health, discussed the local situation on WVXU's Cincinnati Edition broadcast on Thursday. Emergency rooms in the county have seen more patients reporting diarrheal illness, according to that broadcast.
Source of the outbreak
Federal investigators continue to focus on shredded iceberg lettuce from Taylor Farms de Mexico as the source. Taylor Farms issued a voluntary recall on Friday, July 17, covering all iceberg lettuce sourced from central Mexico. The recalled product was distributed across 27 states, including Ohio, between June 29 and July 16.
Taco Bell has also been linked to the outbreak. The CDC advises people not to eat any recalled Taylor Farms lettuce served at Taco Bell locations in Indiana, Kentucky, Michigan, Ohio, and West Virginia.
Walmart pulled Taylor Farms-supplied Marketside brand iceberg salad bags (12-oz., 24-oz., 8-oz., and 16-oz. sizes) with "best by" dates from July 18 through August 3. Customers can return them for a full refund or call 1-800-925-6278.
What residents should know
Cyclosporiasis spreads through contaminated food or water, not person to person. Gwen Biggerstaff, deputy director of the CDC's Division of Foodborne, Waterborne, and Environmental Diseases, said in a July 12 briefing: "The source of this outbreak is what we eat or drink — not casual contact with someone who's sick."
Symptoms typically appear about a week after exposure and include frequent watery diarrhea, loss of appetite, weight loss, bloating, nausea and fatigue. Without treatment, they can last a month or longer and may come and go.
Standard stool tests do not detect the parasite. Patients need to ask their doctor to order a cyclospora-specific test. The effective treatment is the antibiotic trimethoprim/sulfamethoxazole (Bactrim or Septra), taken for seven to 10 days.
The Ohio Department of Health warns that delaying diagnosis "could result in dehydration and related complications."
To reduce risk, public health officials advise rinsing all fresh produce under running water, washing hands before and after handling produce, and avoiding recalled Taylor Farms lettuce. Cooking produce to at least 158°F kills the parasite, according to NPR reporting on CDC guidance, though that effectively means avoiding raw consumption of any suspect greens.
By the numbers
Ohio has reported 88 hospitalizations statewide. No deaths have been reported. Ohio's 2,650 cases already exceed the previous largest U.S. cyclosporiasis outbreak on record, approximately 1,500 cases linked to raspberries, according to CNN reporting on CDC data.
The Ohio Department of Health updates its cyclosporiasis dashboard each Thursday afternoon.
