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Cyclosporiasis in The United States

The following background information on Cyclosporiasis in the United States is abstracted from Gideon www.GideonOnline.com and the Gideon e-book series [1]   (Primary references are available on request)

Cyclosporiasis is the least common reportable protozoan infection in the United States.  In 2008, the reported disease rate among 10 states was 2.25 per 100,000 population.

The true incidence of food-borne cyclosporiasis in the United States has been estimated at 11,407 to 19,808 cases per year (15 hospitalizations), accounting for 0.1% of all food-borne illness. Approximately 42% of cases are imported.

1,110 individual cases of cyclosporiasis were reported during 1997 to 2008.  849 (76.5%) of the cases occurred in seven states, including 498 (44.9% of total) in Florida.  51.7% of cases with known travel history were autochthonous. {p 21471951}

No fatal cases were reported during 1998 to 2006.

Nine food-borne outbreaks (325 cases) of cyclosporiasis were reported during 1998 to 2002; 0 in 2007; 3 (66 total cases) in 2008; 1 (8 cases) in 2009; 0 in 2010.  Eleven   outbreaks (3,533 cases) related to imported food were reported during 1996 to 2014.

Reported disease rates have increased somewhat since 2012.  See graph:

 

Chronology of reported outbreaks:

  1. Outbreak (20 cases) among health-care workers at a hospital in Chicago, Illinois. Related to contaminated water
  1. Outbreak at a country club in New York State
  1. Outbreak in Florida associated with consumption of contaminated fresh raspberries.
  1. Multiple outbreaks (1,465 cases, 978 confirmed) in at least 15 states including New York (307), Florida (220), Massachusetts (170), New Jersey (103), South Carolina (38). Vehicles included raspberries and other fruit. The raspberries were imported from Guatemala and were thought to have been contaminated by water used in pesticide sprays.
  1. Outbreak (56 cases) at a hotel in Texas.
  1. Outbreaks (25 event-associated case clusters encompassing 370 cases) reported from eight states (California, Florida, Maryland, Nebraska, Nevada, Rhode Island, New York and Texas) and Canada (Ontario).
  1. Outbreaks (26 clusters encompassing 228 cases) reported from Virginia, Washington DC and Baltimore. Fresh basil and basil-pesto sauce implicated as the source. An additional 20 possible clusters (75 cases) were under investigation at the time.
  1. Outbreaks (over 1,700 cases during a five-month period) associated with raspberries, mesculun lettuce and basil. Fresh raspberries, imported from Guatemala were implicated in 19 of 21 outbreaks/ 70 sporadic cases confirmed in the United States and Canada during this period.
  1. Outbreak (57 cases) at a wedding in Massachusetts was associated with contaminated berries.
  1. Outbreaks (62 cases in 2outbreaks) in Missouri were associated with fresh basil, grown in either the United States of Mexico.
  1. Outbreak (54 cases) at a wedding in Philadelphia, Pennsylvania was ascribed to imported (Guatemalan) raspberries in a wedding cake. This was the fifth year that outbreaks associated with Guatemalan raspberries had occurred in North America during the spring months.
  1. Outbreak (96 cases) at a residential facility in Pennsylvania was associated with contaminated raw snow peas imported from Guatemala
  1. Outbreak (90 cases) in Illinois and Texas was caused by contaminated basil and spring mix salad.
  1. Outbreak (70 cases) in Florida
  1. Outbreak (100 cases) in Georgia among persons who had visited an aquarium
  1.  Outbreak (643 cases) involving multiple locations was related to contaminated bagged salad imported from Mexico.
  1. Outbreak (202 cases, including 49 in Texas) involved multiple locations.
  1. 2015. Outbreak (72 cases) in Texas
  1.  Outbreak (495 cases) in 30 states was related to ingestion of contaminated cilantro imported from Mexico.
  1.  Outbreak (72 cases) in Texas.

Reference:

  1. Berger SA. Cyclosporiasis: Global Status, 2017. Gideon e-books. https://www.gideononline.com/ebooks/disease/cyclosporiasis-global-status/

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