Program Schedule

Cyclosporiasis 2013: Collaborative Outbreak Investigations

Session: Poster Abstract Session: Public Health
Saturday, October 11, 2014
Room: The Pennsylvania Convention Center: IDExpo Hall BC
  • ID Poster Presentation - Gensheimer - Sep 2014.pdf (353.4 kB)
  • Background:   Cyclospora cayetanensis is a parasite that can cause a prolonged or remitting/relapsing diarrheal illness.  U.S. outbreaks of cyclosporiasis, since the mid-1990s, have been linked to various types of imported fresh produce.  In late June 2013, public health officials in Iowa and Nebraska began receiving reports of laboratory-confirmed cases of cyclosporiasis not associated with international travel.  A total of 631 such cases, with onset dates during June–August, were reported by 25 states; 497 (79%) of the cases were from Iowa, Nebraska, and Texas.

    Methods:      FDA, State and Local officials reviewed distribution records for pertinent food items identified in epidemiologic investigations.  An environmental investigation was conducted at the processing facility and farms.

     Results: In Iowa and Nebraska, restaurant-associated cases were linked to a bagged salad mix (iceberg and romaine lettuces, carrots, and red cabbage) from Taylor Farms, Guanajuato, Mexico.  The environmental investigation conducted by FDA, in conjunction with CDC, industry and Mexican officials, at the processing facility and selected growing areas in Guanajuato found no clear sources of Cyclospora or routes of contamination at the locations that were visited; environmental samples collected by FDA, CDC and Taylor Farms tested negative for Cyclospora. Epidemiologic and traceback investigations for several case clusters in Texas pointed to cilantro harvested from Puebla, Mexico, although a single processor or farm could not be identified.

    Conclusion:  In 2013, at least two unrelated outbreaks of cyclosporiasis occurred, which were linked to different types of produce from different regions of Mexico. As with previous outbreaks, the sources and routes of contamination of these food items were not identified.  To reduce the risk for future outbreaks of cyclosporiasis, investigations to determine what leads to contamination of produce and novel molecular methods to detect and link cases to each other and to food vehicles/sources are needed. Mexico is working with the firms to identify any areas for concern and take necessary corrective actions.


    Kathleen Gensheimer, MD, MPH1, Kari Irvin, MPH2, Francisca Abanyie, MD, MPH3, Jenny Beal, MPH2, Matthew Wise, PhD4, Socrates Trujillo, BS2, Michael Beach, PhD4, Palmer Orlandi, PhD5, Ian Williams, PhD3,4, Rebecca Hall, MPH3, Monica Parise, MD4, Angela Hardin, MPH2, Katie Vierk, MPH2, Tracy Duvernoy, DVM2, Susan Lance, DVM2, Barbara Herwaldt, MD6, Susan Montgomery, DVM4, Patricia Quinlisk, MD7, Kristin Obbink, DVM, MPH7, Tom Safranek, MD8, Linda Gaul, PhD, MPH9 and Venessa Cantu, MPH9, (1)Coordinated Outbreak Response and Evaluation Network, FDA, College Park, MD, (2)FDA, College Park, MD, (3)CDC, Atlanta, GA, (4)Centers for Disease Control and Prevention, Atlanta, GA, (5)FDA, Silver Spring, MD, (6)United States Public Health Service, Centers for Disease Control, Atlanta, GA, (7)Iowa Department of Public Health, Des Moines, IA, (8)Nebraska Department of Health, Lincoln, NE, (9)Texas Department of State Health Services, Austin, TX


    K. Gensheimer, None

    K. Irvin, None

    F. Abanyie, None

    J. Beal, None

    M. Wise, None

    S. Trujillo, None

    M. Beach, None

    P. Orlandi, None

    I. Williams, None

    R. Hall, None

    M. Parise, None

    A. Hardin, None

    K. Vierk, None

    T. Duvernoy, None

    S. Lance, None

    B. Herwaldt, None

    S. Montgomery, None

    P. Quinlisk, None

    K. Obbink, None

    T. Safranek, None

    L. Gaul, None

    V. Cantu, None

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