Second cyclosporiasis case linked to outbreak reported in Clark County

A second Clark County resident has tested positive for cyclosporiasis that could be linked to the current multistate outbreak which has infected over 3,000 people across the nation, the Southern Nevada Health District said.

It reported the first case on Monday.

Cyclosporiasis is a foodborne illness caused by the microscopic parasite Cyclospora cayetanensis, which can infect people after they consume food — such as fresh produce — or water contaminated with feces. 

The Health District said sporadic cases of local cyclosporiasis are reported each year, but until Monday’s case, none in Clark County had been linked to the multistate outbreak under investigation. Five cases of cyclosporiasis have been reported in Clark County so far this year, the health district said.

Since Monday, the Centers for Disease Control and Prevention have received reports of at least 4,173 confirmed cases of cyclosporiasis in the U.S., but more than 5,100 were awaiting “further analysis” to confirm whether the illness was contracted within the country. 

Health district officials assured that there has been no surge in cyclosporiasis cases this year. 

The infected local reported Monday had recently traveled to two states associated with the ongoing outbreak during their likely exposure period, officials said. There is no evidence that the second exposure occurred in Clark County or Nevada, but the health district’s investigation is ongoing. 

“This additional case underscores the importance of remaining aware of foodborne illness risks, particularly when an outbreak is affecting multiple states,” said Dr. Cassius Lockett, District Health Officer for the Health District. “Residents should monitor current recall information and contact a health care provider if they develop persistent watery diarrhea, especially after traveling or eating food associated with the outbreak.”

Cases of the intestinal infection have surged in recent days with 41 states reporting infections, including Michigan, which had over 3,000 cases and first reported its outbreak in May. 

The CDC said in an update earlier this month that four states may be in connection with this outbreak: Michigan, Ohio, West Virginia and Kentucky. 

No deaths have been reported, but 308 people have been hospitalized. 

Last week, the U.S. Food and Drug Administration’s traceback investigation found that California-based Taylor Farms supplied shredded iceberg lettuce to Taco Bell locations where some who became sick said they had eaten before their symptoms began. 

Taylor Farms recalled specific iceberg lettuce products sourced from a farm in Mexico, including certain products sold in grocery stores and distributed to restaurants. The FDA initially reported a positive laboratory finding in one lettuce sample, but revealed over the weekend that it was actually a false positive. 

There are no confirmed product samples for Cyclospora, the health district said. Shredded iceberg lettuce from this source was not reported to have been distributed in Nevada, officials added. 

Experts have made general recommendations to avoid eating raw fruits and vegetables to be safe. Michigan health officials said current evidence at the state level points to lettuce or other salad greens as a potential source of the outbreak, Reuters previously reported. 

The health district encouraged residents to not eat lettuce included in the recall, and opt for whole heads rather than prewashed, bagged products when buying iceberg lettuce not included in the recall. 

For whole heads of lettuce, discard the outer two or three layers, separate the remaining leaves and rinse thoroughly under running water to wash the produce. Washing can reduce the presence of cyclospora, but does not eliminate the risk of contamination. Cooking fresh produce is recommended, the health district said. 

“Cyclospora spreads through contaminated food or water after spending over a week in warm moist environmental conditions to become infectious. Because person-to-person spread is unlikely, prevention focuses on avoiding contaminated fresh produce, making national outbreaks a sign of food supply contamination,” Lockett said.

Symptoms of cyclosporiasis typically begin about one week after exposure, but can develop anywhere from two days to two weeks after consuming a contaminated item. 

The Health District said common symptoms include watery diarrhea, loss of appetite and weight, stomach cramps, bloating, gas, nausea and fatigue. Less common symptoms can also show as a low-grade fever and vomiting. 

To help reduce the risk of illness, the health district recommends people wash hands with soap and water before preparing or eating food; rinse fresh fruits and raw vegetables under running water before eating, cutting or cooking them; and avoid consuming food or water that may be contaminated. 

The health district also urges the public to cook food thoroughly to at least 158 degrees Fahrenheit when possible to kill Cyclospora parasites. 

Anyone experiencing prolonged diarrhea or other symptoms should contact their healthcare provider, as cyclosporiasis can be diagnosed through laboratory testing and is treated with antibiotics. 

The SNHD said it conducts routine surveillance for cyclosporiasis and will continue working with state and federal public health partners to investigate reported cases and monitor for any potential connections to the ongoing multistate outbreak.