The Iowa Department of Public Health, CDC and local public health agencies are investigating an outbreak of an intestinal illness caused by Cyclospora (a rare parasite). As of July 16, 81 cases of Cyclospora infections have been reported to the IDPH, and almost all have been identified through testing at the State Hygienic Lab (SHL). Case counts are updated at approximately 10 a.m. each day. Previous outbreaks have been associated with the consumption of fresh produce, including fresh fruits and vegetables. People become infected with Cyclospora by consuming food or water contaminated with the parasite. The current investigation, however, indicates that fresh vegetables, not fruit, may be the source of the illness.

The source of this outbreak is unknown at this time, however progress is being made. IDPH is working with local public health agencies to interview individuals who are ill to determine if there is a common food exposure that would indicate the source of illness. Cluster investigations continue, which ask questions of both the ill person and their family and friends who are not ill, to determine what the well people did not eat. Onset dates of the illness suggest the ill people had eaten the contaminated food in mid-June. This is a very good indication the food which was the source of the outbreak has already been consumed or discarded, since fresh vegetables have a limited shelf life. At no time was an Iowa-grown fruit or vegetable suspected to be the cause of the outbreak.

Cyclospora infection causes a watery diarrhea that lasts an average of 57 days, if untreated. Most of the illnesses in this outbreak began in mid to late June. Many people report still being ill and some have had relapses.

There is treatment (medicine) available to treat Cyclospora infection. Specific laboratory testing, not commonly ordered, must be done to detect Cyclospora. Specific treatment, not typically used to treat more common diarrheal illnesses, can be prescribed.

If you are experiencing diarrhea, or have recently had a long bout with diarrhea, you should contact your health care provider and see if you should be tested for Cyclospora infection. Additional symptoms of cyclosporiasis (the infection caused by Cyclospora) include: watery diarrhea, fatigue and severe tiredness, loss of appetite, weight loss, bloating, increased gas, stomach cramps, nausea, vomiting, muscle aches and low-grade fever.

Story County has had only one case reported thus, while Polk and Boone Counties have had five and three known cases reported, respectively. Webster County has also had three cases reported. Linn County has had the most outbreaks, as a total of 30 cases have been reported there. For the complete county by county breakdown of Cyclospora cases and/or for more information go to www.idph.state.ia.us and click on "IDPH Investigates Cyclospora Outbreak".

County by county breakdown of cases is as follows:

• Linn County – 31 cases

• Polk County – 5 cases

• Pottawattamie County – 5 cases

• Fayette County – 3 cases

• O’Brien County – 3 cases

• Dallas County – 3 cases

• Buchanan – 3 cases

• Black Hawk County – 4 cases

• Webster County – 3 cases

• Dubuque County – 2 cases

• Mills County – 2 cases

• Des Moines County – 2 cases

• Boone County – 3 cases

• Iowa County – 1 case

• Montgomery County – 1 case

• Benton County – 1 case

• Keokuk – 1 case

• Monona – 1 case

• Butler – 1 case

• Winneshiek – 1 case

• Johnson County – 1 case

• Van Buren County – 1 case

• Story County – 1 case

• Cedar County – 1 case

• Woodbury County – 1 case

Total – 81 cases

For more information, visit www.idph.state.ia.us/EHI/Issue.aspx?issue=Cyclospora Outbreak Investigation