12:21 pm ET
Should you be concerned about cyclosporiasis when you’re pregnant?
Mike Snider
There are plenty of health concerns during pregnancy. Should the recent surge in cases of cyclosporiasis be added to maternal worries? The answer is complicated, but shouldn’t cause alarm.
The good news is that there’s “no strong evidence” that the parasite that causes the infection’s severe gastrointestinal symptoms, including intense diarrhea, crosses the placenta or directly attacks the fetus, Dr. Tyler Evans, founder and CEO of Wellness Equity Alliance and the author of “Pandemics, Poverty, and Politics,” told USA TODAY.
However, someone who is pregnant should also take preventive steps to avoid contracting the illness. You should be “concerned enough to be careful, not enough to be frightened,” Evans said. “Cyclosporiasis is usually not life-threatening, and healthy people generally recover. But pregnancy changes the calculation.”
Symptoms can be dangerous during pregnancy because it can cause “prolonged, watery, often relapsing diarrhea that can last weeks untreated,” Evans said. “In pregnancy, dehydration and fluid loss matter more. Low fluid volume can reduce blood flow and, in some cases, contribute to early contractions. The danger here is not exotic. It is dehydration, and it is manageable if caught early.”
Another aspect to keep in mind is that treatment for the infection is an antibiotic, some of which can cross the placenta. “In pregnancy that drug requires judgment,” said Evans, who served as the first chief medical officer for New York City’s COVID-19 response and has worked in global health across dozens of countries for nearly three decades.
11:55 am ET
Chipotle, Taco Bell, Sweetgreen shares stabilize after initial cyclosporiasis scare
Medora Lee
Shares of fast-food eateries like Chipotle and Taco Bell parent Yum! Brands are slightly lower, trying to recover from fears over the spread of foodborne illness cyclosporiasis.
Out of precaution, Taco Bell temporarily pulled at-risk ingredients like lettuce, pico de gallo, guacamole, and cilantro at select locations after health officials said they’re investigating a potential link to contaminated lettuce. Chipotle said it didn’t believe its ingredients were infected, and Sweetgreen has not issued any public statement.
At 11:34 AM ET, shares of Yum! were down 0.48% at $151.84 each, Chipotle off 0.07% at $34.60 and Sweetgreen down 2.6% at $6.55.
Although shares are under pressure due to the outbreak, historical price actions have shown fast-food stocks usually bounce back after the scare passes. In 2018, McDonald’s shares initially fell after Iowa and Illinois health departments investigated Cyclospora infections linked to the fast-food chain’s salads. Shares recovered in about a week, data show.
11:43 am ET
Taco Bell pulls some ingredients out of caution after cyclosporiasis outbreak
Ken Alltucker
With a fast-moving gastrointestinal illness cyclosporiasis infecting thousands in more than 30 states, the popular fast food chain Taco Bell has removed ingredients from some stores in what it said was a precautionary move.
Taco Bell Corp. said it “voluntarily and temporarily removed limited ingredients” at select restaurants. The fast food chain added public health officials haven’t “confirmed a link to Taco Bell or any specific ingredient, supplier, restaurant or retailer.”
As cyclosporiasis spreads and Taco Bell pulls some ingredients out of caution, one can’t help but think of other restaurants that might be at risk. Shares of Chipotle dropped nearly 5% on Wednesday, even though the chain has not been connected to the cyclosporiasis outbreak.
Chipotle officials said they don’t believe their ingredients are affected by the outbreak of cyclosporiasis, a stomach-churning illness that can trigger explosive, watery diarrhea and other gastrointestinal symptoms.
“We are aware of the Cyclospora investigation and at this time, we don’t believe the ingredients we source are associated,” Laurie Schalow, Chipotle’s chief corporate affairs and food safety officer said in a statement. “We are monitoring the situation closely and evaluating any new information as it becomes available. The health and safety of our guests and team members is our highest priority.”
10:53 am ET
How to treat cyclosporiasis
Melina Khan
According to the CDC, most people with healthy immune symptoms can recover from cyclosporiasis without treatment, but medicine is available.
People with symptoms should see a health care provider, who can prescribe an antibiotic for treatment.
The antibiotic trimethoprim-sulfamethoxazole, which is sold under the names Bactrim, Septra or Cotrim, is commonly prescribed for treatment, but those with a sulfa drug allergy may receive ciprofloxacin or nitazoxanide, according to the Cleveland Clinic.
With proper treatment, most people will feel better after about a week or two but they may still have occasional bouts of diarrhea for up to a month, per the Cleveland Clinic.
10:30 am ET
Should parents be concerned about what kids are eating at camp?
Sara Moniuszko
If you’re a parent with a kid at summer camp amid the cyclosporiasis outbreak, how concerned should you be?
In response to a question from USA TODAY during an Infectious Diseases Society of America media briefing on July 16, Dr. Thomas Moore, University of Kansas-Wichita campus clinical professor of medicine, said “it’s hard to know, primarily because we don’t know where this is coming from, and that’s really the biggest issue.”
The safest thing to do? Practice good food hygiene, he added.
“As a parent, I would just tell my kids just make sure you wash the fruits and vegetables before you eat them,” Moore said. “Hopefully, they’re washed in the kitchen before they were given to the kids.”
“I’m not going to tell people not to eat them because we just don’t know where this is coming from,” he added. “And (fruits and vegetables are) part of a healthy diet.”
Heating food to 158 degrees or higher kills the parasite, according to the health officials.
10:22 am ET
What are the signs, symptoms of cyclosporiasis?
Melina Khan
People who contract cyclosporiasis may not develop symptoms until anywhere between two days to two weeks after infection, according to the CDC.
Per the agency, common symptoms of cyclosporiasis include:
- Watery diarrhea
- Loss of appetite
- Weight loss
- Cramping
- Bloating
- Increased gas
- Nausea
- Fatigue
While some people who are infected may not have symptoms, those who do may be sick for up to a month or more, per the CDC.
10:16 am ET
How do you know if you need to see a doctor?
Sara Moniuszko
You wake up with diarrhea. Should you see the doctor right away? It depends, health experts say.
In a media briefing hosted by that Infectious Diseases Society of America on July 16, Dr. Thomas Moore, a Campus Clinical Professor of Medicine at the University of Kansas-Wichita, said diarrheal disease of all kinds are more common in the summer.
“Somebody has one day worth of loose stools − maybe it’s cyclosporiasis, but it could be almost anything else as well,” he explained, noting the length of symptoms can clue someone into whether additional care is needed or not.
“The clinician’s suspicion should be raised if the diarrhea persists over several days, at least, I would say, three days,” Moore added.
Dr. Jeanne Marrazzo, chief executive officer of the Infectious Diseases Society of America, added to be aware of other symptoms as well, including high fever or blood in the stool.
“Either of those things could signal a more invasive process that almost always would require consideration of antibiotic treatment,” she said.
Concern also depends on someone’s immune strength.
“People that are at higher risk − if they have immunosuppression, the frail older patients, for example − have a lower threshold for ordering testing to see if they would benefit from antimicrobial therapy,” added Dr. Paul Auwaerter, Johns Hopkins School of Medicine director of the Sherrilyn and Ken Fisher Center for Environmental Infectious Diseases.
The CDC advises those who believe they are infected to see a doctor for testing and treatment.
9:42 am ET
Can cyclospora be passed person to person?
Sara Moniuszko
The disease is only “very rarely transmitted from person to person,” Dr. Thomas Moore, University of Kansas-Wichita Campus Clinical Professor of Medicine, said in a media briefing hosted by that Infectious Diseases Society of America on Thursday.
“Only standard isolation precautions are recommended for hospitalized patients,” he added. These precautions may include practices like hand hygiene before and after patient contact as well as personal protective equipment such as gloves, masks and gowns when necessary.
Instead, most people are infected through contaminated food and water.
While skipping fresh fruits and vegetables is “certainly the safest way to avoid the disease,” Moore said, “it’s not necessary.”
“Particularly if you have normal immunity, you can reduce your risk of this and other diarrheal diseases by thoroughly washing fresh produce under clean running water before eating, and by following safe food handling practices,” he added.
9:20 am ET
Reality TV star details ‘vicious’ cyclosporiasis symptoms
Melina Khan
“The Challenge” star Leroy Garrett said on social media that he’s recovering after contracting cyclosporiasis.
“I don’t know exactly when or what produce I consume, I just know that I spent a romantic weekend with my toilet,” he captioned a July 15 Instagram video.
Garrett, who has appeared on more than a dozen seasons of the MTV competition show, said he had “explosive, vicious” diarrhea that kept him on the toilet for much of the day and awake in the middle of the night.
“It feel like you got Timberlands in a dryer inside your stomach,” he said. “Imagine putting some Timberlands in a dryer. You know what that would sound like? That’s what your stomach sounds and feels like.”
The 41-year-old said he went to urgent care, where doctors gave him a stool test before prescribing medication to help with his symptoms.
The “Real World: Las Vegas” alumnus, his wife, fellow “The Challenge” star Kam Williams, and their two children live in Michigan, which is tracking more than 3,700 infections as of July 15, according to the state’s Health and Human Services department.
9:06 am ET
Cyclospora outbreak could linger, infectious disease experts say
Terry Collins and Melina Khan
Several infectious disease specialists across the country told USA TODAY that they are unsure how long the cyclospora outbreak will last, given officials have yet to identify what’s causing it.
“Often, public health officials can trace an outbreak back to a particular farm, grower, supplier, or contaminated water source and issue a targeted recall,” Dr. Suraj Saggar, chief of infectious diseases at Holy Name Medical Center in Teaneck, New Jersey, said July 15. “Right now, they haven’t been able to do that, suggesting there may be multiple contaminated products or multiple unrelated outbreaks occurring simultaneously.”
Dr. Amy Edwards, a pediatrics professor at Case Western Reserve University School of Medicine in Cleveland, said she doesn’t anticipate the surge in cases ending anytime soon.
“I can’t see a way where we’re near the end, as typically most cases are narrow in scope and can be as short as one week or as long as three weeks,” Edwards told USA TODAY. “There could be more than one type of contamination, more than one type of food, and with such a spread like this, it becomes harder to remove the source and harder to get the outbreak under control.”
9:05 am ET
Cyclosporiasis cases in your county
Sara Moniuszko, Ramon Padilla, Dian Zhang and Stephen J. Beard
Thousands of cases of cyclosporiasis have been reported nationwide so far, and the total is still climbing.
While most states have not released county-level data yet, USA TODAY collected figures directly from state health departments to show where reported cyclosporiasis cases are concentrated and which communities have been hardest hit.
For example, Michigan has reported more cyclosporiasis cases than any other state in the nation, and at the county level, Wayne County reported the most cases, 339, followed by Washtenaw and Monroe counties, based on county-level data available through July 13.
When the population is taken into account, Shiawassee is the hardest-hit county, with about 307 cases per 100,000 residents. That’s nearly double the rate reported in Monroe and Lenawee counties, which each had about 165 cases per 100,000 residents.
For other states and interactive graphics of country case numbers, click here for USA TODAY’s related coverage.
9:02 am ET
Is produce safe to eat? Locally-grown options may be safer
Melina Khan
While many are concerned about eating certain produce, experts say locally-grown fruits and vegetables – like those sold at farmers markets – may be a safer option.
Though no produce is risk-free – especially since officials have not yet determined the exact source of this outbreak – experts told USA TODAY that items from farmers markets could be a safer option because they are probably locally-sourced. Local growers are less likely to have contaminated water sources for irrigation, which is one way the parasite can infiltrate produce.
“It’s where it’s grown, not the point of sale,” said Amesh Adalja, a senior scholar at the Center for Health Security at the Johns Hopkins Bloomberg School of Public Health.
Past cyclosporiasis outbreaks in the United States have stemmed from produce coming from other countries, which may be in part because other countries could be using contaminated irrigation sources, said Dana Mordue, an associate professor of pathology, microbiology and immunology at New York Medical College.
“In some places, the procedure may be more lax than what we think we have in the United States,” Mordue said. “In this case though, given the size of the outbreak, it’s making me at least wonder whether or not something is happening within the United States.”