April 24, 2018

Cyclospora Outbreak in Nebraska and Iowa

The Nebraska Department of Health and Human Services and the Iowa Department of Public Health have both announced that there is an outbreak of cyclospora, a rare parasite, in those states. In Iowa, 22 cases have been reported to public health officials as of July 8, 2013. In Nebraska, 26 cases have been reported by other media, although the the most recent official statement dated July 5, 2013 says there are reports of 13 infections. Since fresh produce has been implicated in previous outbreaks, officials recommend that you thoroughly wash all produce before preparing or eating it, but cyclospora is difficult to wash off food.


Cyclosporiasis is an intestinal illness caused by a microscopic parasite. The oocyst is shed in human stool and is spread by people eating something that has been contaminated with feces. It’s usually not passed directly from one person to another, since it can take weeks to become infectious after being passed in a bowel movement. These infections are usually found in tropical or subtropical areas of the world. Symptoms include watery diarrhea, which is sometimes explosive; cramping, weight loss, pain, bloating, gas, nausea, and fatigue. Some people experience vomiting, headache, fever, body aches, and other flu-like symptoms.

The Nebraska alert states that “this most likely represents an outbreak from a common source.” The last time a cyclospora outbreak occurred was in 1997. Raspberries imported from Guatemala were thought to be the source of the parasite. Officials are asking health care workers to be on the lookout for this illness, and to immediately report newly identified cases to the health department.

In Iowa, the case count by county is as follows: Linn (10), Fayette (3), O’Brien (2), Benton (1), Des Moines (1), Mills (1), Polk (1), Van Buren (1). Most illnesses began in mid to late June; at least one person has been hospitalized.

Specific treatment is available, but the diagnosis must be done with very specific laboratory tests. The Iowa alert also said that “other Midwestern states” have reported cases, although we searched the Health Department sites of Minnesota, Wisconsin, Illinois, Indiana, Missouri, Arkansas, North Dakota, and South Dakota we didn’t find any information about outbreaks in those states.

Image Courtesy CDC

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