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Iowa, Nebraska cases of intestinal illness rise

DES MOINES (AP) — More cases of a food-borne intestinal illness have been confirmed in Iowa and Nebraska, with Iowa upping its total Monday to 71 cases of cyclosporiasis and Nebraska raising its to 48.

That’s up from 60 cases in Iowa on Saturday and 35 in Nebraska a day earlier.

Linn County, in eastern Iowa, continued to lead the state with 27 cases. Four cases were reported in Polk County, and 17 other counties reported one case each. Three people have been hospitalized.

Most of Nebraska’s cases were in Douglas County, which is on the state’s eastern edge and borders Iowa, leading health officials in the two states to believe the outbreaks have a common source.

Health officials from the two states said their initial findings suggest that a contaminated vegetable is to blame, and they warned the public to wash all produce thoroughly before eating it raw.

The illness comes from eating food or drinking water contaminated with feces containing the cyclospora parasite. While some research suggests animal feces contamination could cause the illness, an expert in parasitic diseases at the Centers for Disease Control and Prevention in Atlanta said humans are currently the only known carriers.

Food can be contaminated by direct contact with fecal matter or through contact with infected water.

The cause of some past outbreaks couldn’t be determined because the contaminated food had been mixed with others, such as in a salad.

Dr. Barbara Herwaldt, a CDC medical epidemiologist, said the parasite that causes cyclosporiasis is still being studied. It’s more common to be found in tropical or subtropical regions of the world and is sometimes brought back to the United States by travelers.

There have been large multistate outbreaks before exceeding 1,000 cases, but none that large since the 1990s, she said.

“This outbreak is being investigated in earnest. It’s a very high priority at the state and local level and at the federal level,” she said. “It’s very important both for clinical reasons for the individual patients and for public health reasons so we’re taking it very seriously as we always do.”

She said it’s good that the cyclospora organism was identified so that those infected can be treated.

Treatment with a combination of antibiotics can significantly shorten the duration of illness and help prevent relapses, which aren’t unusual in those who don’t seek medical treatment.

Symptoms of cyclosporiasis include watery diarrhea, loss of appetite, weight loss, stomach cramps, nausea, body aches and fatigue. Symptoms may last weeks and could persist for up to two months if not treated.

Officials believe those confirmed with the illness became sick in mid to late June, which suggests whatever contaminated food that caused it may have worked its way through the system.

While most confirmed cases are in Iowa and Nebraska, three other states are investigating cases to determine if there is a link.

The illness is rare in Iowa with typically just one to two cases reported a year, usually involving people who acquired the illness while traveling. It also is rare in Nebraska with no cases reported in the last four years and only one case in 2007 and one in 2008.

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