Health officials are continuing to investigate as cases of cyclosporiasis spread across the US. More than 11,500 cases have been reported in 41 states, according to the most recent CDC data. Of those cases, about 4,100 have been laboratory confirmed, and about 7,400 have yet to be confirmed. The CDC and the FDA have linked the outbreak in 9 states to shredded iceberg lettuce at some Taco Bell locations, supplied by Taylor Farms and sourced from central Mexico. Typically, an investigation begins when clinicians diagnose patients. This can be challenging with cyclosporiasis because the average time between infection and symptom onset is 1 week, but it can take up to 2 weeks or longer. The time delay makes it difficult to determine what infected someone. Testing for Cyclospora is not typically included in routine US laboratory stool testing and must be specifically requested by a healthcare provider, according to the CDC. When public health officials investigate a foodborne illness outbreak such as Salmonella or E. coli, a laboratory can grow the bacterium in culture and use WGS. This process determines the exact order of all the DNA bases in an organism to subtype it. Cyclospora cannot be grown in a laboratory and requires a different type of testing. Therefore, investigators in Cyclospora need to rely more heavily on food interviews and epidemiology, more pattern recognition rather than molecular precision." If officials realize there is a higher-than-expected frequency of cases, they begin a traceback investigation. The investigation involves calling those who are infected and asking them to trace back what they've eaten in the past several days. The next step is to identify what cases have in common. Earlier this month, Taylor Farms de Mexico issued a voluntary recall of all iceberg lettuce sourced from central Mexico, affecting 27 states. The recalled products were distributed from June 29 through July 16 and have best-if-used-by dates up to Aug. 3. Additionally, Taco Bell said it no longer uses lettuce from Taylor Farms de Mexico at any of its restaurants. The CDC said it can take up to six weeks to determine if a sick person is part of the current cyclosporiasis outbreak. @ https://abcnews.com/Health/cyclosporiasis-spreads-us-disease-outbreak-investigation/story?id=134948862
