Linn County, other health agencies encouraging residents to get tested for cyclospora

UPDATE: Public health officials are encouraging people who believe they may be infected with cyclospora to get tested for it after confirming more than 20 cases of the rare intestinal illness in the state on Monday.

Officials with the Iowa Department of Public Health are investigating the outbreak after confirming 22 cases across several Iowa counties, almost half of which have been reported in Linn County alone.

The disease, which causes diarrhea, nausea, vomiting, muscle aches and a low-grade fever, in addition to other symptoms, is spread by ingesting food or water that has been contaminated with infected human feces. Those symptoms can last anywhere from nine to 43 days if left untreated, according to the Iowa Department of Public Health.

Patricia Quinlisk, state epidemiologist and a medical director at the Iowa Department of Public Health, said Monday that, though young children and the elderly typically experience cyclospora symptoms for a longer period of time, an average healthy adult can experience watery diarrhea for up to 57 days if left untreated. Though the disease can often be contracted abroad -- in countries like Guatemala, Peru and Nepal -- Quinlisk said that possibility has been ruled out in this outbreak because only a few people infected have traveled recently.

Most people began experiencing symptoms in mid to late June. Only one case of the disease was reported in Iowa in 2011.

At this point in the investigation, Quinlisk said public health officials have not yet determined a source. She said the Iowa Department of Public Health has been in contact with the Center for Disease Control, and officials are in the process of conducting in-depth interviews with people who have been infected. From those interviews, Quinlisk said health officials hope to find commonalities that point to a product, restaurant or festival from which the disease could have originated.

"What's happening right now, is there is nothing obvious (that's to blame) and in the U.S. we don't know of anything that's an obvious risk, so we have to do a lot of interviews and questioning trying to figure out something out people have in common," Quinlisk said.

If health officials determine a source, she said the public will be notified so they can protect themselves.

Other cases of the parasite have been detected in Nebraska and other states in the Midwest, but health agencies have not yet identified a source for the illness. Because fresh produce has been identified as a source for exposure in previous outbreaks, public health officials are encouraging people to thoroughly wash their fruits and vegetables before eating or serving them. Those infected are also urged to wash their hands frequently to prevent spreading the disease.

The department has also identified cases in Fayette, O'Brien, Webster, Benton, Des Moines, Mills, Polk and Van Buren counties. That only includes the cases that have been reported to the Iowa Department of Public Health, which were identified through testing at the State Hygienic Lab. At least one person has been hospitalized.

She added that right now, she does not think there is anything unique about Linn County that could explain the high number of cases, but said there were likely more diagnoses' from that area because Linn County uses the State Hygienic Lab for it's testing, and that lab routinely tests for cyclospora. Most other labs do not routinely test for the rare parasite. She also said the county's higher population could play a role in the numbers.

Since the outbreak, Quinlisk said the Iowa Department of Public Health is encouraging people who think they may have been infected to get tested for the disease so they can receive treatment, as treatment for cyclospora is different than the treatment that is prescribed for typical diarrhea.

"This is not a little diarrhea over the weekend and back to work on Monday," Quinlisk said. "This is something you can be sick with for quite awhile and that's why it's important to tell people it's out there in Iowa. If you're having this and it makes you lose your appetite or fatigued you need to go to the doctor and get tested for it."

How to wash produce

Cleaning produce should begin and end with washing hands for at least 20 seconds with soap and warm water. When washing produce, the Food and Drug Administration recommends cutting away damaged areas before preparing. All produce should be washed thoroughly under brisk water. The FDA does not recommend using detergent or soap to clean fresh food. Firm produce, like cucumbers and melon, can also be cleaned with a produce brush. Produce should be cleaned with a clean cloth or paper towel.

• LINK:More from the FDA on cyclospora and proper food washing procedures

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