Increase in Cyclosporiasis Infections since May 2018
Summary and Action Items
- The Illinois Department of Public Health (IDPH) continues to investigate an increase in Cyclosporiasis infections since May 2018.
- Health care providers should consider and test for Cyclospora when seeing a patient with prolonged unexplained diarrhea.
- Clinicians and laboratories should report new cases to their local health department to assist with the onoing investigation.
Cyclosporiasis is an intestinal illness caused by the microscopic parasite Cyclospora cayetanensis. People can become infected with Cyclospora by consuming food or water contaminated with the parasite. Often, cases are seen among individuals with international travel. However, cases can be domestically acquired and foodborne outbreaks do occur. Since May 2018, a total of 420 domestically acquired cases have been reported to IDPH, with onset dates raning from 5/6/18 to 7/18/18. Most cases are adults, and 7.5 % of cases have required hospitalization.
An association with eating McDonald's salads has been identified and McDonald's Corporation is working closely with state and federal partners to identify the course. Additional cases are associated with an outbreak from a July 3rd event at the Evanston GOld Club in Skokie, IL. FOr the remainder of the domestically acquired cases reported in Illinois (roughly a third), an epidemiological link or source has not been identified.
The average incubation period is seven days. Cyclospora can cause water diarrhea, loss of appetitie, weight loss, abdominal cramps, bloating, increase in gas and prolonged fatigue. Symtopms can last for a few days to a month or longer. Symptoms may go away and come back again multiple times. Persons also can carry the organism asymptomatically. Mose people who have health immune systems will recover without treatment. However, there is an effective antibiotic, and clinicians should consider treatment of confirmed cases based on clinical status.
People can become infected with Cyclospora by consuming food or water contaminated with the parasite. In the US, foodborne outbreaks of cyclosporiasis have perviously been linked to various types of imported fresh produce. Person-to-person transmission generally does not occur.
Cyclospora infection is diagnosed by examining stoll specimens, or with the use of culture-independent diagnostic tests on stool speciments. If stool cultures are used, laboratories should use sensitive recovery methods and detection methods that highlight Cyclospora oocysts. Multiple stool cultures may be needed to increase sensitivity.
Avoind food or water that may have been contaminated with feces is the best way to prevent cyclosporiasis. COmsumers and retailers should always follow safe fruit and vegetable handling recommendations; additional resources are provided below.
IDPH and LHD Reponse
IDPH, along with Local Health Dpeartments, continues to investigate cases through extensive case interviews, identifying potential new outbreaks, and work with federal partners to identify new sources of exposure.
Please contact your local health department with any questions about human cases or the IDPH Foodborne Program at 217-782-2016 with any questions about product issues. Local health department contact information can be found at: http://www.idph.state.il.us/IDPHPrograms/v_LHDDirectory/Show-V-LHDDirectory-Public.aspx
IDPH resources: http://dph.illinois.gov/topics-services/diseases-and-conditions/diseases-a-z-list/cyclospora
Beware of Bats and Exposure to Rabies17 bats tested positive for rabies IDPH News Release July 11th 2018
Multi-State Salmonella Outbreak Linked to Cereal
One case identified in Illinois
Springfield - The Illinois Department of Public Health (IDPH) is reporting one case of Slamonella that mathces a multi-state outbreak strain. The Centers for Disease Control and Prevention (CDC) is reporting 73 cases of Salmonella Mbandaka from 31 states. The CDC investigation indicated Kellogg's Honey Smacks cereal is the likely source of this multi-state outbreak.
"The Illinois Department of Public Health is urging people to check their cupboards for Kellogg's Honey Smacks and to throw them out if they find them, even if they have already eaten some and have not become sick," said IDPH Director Nirav D. Shah, M.D., J.D. "If you have recently eaten the cereal and experience diarrhea, fever, and cramps, contact your health care provider."
Kellogg Compay announced it is voluntarilty recalling 15.3 oz and 23 oz packages of Kellogg's Honey Smacks cereal. CDC, pulbic health and regulatory officials in several states, and the U.S. Food and Drug Administration continue to investigate this multi-state outbreak.
Most people affected by Salmonella develop diarrhea, fever, and abdominal cramps 12 to 72 hours after eating food contaminated by the bacteria. The illness usually lasts 4 to 7 days, and most people recover without treatment. However, diarrhea for some people may be so severe that they need to be hospitalized. The elderly, infants, and those with compromised immune systems are more likeyl to have a severe illness.
IDPH News Release June 15, 2018
Multi-State Salmonella Outbreak Linked to Pre-cut Melons
6 cases identified in Illinois
Springfield - The Illinois Department of Public Health (IDPH) is reporting six cases of Salmonella that match a multi-state outbreak strain. The Centers for Disease Control and Prevention (CDC) is reporting 60 cases from five states - Illinois, Indiana, Michigan, Missouri, and Ohio. The CDC investigation indicates pre-cut melons, including fruit salads, are a likely source of this multi-state outbreak.
"The Illinois Department of Public Helath is urging people not to eat pre-cut melon purchased from any Walmart store in Illinois, or any of the other affected states, at this time," said IDPH Director Nirav D. Shah, M.D., J.D. "If you have recently purchased pre-cut melon from Walmart, throw it out. If you have recently eaten pre-cut melon from a Walmart store and experienced diarrhea, fever, and cramps, contact your health care provider."
Illinois cases range in age from 23 to 87 years and have been reported in all regions of the state. Therefore, it is recommended that people not eat pre-cut melon from Walmart stares anywhere in Illinois. As the investigation continues, additional grocery stores may be added.
Most people affected by Salmonella develop diarrhea, fever, and abdominal cramps 12 to 72 hours after eating food contaminated by the bacteria. The illness usually lasts 4 to 7 days, and most people recover without treatment. However, diarrhea for some people may be so severe that they need to be hospitalized. The CDC has indicated there have been more hospitalizations with this outbreak than what is typically seen. The elderly, infants, and those with compromised immune systems are more likely to have a severe illness.
The U.S. Food and Drug Administration is working to identify the source of Salmenolla and there may be recalls as more information is learned. Walmart stores in Illinois have removed pre-cut melons linksed to this outbreak from their shelves.
So far only pre-cut melons have been linked, but it is important to remember food saftey measures if you buy whole melons. Make sure to wash the melons before you start cutting. Also, make sure you've washed your hands and all utensils - knives and cutting boards, and don't let fresh fruits and vegetables come into contat with raw meat.
IDPH Press Release June 8, 2018
Make Safety a Priority this Summer
IEMA encourages families to prepare for extreme heat, severe weather, and more
Springfield - As the end of the school year approaches, and families begin to plan their annual summer vacations, the Illinois Emergency Management Agency is reminding Illinois residents that with the right tools and a little preparation, summertime can be safe, fun, and relaxing.
Each year in the U.S., an average of 37 children die from heatstroke after being left in locked cars. Heat can be more severe on children becuase their bodies warm at a faster rate than adults. Parents should develop a routine that will ensure the backseat is always checked before the care is locked, such as putting a purse, cell phone, or other needed item in the back seat or consider opening the car's back door every time the car is parked.
Summer's extreme heat can also lead to heat-induced illnesses, including heat exhaustion or heat stroke. Remember to check in on family, friends, neighbors, the elderly and pets to ensure they are safe. When extreme heat strikes, limit your time outdoors, seek air conditioning and drink plenty of water. If your home does not have air conditioning, you should familiarize yourself with your community's cooling centers.
Warmer temperatures also bring an additional threat for severe weather. The month of June is home to National Lightning Safety Awareness Week. This is a great time for families to learn how to reduce their risk while enjoying the great outdoors. Remember, if you hear thunder, lightning is close enough to pose an immediate threat. Seek shelter as qucikly as possible becuase no place outside is safe when a thunderstorm strikes.
The best way to protect you and your family is to monitor the weather when planning or attending outdoor events. It is critical for people to have multiple ways to receive notifications and updated information about severe weather warnings.
"Whether you're relaxing by the pool, taking in a ballgame, or traveling away from home, severe weather can strike at any time so it is important that you are aware of your surroundings," said Acting Director William Robertson. "There are a variety of ways you can be alerted to critical, lifesaving information, no matter where you may be - including: NOAA wather radios, weather apps for your smart phone, television and radio broadcasts, the internet, and outdoor warning sirens."
For more information on how to plan and prepare for an emergency, including a list of state and local resources, check out our website at www.ready.illinois.gov.
Illinois e-News Release June 4, 2018
Swin Healthy. Stay Healthy.
May 21-27, 2018 is Healthy and Safe Swimming Week
Springfield - Healthy and Safe Swimming Week, May 21-27, 2018, is being observed the week before Memorial Day, a day when many pools open for the summer. This year's national theme is "Swim Healthy. Stay Healthy." The week is dedicated to educating people on how they can take an active role in protecting themselves and preveting the spread of germs when swimming.
"Swimming is a great physical activity that can help improve your health, as long as you take some simple steps," said Illinois Departmetn of Public Health Director Nirav D. Shah, M.D., J.D. "When you get to the pool, check if you can see the drain at the bottom of the deep end, and look for safety equipment if a lifeguard is not on duty. Also, remember to shower before getting in the water, and if you are sick or have been sick recently, don't swim."
Diarrhea is the most common cause of recreational water illness (RWI). Just one diarrheal or vomiting accident in the water can release millions of germs. If other swimmers swallow a mouthful of the water, it can cause diarrhea lasting up to three weeks. It can be difficult to resolve swimming-related disease outbreaks when infected individuals visit multiple pools or water parks.
Crypto (short for Cryptosporidium) is the leading cause of outbreaks link to pools and water parks. Crypto can survive in an adequately chlorinated pool for more than one week. Other germs that can cause illness include Giardia, norovirus, Shigella, and E. coli. RWIs can also be caused by chemicals added to treat water. Other common RWIs include skin, ear, respiratory, eye, neurologic, and wound infections.
Here are some tips swimmers should take.
- Don't swim or let your kids swim if they have or have had diarrhea in the past two weeks. If there is an accident, let the pool operator know.
- Try not to get water in your mouth.
- Check out the latest pool inspection report and do your own mini-inspection.
- Take kids on bathroom breaks every 60 minutes.
- Check diapers every 30-60 minutes and change them in a bathroom or diaper-changing area - not waterside - to keep germs away from the water.
- Shower before you get in the water. Rinsing off in the shower for just one minute helps get rid of most stuff that might be on a swimmer's body.
Swimming in lakes and other natural bodies of water comes with a unique set of risks such as amoeba and algae. To reduce your chances of becoming ill, try to limit the amount water up your nose by holding your nose or using nose clips when diving or water skiing. Avoid putting your head underwater and don't stir up mud and scum while swimming in warm freshwater areas. If you see that the beach is closed, stay out of it. Don't swim, water ski, or boat in areas where the water is discolored or where you see foam, sum, or mats of algae on the water's surface.
Swimming safety is also important. According to the Centers for Disease Control and Prevention, about ten people die from unintentional drowning every day. Of these, two are children aged 14 years and younger. There are precautions you can take to help prevent drowning.
- Know how to swim and do not swim beyond your limits.
- Learn CPR (cardiopulmonary resuscitation).
- Use lifejackets when boating.
- Avoid drinking alcohol before or during swimming, boating, or water skiing.
To check the status of a swimming facility licensed by IDPH, use the IDPH Swimming Facility Search on our website. To learn about beach closures, advisories, and test results, check the online Illinois Beach Guard System.
IDPH News Release May 22, 2018