Cyclospora outbreak to be declared over

Melanie Moser/CDC/AP

Federal officials are planning to declare the end of this summer’s outbreak of cyclosporiasis tied to iceberg lettuce, the Washington Post reported. The declaration may come as soon as Thursday.

The outbreak, spanning 20 states, has sickened at least 11,458 people, among whom 495 have been hospitalized and two died , according to the US Food and Drug Administration and the US Centers for Disease Control and Prevention, as of August 27.

The outbreak grew to be the largest on record in the US. The hardest-hit state was Michigan, where about 1 in every 1,000 people had cyclosporiasis.

While the declaration marks a significant public health moment, the iceberg lettuce connected to the outbreak has been recalled, and in an update last month , the FDA said it “remains confident that all recalled iceberg lettuce related to this specific Cyclospora outbreak is off the market” and that “product should no longer be available in stores or restaurants.”

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Is it safe to eat lettuce yet? What to know as cyclosporiasis outbreak lingers

Investigators said data pointed them toward shredded iceberg lettuce associated with illnesses in people who reported eating at some Taco Bell locations. The FDA traced the lettuce to the company Taylor Farms and growers based in Mexico. In mid-July, Taylor Farms de Mexico announced that it had removed all iceberg lettuce sourced from central Mexico from the US market, and Taylor Farms began a recall .

The FDA noted that most of the illnesses tied to this outbreak began before the Taylor Farms iceberg lettuce recall was announced July 17.

Taylor Farms and the US Department of Health and Human Services did not respond to CNN’s request for comment Thursday.

The Taylor Farms facility in Doctor Mora, Mexico, remains closed with no reopening date, a worker told CNN. “The only people at the plant are maintenance workers servicing equipment,” the person said.

The person also said field workers were told they may be able to return Monday but are still awaiting confirmation.

The Taylor Farms plant in Doctor Mora has not processed any food packaging since about July 10, when workers were called in to destroy bags of lettuce that had been returned after being shipped to the US.

Cyclosporiasis outbreak has affected about 1 in every 1,000 people in Michigan and killed two

When someone is infected with cyclospora, the microscopic parasite that causes cyclosporiasis, they can develop explosive diarrhea along with other intestinal symptoms – and it can take two days to two weeks for symptoms to appear . It can also take as long as six weeks for CDC and state health officials to determine whether an illness was connected to the outbreak, according to the FDA. As a result, there can be a lag in when a case gets reported after someone is exposed to the parasite.

“There is quite a delay between when the contamination occurred versus when people were actually consuming this and then them actually reporting sick,” Matthew Moore, an associate professor of food science at the University of Massachusetts Amherst, said last month .

“It sounds like all the product that was implicated, at least as far as we know, has been recalled,” he said. “Unlike some other pathogens like salmonella – that potentially could be person-to-person, where you have an initial spike that’s getting people sick, and then they’re getting other people sick, where you could potentially continue the outbreak – with cyclospora, because it’s not transmitted person-to-person, it’ll just kind of die off.”

Federal health officials were expected to declare the outbreak over once they’re confident that new illnesses are no longer emerging, Dr. Colleen Kraft, a professor of infectious diseases at Emory University School of Medicine, said in an email last month .

“They also need time for recently diagnosed cases to work their way through laboratory testing, patient interviews and epidemiologic linkage,” Kraft said. “Essentially the immediate consumer risk from the recalled product appears to have passed.”

梅兰妮·莫泽/美国疾病控制与预防中心/美联社

据《华盛顿邮报》报道，联邦官员计划宣布今年夏季与卷心莴苣相关的环孢子虫病疫情结束。该声明最早可能于周四发布。

据美国食品药品监督管理局和美国疾病控制与预防中心 8 月 27 日的数据显示，此次疫情已蔓延至 20 个州，至少 11458 人感染，其中 495 人住院治疗，2 人死亡。

此次疫情发展成为美国有史以来规模最大的一次。受灾最严重的州是密歇根州，该州约有千分之一的人患有环孢子虫病。

虽然这一声明标志着一个重要的公共卫生时刻，但与此次疫情相关的冰山莴苣已被召回。上个月，FDA 在一份更新中表示，“仍然相信所有与此次环孢子虫疫情相关的召回冰山莴苣都已下架”，并且“该产品不应再在商店或餐馆出售”。

斯韦特兰娜·波波娃/iStockphoto/Getty Images

现在吃生菜安全吗？环孢子虫病疫情持续蔓延，我们需要了解哪些信息？

调查人员表示，数据显示，一些在塔可钟餐厅用餐后出现不适症状的顾客，其病因可能与切碎的卷心莴苣有关。美国食品药品监督管理局（FDA）追踪到这些莴苣来自墨西哥的泰勒农场公司及其种植户。7月中旬，泰勒农场墨西哥公司宣布，已将所有产自墨西哥中部的卷心莴苣从美国市场下架，并启动了召回程序。

美国食品药品监督管理局指出，与此次疫情相关的大多数病例都发生在泰勒农场冰山莴苣于 7 月 17 日宣布召回之前。

周四，泰勒农场和美国卫生与公众服务部均未回应 CNN 的置评请求。

据CNN报道，位于墨西哥莫拉博士镇的泰勒农场工厂仍然关闭，尚未确定重新开放日期。一名工人表示：“工厂里只有维修人员在维护设备。”

该人士还表示，现场工作人员被告知他们可能周一就能返回工作岗位，但仍在等待确认。

位于莫拉博士镇的泰勒农场工厂自 7 月 10 日左右以来就没有加工过任何食品包装，当时工人们被召集来销毁运往美国后退回的生菜袋。

密歇根州爆发环孢子虫病疫情，约每1000人中就有1人感染，并造成两人死亡。

当有人感染环孢子虫（一种引起环孢子虫病的微小寄生虫）时，可能会出现爆发性腹泻以及其他肠道症状——症状可能需要两到两周才会出现。据美国食品药品监督管理局（FDA）称，疾病控制与预防中心（CDC）和州卫生官员可能需要长达六周的时间才能确定病例是否与疫情有关。因此，从有人接触寄生虫到病例报告之间可能存在时间滞后。

“从污染发生到人们实际食用这种食品，再到他们实际报告生病，这之间存在相当大的时间差，”马萨诸塞大学阿默斯特分校食品科学副教授马修·摩尔上个月表示。

他说：“听起来所有涉事产品，至少据我们所知，都已被召回。与其他一些病原体（例如沙门氏菌）不同——沙门氏菌可能在人与人之间传播，最初会出现感染高峰，导致人们生病，然后这些人又会传染给其他人，从而可能导致疫情持续爆发——环孢子虫不会在人与人之间传播，它会逐渐消失。”

埃默里大学医学院传染病学教授科琳·克拉夫特博士上个月在一封电子邮件中表示，联邦卫生官员预计一旦确信不再出现新的疾病，就会宣布疫情结束。

克拉夫特表示：“他们还需要时间让新确诊的病例完成实验室检测、患者访谈和流行病学关联分析。基本上，召回产品带来的直接消费者风险似乎已经过去。”