Michigan reports two deaths in cyclosporiasis outbreak

Two Michigan residents who contracted cyclosporiasis have died, state health officials said Monday, marking the first reported fatalities in what The Guardian described as the largest U.S. outbreak of the intestinal illness.

The Michigan Department of Health and Human Services did not identify the two people and said it would not release additional information about the cases. Both had “significant underlying health conditions that may have been impacted by cyclosporiasis and dehydration,” the department said.

“Cyclosporiasis is generally not a life-threatening illness. Death resulting from cyclosporiasis is uncommon in the United States,” the department said in a news release.

The illness is caused by Cyclospora, a parasite found in human feces. Dr. William Schaffner, an infectious disease specialist at Vanderbilt University Medical Center, told NBC News that the infection can lead to dehydration because of fluid loss from severe diarrhea and vomiting. Symptoms also can include nausea and other gastrointestinal problems. Schaffner said the illness is often treated with Bactrim, an antibiotic, though many people with healthy immune systems recover on their own.

Michigan health officials reported 11,234 outbreak-linked cases Monday, an increase of 461 from Friday, according to The Guardian. The outbreak has led to 193 hospitalizations in the state. Wayne County has reported the most cases, with 1,379 infections, and adults ages 30 to 39 have been the hardest hit, accounting for 2,216 reported cases, state data showed.

The outbreak has been linked to iceberg lettuce sourced from Taylor Farms operations in central Mexico. NBC News reported that outbreaks in Michigan and nine other states have been linked to lettuce served at Taco Bell that was supplied by Taylor Farms and sourced from central Mexico. The Guardian reported that an FDA investigation linked the outbreak, which it said had expanded to nine states, to iceberg lettuce from privately held Taylor Farms operations in central Mexico, while authorities continue to look for other potential sources.

Last month, Taylor Farms de Mexico issued a voluntary recall of all iceberg lettuce supplied from central Mexico, NBC News reported.

Cases have been rising across the United States in recent weeks, according to the Centers for Disease Control and Prevention. NBC News reported that cases have been recorded in 45 states during an unusually severe cyclosporiasis season. The Guardian reported that the CDC had recorded 6,707 laboratory-confirmed cases nationwide as of July 28, with more than 11,500 additional suspected cases awaiting confirmation or further investigation.

The CDC’s surveillance updates include only laboratory-confirmed cases, while state health departments may also report probable infections, which can produce higher case counts. The agency has said it is working with states to update the national tally as additional cases are confirmed.

The U.S. Department of Health and Human Services said it was aware of the Michigan deaths. “This development highlights the importance of identifying the source of the outbreak and preventing additional illnesses,” Wade Syers, a food safety specialist at Michigan State University Extension, told The Guardian.

The Guardian also reported that some U.S. consumers have avoided certain restaurant chains and bought less lettuce in grocery stores as the multistate outbreak has fueled confusion over what is safe to eat.