Linggo, Agosto 4, 2013

Cyclospora

Looked at a number of reports about this situation-Question is-They found it to come from bagged salad mix-But don't know what brand-Yet they say it is no longer on the shelves?There must be something I'm missing here.If salad mix can be identified & knowledge that the contaminated run is no longer on the shelves-How can the brand not be known? Common sense tells me that the brand is most certainly known-It also tells me that the method of production, fertilization & country of origin is also.

 




Epidemiologic Investigation

As of August 1, 2013 (5pm EDT), CDC has been notified of 400 cases of Cyclospora infection from the following 17 health departments: Iowa, Texas, Nebraska, Florida, Wisconsin, New York City, Georgia, Illinois, Arkansas, Kansas, Louisiana, Missouri, Connecticut, Minnesota, New Jersey, New York, and Ohio.

Most of the illness onset dates have ranged from mid-June through early July.
At least 22 persons reportedly have been hospitalized in five states.

Nebraska and Iowa have performed investigations within their states and have shared the results of those investigations with CDC. Based on their analysis, Cyclospora infections in their states are linked to a salad mix. CDC will continue to work with federal, state, and local partners in the investigation to determine whether this conclusion applies to the increase in cases of cyclosporiasis in other states. Read More
It is not yet clear whether the cases from all of the states are part of the same outbreak.

Additional cases are currently under investigation and will be included on this page as states confirm them. Cases in this outbreak are defined as laboratory-confirmed Cyclospora infection in a person who became ill in June or July, 2013, and had no history of travel outside of the United States or Canada during the 14 days prior to onset of illness.

Previous outbreak investigations have implicated various types of fresh produce.
Laboratory Investigation

To date, CDC has confirmed 41 cases of Cyclospora infection in CDC laboratories. One of the cases was confirmed via telediagnosis.

CDC encourages laboratories to obtain confirmation of cases using telediagnosis. Telediagnosis allows for rapid laboratory confirmation. State health laboratories may submit images showing suspected Cyclospora oocysts to CDC. Images may be captured from modified acid-fast stained smears or from wet mounts examined by UV fluorescence microscopy. Both techniques require concentrated stool specimens. Instructions for submitting images for telediagnosis are found on the DPDx site.

New Development
On June 28, 2013, CDC was notified of 2 laboratory-confirmed cases of Cyclospora infection in Iowa residents who had become ill in June and did not have a history of international travel during the 14 days before the onset of illness. CDC has been collaborating with public health officials in several states and with regulatory officials at the FDA to investigate an outbreak of Cyclospora infection.

On August 2, 2013, CDC received results of a traceback investigation from FDA. Based on the results of FDA's traceback and CDC's independent analyses of the data from the epidemiologic investigations in Iowa and Nebraska, CDC confirmed an association between consuming a pre-packaged salad mix and being ill with cyclosporiasis during June and July 2013 in those two states.

The traceback investigation conducted by FDA identified Taylor Farms de Mexico, S. de R.L. de C.V., a processor of foodservice salads, as the source of the pre-packaged salad mix identified in the cyclosporiasis outbreak in Iowa and Nebraska.

Investigation of the Outbreak
The national investigation is ongoing and collaborative. CDC's initial efforts included providing scientific consultation to Iowa and Nebraska during early stages of the outbreak. By July 16, 2013, as cases were reported from other states, CDC began leading a multistate epidemiologic investigation, including coordination and analysis of data from state and local health departments and laboratory confirmation of cases, including via DPDx telediagnosis. During this and other multistate foodborne disease outbreaks, CDC has served as the lead coordinator among public health partners to help define the size and extent of the outbreaks and to identify the cause(s).

CDC has dedicated a team of epidemiologists, laboratory scientists, statisticians, and communicators to the work on the outbreak full time, with additional staff assisting. On July 24, 2013, CDC initiated an Epi-Aid, and has deployed an Epidemic Intelligence Service (EIS) Officer and a Public Health Prevention Service (PHPS) fellow to Texas to assist with the epidemiologic investigation of cyclosporiasis cases in that state.
Previous investigations have implicated various imported fresh produce items. At this stage of the investigation it is unclear if transmission is still occurring nationally and if all of the reported cases are part of the same outbreak.

CDC and its public health partners are vigorously working to determine if the conclusion reached in Iowa and Nebraska helps explain the increased cases of cyclosporiasis in other states. We will update the public on the progress of the national investigation as information becomes available.

source: http://www.cdc.gov/parasites/cyclosporiasis/outbreaks/investigation-2013.html

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