Alabama Cyclosporiasis Outbreak Grows to 85 Cases, Concentrated in North Alabama

GADSDEN, AL – State health officials are urging North Alabama residents to take food-safety precautions as an outbreak of cyclosporiasis continues to grow across the state.

The Alabama Department of Public Health reports 85 confirmed cases statewide, with more than 70 percent of them in the Northern Health District that includes Etowah County and surrounding areas. At least two people have been hospitalized. Alabama Public Radio has reported that the statewide outbreak has turned deadly. GadsdenThrive is working to independently confirm that report and will update this story with details.

What is causing the Alabama outbreak?

The outbreak in Alabama is part of a larger national one. Federal health officials identified lettuce grown in Mexico and served at Taco Bell locations in nine states as a source of the widespread outbreak. As of late July, the number of cases linked to that lettuce was about 1,947 nationally, including at least 98 people who had to be hospitalized, according to the Centers for Disease Control and Prevention.

In Alabama, of the 85 confirmed cases, about 22 are tied to Mexican-style restaurant chains operating in the state. Four of those are connected to the multi-state Taco Bell outbreak, and four are associated with a Mexican-style restaurant chain based in Florida. Health officials have stressed that no single brand or product has been blamed for every case, and the investigation is ongoing.

What is cyclosporiasis?

Cyclosporiasis is an intestinal illness caused by a microscopic parasite called Cyclospora cayetanensis. A person becomes infected by swallowing food or water contaminated with the parasite. It does not spread directly from one person to another, which sets it apart from many common stomach bugs.

Domestically acquired cases in the United States are most often linked to contaminated fresh produce, including basil, cilantro, leafy greens such as lettuce, snow peas, raspberries and melons. The illness is most commonly reported in the United States from spring through late summer, roughly May through August.

What are the symptoms?

The most common symptom is watery diarrhea that can come and go, sometimes for weeks. Other symptoms include stomach cramping, nausea, loss of appetite, fatigue and a low-grade fever. Symptoms typically begin about a week after a person swallows the parasite.

Because the illness can last for weeks and can relapse, people often mistake it for a stubborn stomach virus. Anyone with prolonged or relapsing watery diarrhea should contact a health-care provider and mention cyclosporiasis specifically, since a standard stool test may not detect the parasite unless the laboratory is looking for it.

The good news is that cyclosporiasis is treatable. A course of antibiotics, most commonly the combination drug known as TMP-SMX, usually clears the infection. People who cannot take that medication should talk with their provider about alternatives.

How can residents protect themselves?

There is no vaccine for cyclosporiasis, so prevention centers on food safety. The CDC advises washing all fruits and vegetables thoroughly under running water before eating, cutting or cooking them, even produce labeled as pre-washed. Firm produce such as melons and cucumbers should be scrubbed with a clean produce brush.

Health officials caution that washing may reduce contamination but cannot guarantee removal of the parasite, because its small size and the uneven surface of items like raspberries can trap it. Staying aware of recall and outbreak notices is another important layer of protection, since these cases usually trace back to a contaminated batch of produce or a restaurant supply chain rather than anything done wrong at home.

Frequently asked questions

Is cyclosporiasis contagious from person to person? No. The parasite needs time in the environment before it can infect someone, so it is not passed directly between people. Infection comes from swallowing contaminated food or water.

How long do symptoms last? Without treatment, symptoms can last from a few days to several weeks and may come and go. Antibiotic treatment usually shortens the illness.

What should I do if I think I have it? Contact a health-care provider, describe your symptoms, and specifically mention cyclosporiasis so the correct test can be ordered.

Are local restaurants involved? State officials have tied some Alabama cases to Mexican-style restaurant chains but have not identified specific Etowah County locations. GadsdenThrive will report any confirmed local information.

Residents can find updates and food-safety information on the Alabama Department of Public Health website at alabamapublichealth.gov. GadsdenThrive will report any confirmed local case counts or additional guidance from state health officials.