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Michigan health officials have confirmed the state’s first two deaths linked to a widespread cyclosporiasis outbreak, as reported on Monday (August 3). The Michigan Department of Health and Human Services (MDHHS) said both individuals who died had significant underlying health conditions that may have been impacted by cyclosporiasis and dehydration. Their identities and further personal information have not been released.
Cyclosporiasis is an intestinal illness caused by the parasite Cyclospora cayetanensis, which is typically spread through food or water contaminated with human feces. Symptoms often include watery diarrhea—sometimes frequent and explosive—fatigue, nausea, cramping, and loss of appetite. Dehydration from these symptoms can be especially dangerous to those with pre-existing health issues. According to MDHHS, “Cyclosporiasis is generally not a life-threatening illness. Death resulting from cyclosporiasis is uncommon in the United States.” The Detroit Free Press reports that Michigan typically sees about 50 cases of cyclosporiasis per year, but the current outbreak has surged to 11,234 cases statewide as of Monday.
Of those infected, 193 people have been hospitalized. The hardest-hit areas include Wayne, Washtenaw, Oakland, and Ingham counties, though cases have now been reported in most of Michigan’s 82 counties. Health officials believe the recent spike in reported cases was partly due to a backlog in reporting at one health system, rather than a sudden increase in new illnesses. The Michigan Department of Health and Human Services has stated that the share of emergency room visits for diarrhea has started to slow, suggesting the worst of the outbreak may be passing.
Investigators from the U.S. Centers for Disease Control and Prevention (CDC) have linked many cases to iceberg lettuce from specific distributors. However, no single grower, supplier, or produce type has been officially confirmed as the source, and other foods have not been ruled out. Taylor Farms has recalled all iceberg lettuce sourced from central Mexico.
MDHHS is urging restaurants and commercial kitchens to buy whole heads of lettuce instead of pre-washed, bagged greens, discard the outer leaves, and thoroughly rinse the rest under running water. Any leafy greens that can be cooked should be, since cooking at 158 degrees or higher kills the parasite. Health officials also advise washing all fruits and vegetables under running water before eating or preparing them, scrubbing firm produce with a clean brush, and refrigerating cut or cooked produce as soon as possible.
Cyclosporiasis is treatable with antibiotics, and most people recover fully. Severe outcomes are rare and tend to occur in those who are medically vulnerable, as seen in the two reported deaths. Anyone experiencing ongoing diarrhea, especially if accompanied by other symptoms, is urged to contact their health care provider and local health department.
Michigan’s outbreak is part of a larger national surge, with the CDC tracking increased cases in several states this summer. The situation is ongoing, and officials continue to investigate the source and monitor new developments.