California’s cyclosporiasis cases are ‘higher than expected,’ but officials aren’t sure why

California is reporting more cases of cyclosporiasis than it would on average for this point in the summer, including two recent cases where residents ate at out-of-state Taco Bell restaurants, according to state health officials and data.

Despite the uptick, officials say California is not included in the cyclosporiasis outbreak that’s hit 15 states, sickening tens of thousands of people with prolonged bouts of diarrhea.

However, officials with the California Department of Public Health told The Times the number of cases is “now higher than what we might expect for this point in the season.”

Latest cyclosporiasis case breakdown in California

California’s cyclosporiasis data now includes probable cases — meaning an ill person showed signs and symptoms of the parasite but the case lacks laboratory confirmation — as well as internationally acquired cases, significantly increasing the state’s case count from previous estimates in June.

Between Jan. 1 and July 15, there were 201 confirmed and probable cyclosporiasis cases in California, the state health department reported.

Of the total number of cases, 39 were domestically acquired, meaning these infected people became ill either in the state or after traveling within the United States.

The rest became ill after traveling internationally, it’s unclear where the sick individuals had traveled to.

“To date, CDPH is aware of 2 cases that traveled to an affected state, ate food at a Taco Bell location and are determined by CDC to be linked to the outbreak,” the agency stated. Because the parasitic disease was contracted from contaminated produce out of state, California is not counted as being a part of the current outbreak.

Of the 201 confirmed and probable cases in California, 11 people were hospitalized, officials said.

There have been no deaths in relation to the California cases of cyclosporiasis.

Why cases in California have gone up

Public health officials are working with local health departments to actively monitor cyclosporiasis cases statewide to determine if there are potential outbreaks here, and identify a possible cause for the increase in cases.

The agency said the high number of cyclosporiasis cases could be attributed to:

• Cyclosporiasis receiving recent, national attention due to the multi-state outbreak. “This has led to increased awareness of the illness in California and nationwide, which has likely led to increased testing for the illness,” the Department of Public Health stated. “We may be identifying more cases than we have in previous years.”
• Overall improvements to the department’s surveillance and data collection methods.
• An increase in cases in travelers to areas with cyclosporiasis outbreaks, whether international or domestic.

What’s happening in the multi-state outbreak

To date, 15 states have reported high numbers of cyclosporiasis cases; the epicenter continues to be in Michigan, whose state public health department has reported more than 12,400 sickened residents, 279 hospitalizations and two deaths.

The two patients who died may have had underlying health conditions that made them particularly vulnerable to the gastrointestinal illness and dehydration that can come with the disease, Michigan public health officials said.

According to the Centers for Disease Control and Prevention, cyclosporiasis is rarely fatal.

On Thursday, Michigan officials said the state’s data now suggests that, “new cyclosporiasis case reports are slowing, including a downward trend in diarrhea-related emergency department visits.”

On average, people exposed to cyclosporiasis — typically through contaminated food or water — start to feel sick seven days after exposure, but symptoms can take up to 14 days to appear.

Given the weeklong average incubation period, Michigan data suggests that:

• Most exposures occurred in late June to early July.
• The majority of the contaminated produce is likely no longer available for consumption.

The outbreak, which began in May, has affected tens of thousands of people who reported feeling ill after eating Taco Bell products with shredded lettuce.

Traceback and outbreak data have linked the shredded iceberg lettuce supplied to the Taco Bell locations to the Salinas-based company Taylor Farms and its Taylor Farms de Mexico facility in Central Mexico.

The company, also known as Taylor Fresh Foods, announced last month it was voluntarily recalling various products including chopped lettuce, shredded lettuce, blends of iceberg, romaine lettuce and salad mixes that were supplied to restaurants and retailers in 27 states.

Since May 1, the CDC has laboratory-confirmed 10,468 domestic cases of cyclosporiasis and is aware of more than 12,255 additional cases that have yet to be laboratory confirmed.

Officials say the true number of cases is likely higher because some people recover without medical care and are not tested for the parasite.