Something You Ate?

Cyclospora outbreak leads to intestinal misery in Travis County

Something You Ate?

If you're anything like me, you spent the first two weeks of June chained to the porcelain throne. I lost a lot of water weight; we won't get into what got jettisoned alongside it. By the time I hit recovery, some friends had started talking.

A few dozen acquaintances, I learned, had also been affected by the ailment: severe diarrhea with few other discernible symptoms (small chills, fatigue, and weight loss are among them). Was it contagious, or did we all eat something together? Some of the affected were folks I hadn't seen in months. So was city water to blame? It hit each of us the week after Memorial Day, when much of Central Texas flooded.

Last Tuesday, local news outlets throughout the county got an email indicating that "the Austin-Travis County Health & Human Services Department is investigating an outbreak of cyclospora, an intestinal illness caused by a microscopic parasite." People are eating food that's been contaminated by fecal matter, basically, and it's happening all over Texas. There were 15 confirmed and probable local cases (as well as 11 under investigation) when the news went out last Tuesday. On Monday, ATCHHS reported that the number was up to 50.

"There have been previous outbreaks around the United States, including outbreaks in the last three summers," explained Jeff Taylor, a senior epidemiologist with the ATCHHS. "The initial outbreaks that occurred in the Nineties were related to raspberries from Guatemala. Recent summers have had outbreaks related to lettuce mixes, basil, and then cilantro. In 2013, cases started occurring throughout the United States in early summer. In Texas, it occurred into the fall. They were linked to produce or fresh berries in [other recent] outbreaks. We may see the same thing this year. We just don't know what food it may be yet."

Taylor and three colleagues spent months trying to sort through the minefields of the cyclospora scene in search of some common thread that could tie patients together. Our interview was essentially a cross-examination, with me asking about incubation periods (one to 10 days, with onset of diarrhea kicking in about seven days after ingestion) and him asking where I ate the week before the first judgment day (a catered wedding, to name just one). He said the illness can last anywhere from a few days to a month or longer, with episodes returning intermittently to remind you just how horrible life can be. Taylor said it can be treated with antibiotics, however, and encouraged anyone who's logged a lot of toilet time through June to call the disease prevention hotline at 512/972-5555. The more cases HHS can get confirmed, the more dots can be connected.

"If we get a lab-confirmed case that also says they went to a wedding reception that week, we'll know we have a common exposure," he said. "That limits the food items and helps us narrow it down. Health departments throughout the state will be looking at common cases – where you went to a restaurant, bar mitzvah, or wedding reception," which is good for research. "It's much easier for people to remember what you ate at a wedding reception."

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cyclospora, Austin-Travis County Health & Human Services, Jeff Taylor

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