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TUESDAY, Aug. 13 (HealthDay News) -- The Mexican company that distributes a salad mix tied to a U.S. outbreak of cyclospora illnesses said Monday that it was suspending shipments of the product to the United States.
The company, Taylor Farms de Mexico, "officially informed FDA that, as of August 9, 2013, the company voluntarily suspended production and shipment of any salad mix, leafy green, or salad mix components from its operations in Mexico to the United States," the U.S. Food and Drug Administration said on its website.
The move was announced as U.S. health officials continue to try to track down the source of the widespread stomach bug outbreak, which now numbers 535 cases spread across 18 states. According to the U.S. Centers for Disease Control and Prevention, at least 32 people in five states have been hospitalized with severe cases of cyclospora infection.
Last week, the source of the outbreak in at least two states had been traced to Taylor Farms, which supplied salad mix to Olive Garden and Red Lobster restaurants and is the Mexican branch of Taylor Farms of Salinas, Calif.
"To date only the salad mix has been implicated in the outbreak of cyclosporiasis in Iowa and Nebraska," the FDA said. The agency says it is trying to determine whether the prepackaged salad mix was the source of infections in the other states.
Taylor Farms chairman and CEO Bruce Taylor said in an email last week that the plant involved produced 48 million servings of salads for thousands of restaurants in the Midwest and eastern United States in June, the month the outbreak started, the Associated Press reported. He added that the plant has an extensive water-testing program.
"All our tests have been negative and we have no evidence of cyclospora in our product," Taylor said in the email. "We are working closely with the FDA to continue this investigation."
Taylor noted that Taylor Farms de Mexico does not supply Olive Garden and Red Lobster restaurants in Texas, the state that now has the highest number of illnesses in the outbreak.
States that have recorded cases of cyclospora infection include Arkansas, Connecticut, Florida, Georgia, Illinois, Iowa, Kansas, Louisiana, Minnesota, Missouri, Nebraska, New Hampshire, New Jersey, New York, Ohio, Texas, Virginia, and Wisconsin. According to the CDC, 215 of the illnesses reported so far were in Texas. Iowa has had 153 illnesses and Nebraska has had 86.
Meanwhile, U.S. health officials said the overall investigation continues.
In a posting on its website, the CDC said that it "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. It is not yet clear whether the cases from all of the states are part of the same outbreak."
Prior outbreaks of cyclospora infection have typically been caused by tainted produce, the agency noted.
One expert said that while cyclospora can make people very ill, it is not usually life-threatening.
"On the infectious disease scale, this ranks well below the more notorious and dangerous ailments like E. coli and salmonella," said Dr. Lewis Marshall Jr., chairman of the outpatient services at Brookdale University Hospital and Medical Center in New York City.
"It is unlikely to be fatal, but certainly can make one's life miserable," he added. "Symptoms include crampy abdominal pain, watery diarrhea, loss of appetite, bloating, nausea, fatigue, fever, headache and body aches."
Cases of cyclosporiasis are caused by a single-celled parasite and cannot be spread from person to person. The parasite has to be ingested via contaminated water or foods such as fruit and vegetables, according to Dr. Monica Parise, chief of the parasitic diseases branch at the CDC.
"It can be pretty miserable, because it can give diarrhea that can last for days," Parise said.
It takes about a week for people who are infected to become sick.
Marshall said there may be more cases of cyclospora infection out there than people realize. It is possible "that most occurrences go unreported, as many people wouldn't recognize the symptoms as any different than a common stomach bug," he explained.
Dr. Thomas Frieden, CDC director, urged people who have suffered from diarrhea for longer than a couple of days to be tested for cyclospora.
"If not treated, symptoms can last from a few days to a month or longer, go away and then return later," Marshall said. "Cyclospora can be treated with an antibiotic combination of trimethoprim-sulfamethoxazole [Bactrim]."
The best option, however, is to avoid the bug altogether.
"The safest way to protect oneself and one's family is to always rinse fresh produce under water, and even put vegetables in a cold water bath ahead of time to properly clean them," Marshall advised.
One expert stressed that the wash-your-produce rule includes prepackaged salads.
"Wash all your fruits and salads before ingesting," said Dr. Salvatore Pardo, vice chairman of the emergency department at Long Island Jewish Medical Center in New Hyde Park, N.Y. "My hunch is the public does not do this to 'prepackaged' salad, which is normally purchased for convenience and dumped into the bowl since it tends to be free from particles -- dirt, sand, critters -- one would normally find in locally picked ingredients."
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