The Illinois Department of Public Health is reporting more than 500 cases of cyclosporiasis across Illinois, of which 200 report eating salads from McDonald’s.

The IDPH is presently investigating the increase, officials said in a Friday news release.

As of Friday (July 27, 2018), IDPH is reporting 574 cases of cyclosporiasis in counties across Illinois, with people becoming ill starting in mid-May.

Of those Illinois cases, 214 reported eating salads from McDonald’s in the days before becoming ill.

According to the IDPH, 158 Illinois cases are linked to a private event held at the Evanston Golf Club.

According to the Centers For Disease Control, cyclospora illnesses have been reported in 15 states: Connecticut, Florida, Iowa, Illinois, Indiana, Kentucky, Michigan, Minnesota, Montana, Nebraska, Ohio, South Dakota, Tennessee, Virginia and Wisconsin.

The patients in Connecticut, Michigan, Tennessee and Virginia bought their salads in Illinois while traveling.

On July 20, McDonald’s updated its statement on salads, noting that Illinois restaurants have replaced the lettuce blend linked to the parasite.

“The health and safety of our customers and the people who work in McDonald’s restaurants is always our top priority,” officials said. “The additional states identified by the FDA and CDC are among the same states where a week ago we proactively decided to remove our lettuce blend in impacted restaurants and replace it through a different supplier.”

What Is Cyclospora?

Cyclospora is a one-celled parasite too small to be seen with the naked eye (only 8 to 10 microns in diameter). Its full name is Cyclospora cayetanensis. It used to be called by such names as cyanobacterium-like, coccidia-like and Cyclospora-like bodies.

Typically, ery few cases are reported each year in Illinois.

Because Cyclospora is a newly recognized infectious organism, many questions about its biology, the ways it is spread and the illness it causes remain unanswered.

How Is Cyclospora Spread?

Cyclospora is spread by a person putting something in his or her mouth that was contaminated with infected stool. For example, the parasite can be transmitted by swallowing contaminated water or food. It is not known how common the various modes of transmission are, nor is it known whether animals can be infected and can serve as sources of infection for humans.

In contrast to many other organisms, Cyclospora is not infectious at the time it is passed in the stool of an infected person.

Who Is At Risk?

Persons of all ages are at risk for infection. Although travelers to tropical countries may be at increased risk, infection can be acquired in such countries as the United States and Canada. The risk may vary with season. Some evidence suggests that infection is most common in spring and summer.

What Are The Symptoms?

Cyclospora infects the small intestine and typically causes an illness characterized by watery diarrhea, with an average of about six to seven stools per day. Other symptoms can include loss of appetite, weight loss, bloating, increased gas, stomach cramps, nausea, vomiting, tiredness, muscle aches and low-grade fever.

Some persons notice flu-like symptoms before they notice the gastrointestinal symptoms. Some persons infected with Cyclospora do not develop any symptoms.

The length of time between becoming infected and developing symptoms probably averages at least several days and quite commonly is about a week.

What Should You Do If Infected?

If you think you may be infected with Cyclospora, you should consult your physician. Identification of this parasite in stool requires special kinds of laboratory techniques that are not routinely used.

Therefore, your physician should specifically request testing for this parasite. More than one stool sample may need to be checked to find the organism. Your physician also may want to have your stool checked for other infectious organisms that can cause similar symptoms.

How Is The Infection Treated?

Infection with Cyclospora is treatable with antibiotics. Infected persons who have diarrhea should rest and drink plenty of fluids. They should seek their physician’s advice before taking a medication to slow their diarrhea.

How Can Infection Be Prevented?

Based on the currently available information about how Cyclospora infection is spread, avoiding food and water that may be contaminated with stool probably is the best way to prevent infection. In addition, produce should be washed thoroughly before it is eaten.

Infected persons should wash their hands often to prevent the spread of infection. Persons who have previously been infected with Cyclospora can become infected again.

SOURCE: Illinois Department of Public Health news release, Centers For Disease Control