Dallas County Department of Health and Human Services says more than a dozen cases of cyclosporiasis have been reported in the county since July 8.
County health officials said the cases were not the result of recent international travel, and are more likely related to the statewide outbreak that's taken place over the last two months.
DCHHS said the investigation into a common exposure source is ongoing, but outbreaks this summer and in recent years have been associated with imported cilantro from the state of Puebla in Mexico.
The FDA announced on Monday the likely cause of hundreds of U.S. cases of cyclosporiasis were related to human feces and toilet paper found in growing fields in Puebla.
Earlier this week, the Texas Department of State Health Services said there were 205 cases of cyclosporiasis reported statewide. At the time, state officials said there were 17 cases in Dallas County. The county now reports that number at 14 cases.
In 2014, there were 200 reported cases of cyclosporiasis in Texas tied to tainted cilantro from Mexico.
At this time a recall has not been issued. Concerned shoppers are cautioned to ask their grocer about the origin of the cilantro sold in stores and to thoroughly wash all fresh produce. The Texas DSHS warns washing produce may not entirely eliminate the risk because cyclospora can be difficult to wash off. Cooking will kill the parasite.
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What to Know About Cyclospora/Cyclosporiasis: CDC
How is the parasite spread?
Cyclospora is spread by people ingesting something contaminated with feces. Since the parasite needs time to become infectious after being passed in a bowel movement, it's unlikely that it can be passed directly from person to person.
Who is at risk of infection?
People living or traveling in areas where the parasite is endemic are at risk. In the U.S., foodborne outbreaks have been linked to imported produce in 2014 and 2015.
What are the symptoms?
Some infected persons are asymptomatic, particularly in settings where cyclosporiasis is endemic. Among symptomatic persons, the incubation period averages ~1 week (ranges from ~2-14 or more days). cyclospora infects the small intestine and typically causes watery diarrhea, with frequent, sometimes explosive, stools. Other common symptoms include loss of appetite, weight loss, abdominal cramping/bloating, increased flatus, nausea, and prolonged fatigue. Vomiting, body aches, low-grade fever, and other flu-like symptoms may be noted. If untreated, the illness may last for a few days to a month or longer, and may follow a remitting-relapsing course. Although cyclosporiasis usually is not life threatening, reported complications have included malabsorption, cholecystitis, and Reiter's Syndrome (reactive arthritis).
How do you prevent infection?
On the basis of currently available information, avoiding food or water that might have been contaminated with stool is the best way to prevent infection. Travelers to cyclosporiasis-endemic areas should be told that food and water precautions for cyclospora are similar to those for other intestinal pathogens, except that cyclospora is unlikely to be killed by routine chemical disinfection or sanitizing methods. Symptomatic reinfection can occur. Cooking produce with the parasite will kill the parasite.
What should I do if I believe I'm infected?
See your doctor immediately.
How is the infection treated?
Cyclosporiasis infections are generally treated with a combination of two antibiotics. Those with diarrhea should also get rest and drink plenty of fluids.
More Information: Centers for Disease Control and Prevention
