FDA Tackles Prevalence of Cyclospora Infections with New Action Plan

The increasing prevalence of a foodborne parasite prompted the FDA to develop an action plan to deal with Cyclospora contamination, with particular emphasis on fresh produce.

The Food and Drug Administration unveiled the plan yesterday, July 1, referring to the first known contamination of U.S. products in 2018, as well as an outbreak that year attributed to McDonald’s salads.

However, a statement released with the plan does not mention a recall launched last week by Dole involving domestic blueberries contaminated with the pest. American blueberries are being recalled in the United States and Canada, but no illness has yet been confirmed.

Develop the “Cyclospora Prevention, Response and Research Action Plan”, an FDA working group particularly focused on 2018-2020. Frank Yiannas, FDA deputy commissioner for food policy and response, said part of the increase in Cyclospora detection and disease is likely due to progress in testing.

According to the Centers for Disease Control and Prevention, there have been around 6,000 cases of cyclosporosis contracted in the country in the past three years. The number is not representative of the actual number of infections – which are expected to be much higher – as many sick people do not seek medical treatment or testing.

Before 2018, in the United States, only imported fresh produce was contaminated with the parasite. Another factor in the increase in the number of positive tests in foreign and domestic products is a special program implemented by the FDA in 2018.

“Using a test method developed by scientists at the FDA, C. cayetanensis (the parasite that causes infection in humans) was first found in domestically grown produce, cilantro, during a 2018 surveillance sampling mission not associated with an outbreak, ”according to the FDA’s announcement regarding the new plan to action. “Shortly afterwards, C. cayetanensis was again detected during an outbreak linked to a bagged salad mix used by McDonald’s restaurants made with ingredients sourced primarily from domestic producers.

Even without the new action plan, the FDA began to implement measures to control the number of infections. The FDA took samples of imported products, inspected foreign farms, and created import alerts in response to unfavorable results. Import alerts tell FDA field staff, as well as industry, that the agency has sufficient evidence to permit the detention without physical examination (DWPE) of products that appear to violate laws and regulations of the FDA.

As part of the action plan, which is inspired by our action plan on Shiga toxin-producing E. coli (STEC) in leafy vegetables, the Cyclospora plan focuses on improving prevention , improving response activities and filling knowledge gaps to help prevent food contamination and to help prepare for future outbreaks, according to a statement from Susan Mayne, director of the Center for Food Safety and Applied Nutrition from the FDA.

The plan’s working group includes multidisciplinary experts from the FDA and CDC with the goal of reducing the public health burden of foodborne illnesses caused by Cyclospora. in products. The working group developed the plan as a strategic guide in three priority areas: improving prevention, improving response activities and filling knowledge gaps.

About Cyclospora
Cyclospora cayetanensis is a parasite composed of a single cell, too small to be seen without a microscope. It causes an intestinal infection called cyclosporosis, according to the CDC.

Cyclospora is spread by people who ingest something – such as food or water – that has been contaminated with feces. Contamination can be very small amounts, invisible to the naked eye. Cyclospora usually needs at least one to two weeks after having a bowel movement to become infectious to another person. Therefore, Cyclospora is unlikely to be passed directly from person to person. People can get infected with Cyclospora more than once.

The time between infection and illness is usually about a week. Cyclospora infects the small intestine and usually causes watery diarrhea, with frequent, sometimes explosive stools. Other common symptoms include loss of appetite, weight loss, stomach cramps / pain, bloating, increased gas, nausea, and fatigue. Vomiting, body aches, headache, fever, and other flu-like symptoms may be noted. Some people infected with Cyclospora do not have any symptoms.

If left untreated, the disease can last from a few days to a month or more. Symptoms may seem to go away and then reappear one or more times. It is common for infected people to feel very tired.

The recommended treatment is a combination of two antibiotics, trimethoprim-sulfamethoxazole, also known as Bactrim, Septra, or Cotrim. People with diarrhea also need to rest and drink plenty of fluids. No highly effective alternative medicine has yet been identified for people infected with Cyclospora who are unable to take sulfa drugs. Health care providers can discuss other treatment options with patients.

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