Cyclospora outbreak deaths in Michigan had been identified by state health officials, while the Centers for Disease Control and Prevention had publicly acknowledged the two cases without yet adding them to its numerical outbreak totals. The gap was a reporting-lag snapshot, not evidence that the federal government had hidden the deaths.
The Michigan Department of Health and Human Services said medical records showed both people had significant underlying health conditions that may have been affected by cyclosporiasis and dehydration, according to reporting by Ars Technica and a syndicated CNN report. The state did not say that the parasite alone caused either death.
CDC added a notice to its outbreak page saying it was aware of two cyclosporiasis-related deaths in Michigan involving people with underlying health conditions. But the agency’s data table had not yet incorporated them at the time. Emily Hilliard, press secretary for the Department of Health and Human Services, confirmed the Michigan information to Ars Technica and said CDC and the Food and Drug Administration planned to update national illness, hospitalization and death figures that week.
Why did earlier CDC data say there were no deaths?
The apparent conflict is about timing. In its July 14 Health Alert Network advisory, CDC reported 1,645 confirmed domestically acquired cases since May 1, with 141 hospitalizations among patients for whom that information was available and no deaths reported. The Michigan deaths were identified later.
Surveillance totals also change because agencies separate confirmed cases from reports that still need investigation. The July advisory said CDC was aware of more than 5,100 additional cases requiring analysis. A later syndicated CNN report put the season’s domestic tally above 18,000, including 6,707 confirmed cases and roughly 11,500 still being evaluated for whether they were acquired in the United States. Those are not directly interchangeable figures.
What is cyclosporiasis and how serious is it?
Cyclosporiasis is an intestinal illness caused by the microscopic Cyclospora parasite. People can become infected through food or water contaminated with the parasite; CDC says direct person-to-person spread is unusual. Watery diarrhea is the most common symptom, and patients can also experience nausea, fatigue, appetite loss, bloating and weight loss.
The illness can be severe, particularly when dehydration is involved, but CDC says it is not usually life-threatening. Detecting the parasite can also be difficult: routine stool examinations may miss it, the agency said, which contributes to underdiagnosis and underreporting.
Michigan had reported 11,234 cases and 193 hospitalizations when it announced the deaths, according to the CNN report. Federal and state agencies were investigating several clusters. Taylor Farms had recalled iceberg lettuce, but the available reporting does not establish that the recalled product caused every illness or either Michigan death.
CDC considers May through August the annual U.S. cyclosporiasis season, when case counts generally rise. Its July advisory said the agencies and state health departments were still investigating the sources of the multistate outbreaks.
This story draws on original reporting from Ars Technica.
