Cases of the potentially debilitating parasitic infection cyclosporiasis, which can cause explosive diarrhea, have risen 20% in the Sarasota-Manatee region, according to the latest Florida Department of Health data updated Aug. 6.
While Sarasota County's case count has remained at four since May 1, Manatee County's total has increased to eight, up from six a week ago.
Cases were reported for the first time in Charlotte County, just south of Sarasota County, as well as in Baker and Indian River counties, according to Florida Department of Health data updated Aug. 6.
Broward County saw the largest increase, with 12 new cases; Bay added nine, and Lee and Miami-Dade added seven each. Cyclosporiasis has now been reported in 42 of Florida's 67 counties.
That brings the state total cases to 342 since May 1, when a large outbreak in nine states was linked to iceberg lettuce, a 34.6% jump since the week before. The parasitic infection known for causing explosive diarrhea has been rapidly spreading around the country and has been linked to two deaths in Michigan, one of the hardest-hit states.
Nationally, more than 10,000 confirmed cases in 47 states have been reported by the Centers for Disease Control and Prevention (CDC). Laboratories have not yet confirmed at least 12,255 additional cases, the CDC said on Aug. 4.
Death from cyclosporiasis is uncommon, the CDC said. Michigan's health department noted that both patients had "significant underlying health conditions" that may have been impacted by the illness and resulting dehydration.
The largest outbreak has been connected to iceberg lettuce grown in Mexico and distributed by California-based Taylor Farms in nine states, prompting recalls and warnings for consumers who bought certain packaged salad products. The Food and Drug Administration is also investigating smaller outbreaks around the country.
Florida's cases have not been linked to any specific outbreak.
Cyclosporiasis cases in Florida
Florida continues to see a surge in cyclosporiasis cases, with state health officials reporting 342 probable and confirmed cases between May 1 and Aug. 1, out of a total of 352 reported cases this year. State and federal officials have not confirmed whether the state's cyclosporiasis cases are linked to any specific outbreak.
Cyclosporiasis is not uncommon in Florida, where the warm climate and year-round access to fresh produce make it especially vulnerable. The state often sees a seasonal rise in cyclosporiasis during late spring and summer, with an average of 246 cases of cyclosporiasis every year from 2015 through 2025. Cases surged over 500 in both 2019 and 2022.
Cases by county since May 1, with last week's increase:
- Alachua County: 4
- Baker County: 1 (+1)
- Bay County: 16 (+9)
- Brevard County: 6 (-1)
- Broward County: 34 (+12)
- Charlotte County: 1 (+1)
- Collier County: 7 (+1)
- Columbia County: 1
- Duval County: 8 (+2)
- Escambia County: 3
- Flagler County: 3
- Gadsden County: 1
- Hernando County: 1
- Highlands County: 2
- Hillsborough County: 10 (+2)
- Indian River County: 1 (+1)
- Jackson County: 2 (+1)
- Lake County: 6 (+2)
- Lee County: 30 (+7)
- Leon County: 5 (+1)
- Manatee County: 8 (+2)
- Marion County: 5 (+2)
- Martin County: 2
- Miami-Dade County: 47 (+7)
- Monroe County: 1
- Nassau County: 1
- Okaloosa County: 7 (+3)
- Orange County: 25 (+4)
- Osceola County: 8
- Palm Beach County: 16 (+16)
- Pasco County: 5
- Pinellas County: 16 (+5)
- Polk County: 10 (+3)
- Santa Rosa County: 5 (+1)
- Sarasota County: 4
- Seminole County: 11 (+6)
- St. Johns County: 9 (+2)
- St. Lucie County: 3
- Sumter County: 2
- Volusia County: 11 (+3)
- Wakulla County: 1
- Walton County: 3 (+1)
Who is getting cyclospora infections in Florida?
Florida's 342 victims of cyclospora infections are all ages from the 5-9 age range and up, FDOH data showed, including three people 85 years of age or older.
Of those cases, 201 were acquired in Florida, 31 were acquired in another state, and 45 were acquired outside the country, data shows. The source of 65 of the cases was unknown.
Cyclosporiasis by the numbers
States are reporting much higher numbers of cases than the CDC, especially Ohio and Michigan, as state numbers include both probable and confirmed cases and have a faster reporting turnaround. As of Aug. 6, Ohio is reporting 4,087 cases, and Michigan is reporting 12,218 cases and two deaths.
CDC numbers are reported weekly and include only cases that are laboratory-confirmed, acquired domestically, and occurred since May 1. CDC numbers tend to experience a six-week lag, according to the agency.
Since May 1, the CDC has confirmed reports of:
- 10,468 laboratory-confirmed domestic cases of cyclosporiasis
- 517 hospitalizations
- 2 deaths
- 47 states reporting cases
What cyclosporiasis is and why it matters
Cyclospora is a microscopic parasite that can contaminate fresh produce, particularly items like lettuce, herbs and other leafy greens that are often eaten raw. The parasite can cause cyclosporiasis, a gastrointestinal illness that frequently leads to several days or even weeks of watery or “explosive” diarrhea, stomach cramps, nausea, and fatigue.
For healthy adults, the illness can be miserable but manageable; for older residents, pregnant women and people with weakened immune systems, the risk of dehydration and complications is significantly higher.
Investigations by the Food and Drug Administration, the CDC, and state health officials have linked the larger, nine-state outbreak to California produce supplier Taylor Farms, which issued a voluntary recall on July 17 of iceberg lettuce products from Taylor Farms de Mexico.
What are the symptoms of cyclosporiasis?
Symptoms of cyclosporiasis may vary, according to the CDC, but watery diarrhea is the most common. Others include loss of appetite, weight loss, cramping, bloating, increased gas, nausea, and fatigue.
Some people may also experience vomiting, body aches, headaches, low-grade fever, and other flu-like symptoms. Others may show no symptoms at all.
Symptoms can begin to show from two days to two weeks or more after infection, the CDC said. Without treatment, symptoms can last anywhere from a few days to a month or longer.
If symptoms persist, contact your health care provider.
How to avoid cyclospora
The single best way to avoid the illness is not to eat food connected with an outbreak, the CDC said.
Fightbac.org offers more tips on avoiding foodborne illnesses:
- Wash your hands. Before and after handling food, wash your hands with warm water and soap for at least 20 seconds.
- Discard outer layers. When possible, throw away the outer layer of fruits and vegetables, such as the outer two to three layers of leafy greens.
- Rinse produce thoroughly. Rinse all fresh fruits and vegetables under clean running water, even if you plan to peel them. Use a clean vegetable brush to scrub firm produce. However, Cyclospora parasites are resistant to rinsing.
- Be cautious with pre-washed or pre-cut produce. Commercial washing processes may not be sufficient to remove the parasite. Many of the Taylor Farms products that were recalled were pre-cut lettuce in bags, such as salad kits.
- Avoid cross-contamination. Clean kitchen countertops, cutting boards, utensils, etc. with hot, soapy water.
- Prioritize cooking. If the produce can be cooked, heating it to a temperature of at least 158 degrees is the safest option, as the parasite is resistant to routine chemical disinfection and washing alone cannot guarantee its removal. Cyclospora cannot survive at these elevated temperatures.
To have as much control as possible over your produce, you might try growing it yourself.
C. A. Bridges is a journalist for the USA TODAY Network-Florida's service journalism Connect team. You can get all of Florida’s best content directly in your inbox each weekday by signing up for the free newsletter, Florida TODAY.
(This story was updated to add new information.)
This article originally appeared on Sarasota Herald-Tribune: Sarasota-Manatee cyclosporiasis cases rise as Florida outbreak grows
