Auglaize County reports first cyclosporiasis case

WAPAKONETA - A gastrointestinal illness brought on by a microscopic parasite found in raw produce has made its way to Auglaize County, just a week after a case was detected in Mercer County.

At the Auglaize County General Health District's regular board of health meeting on Tuesday morning, director of health promotion and planning Natalie Karner informed board members that a case of cyclosporiasis was logged in the county this week.

The disease - which causes explosive diarrhea and is often found on raw produce such as berries and greens - is running rampant through Michigan and, as a result, has spilled into the northwest region of Ohio, Karner said.

"Although it's not abnormal to see cyclosporiasis cases, they are typically associated with traveling outside the U.S. The current outbreak is impacting individuals that don't have travel history," she said. "The CDC most recently reported 843 cases (in Ohio), but they added a disclaimer in a bunch of spots that there is a lag in reporting, and there's a very, very large lag in reporting. When I looked at Michigan's state health department's website last night, they had 2,600 cases alone in Michigan - that was in Michigan alone. When I actually checked regionally, we had Toledo-Lucas who has the most cases out of Ohio, their dashboard yesterday said that Toledo-Lucas - so Lucas County - had 531 cases just in Lucas County and we had over 900 cases in the region. Our region is most likely impacted due to distributors that might be implicated."

As of Tuesday morning, the Michigan Department of Health and Human Services website had updated its statewide total cases to 3,309. Lucas County has logged 638 cases of the illness as of Tuesday, with 1,119 cases detected in the northwest Ohio region.

While the investigation into the current nationwide outbreak is ongoing, available information indicates that lettuce or salad greens may be a potential source, per the Michigan DHHS website. However, other food items cannot be completely ruled out. No specific type of produce, grower or supplier has been identified as the source.

Symptoms of the disease include watery diarrhea, loss of appetite, weight loss, abdominal cramps and/or bloating, nausea, and prolonged fatigue.

Most people infected with cyclospora experience symptoms between two and 14 days after ingesting the parasite. Sometimes those infected can have no symptoms at all.

Cyclospora spreads when people eat food or drink water contaminated with feces. It is not spread directly from one person to another. Humans are the only host of the disease.

There are no over-the-counter treatments for cyclospora. It is treated with sulfa-antibiotics such as Bactrim, Septra or Cotrim. Those allergic to sulfa drugs can talk to their healthcare provider about other potential options.

Local, state and federal health agencies are collaborating on an investigation to determine the disease source from patient interviews.

"We've had one case that's associated with the outbreak," Karner said. "If we were to get- knock on wood- if we were to get 20 cases here, each interview takes about an hour. It is a very long hypothesis-generating questionnaire from the CDC."

She recommended residents purchase their produce locally as a first line of defense against the disease; locals are also encouraged to stick to peelable fruit in the time being, and cook vegetables to 160 degrees or higher prior to consumption.

"Right now we're looking at this likely being something at a commercial distributor level," she said. "Wash your produce, store it in a refrigerator and if you are immunocompromised or you just really, really, really wanna avoid (the disease), stick to fruits that are peelable as well as vegetables that are cooked to 160 degrees or higher."

Also on Tuesday, board of health members:

• discussed Ohio House Bill 692, to revise household sewage treatment system law. The legislation was passed in the House on June 10 and introduced to the Senate June 11, where it remains. It is sponsored by State Reps. Justin Pizzulli, R-Scioto County, and Marilyn John, R-Richland County.

• heard a medical presentation on vitamin D and calcium deficiencies and their correlation to bone fractures from medical director Dr. Juan Torres.

• discussed various community outreach initiatives, spearheaded by Karner, such as honorary lemonade stand certifications.

• approved a one-year nursing contract for Diane Schulze on an as-needed basis.

• went into an executive session to discuss staff compensation. No action was anticipated following.

The health board meets next at 8:30 a.m. Aug. 11 at the Auglaize County Health Department, 813 Defiance St., Wapakoneta.