Posted: October 1st, 2023

# Outbreak Investigation of a Multistate Outbreak of Cyclosporiasis

Outbreak investigation topic:

Bagged Salad Mix (contaminated food) Cyclospora (Germ)

Link:

https://www.cdc.gov/parasites/cyclosporiasis/outbreaks/2020/index.html

During week six and seven, review the steps of an outbreak investigation, Table 6.2- Epidemiologic Steps of an Outbreak Investigation (from the textbook) for information related to how to answer the questions.

1. Prepare for fieldwork

2. Establish the existence of an outbreak

3. Verify the diagnosis

4. Construct a working case definition

5. Find cases systematically and record information

6. Perform descriptive epidemiology

7. Develop hypotheses

8. Evaluate hypotheses epidemiologically

9. As necessary, reconsider, refine, and re-evaluate hypotheses

10. Compare and reconcile with laboratory and/or environmental studies

11. Implement control and prevention measures

12. Initiate or maintain surveillance

13. Communicate findings

Then, for this assignment complete these 6 questions related to your approved outbreak. In a word document, answer the following questions related to your approved outbreak.

1. Provide CDC link to approved outbreak

2. How did they prepare for field work?

3. How did they establish an existence of an outbreak including the analysis by time, place, and person?

4. What was the hypothesis?

5. What was the verified diagnosis?

6. How did they communicate the findings?

Outbreak investigation topic:

Bagged Salad Mix (contaminated food) Cyclospora (Germ)

Link:

https://www.cdc.gov/parasites/cyclosporiasis/outbreaks/2020/index.html

During week six and seven, review the steps of an outbreak investigation, Table 6.2- Epidemiologic Steps of an Outbreak Investigation (from the textbook) for information related to how to answer the questions.

1. Prepare for fieldwork

2. Establish the existence of an outbreak

3. Verify the diagnosis

4. Construct a working case definition

5. Find cases systematically and record information

6. Perform descriptive epidemiology

7. Develop hypotheses

8. Evaluate hypotheses epidemiologically

9. As necessary, reconsider, refine, and re-evaluate hypotheses

10. Compare and reconcile with laboratory and/or environmental studies

11. Implement control and prevention measures

12. Initiate or maintain surveillance

13. Communicate findings

Then, for this assignment complete these 6 questions related to your approved outbreak. In a word document, answer the following questions related to your approved outbreak.

1. Provide CDC link to approved outbreak

2. How did they prepare for field work?

3. How did they establish an existence of an outbreak including the analysis by time, place, and person?

4. What was the hypothesis?

5. What was the verified diagnosis?

6. How did they communicate the findings?

Outbreak investigation topic:

Bagged Salad Mix (contaminated food) Cyclospora (Germ)

Link:

https://www.cdc.gov/parasites/cyclosporiasis/outbreaks/2020/index.html

During week six and seven, review the steps of an outbreak investigation, Table 6.2- Epidemiologic Steps of an Outbreak Investigation (from the textbook) for information related to how to answer the questions.

1. Prepare for fieldwork

2. Establish the existence of an outbreak

3. Verify the diagnosis

4. Construct a working case definition

5. Find cases systematically and record information

6. Perform descriptive epidemiology

7. Develop hypotheses

8. Evaluate hypotheses epidemiologically

9. As necessary, reconsider, refine, and re-evaluate hypotheses

10. Compare and reconcile with laboratory and/or environmental studies

11. Implement control and prevention measures

12. Initiate or maintain surveillance

13. Communicate findings

Then, for this assignment complete these 6 questions related to your approved outbreak. In a word document, answer the following questions related to your approved outbreak.

1. Provide CDC link to approved outbreak

2. How did they prepare for field work?

3. How did they establish an existence of an outbreak including the analysis by time, place, and person?

4. What was the hypothesis?

5. What was the verified diagnosis?

6. How did they communicate the findings?

Outbreak investigation topic:

Bagged Salad Mix (contaminated food) Cyclospora (Germ)

Link:

https://www.cdc.gov/parasites/cyclosporiasis/outbreaks/2020/index.html

During week six and seven, review the steps of an outbreak investigation, Table 6.2- Epidemiologic Steps of an Outbreak Investigation (from the textbook) for information related to how to answer the questions.

1. Prepare for fieldwork

2. Establish the existence of an outbreak

3. Verify the diagnosis

4. Construct a working case definition

5. Find cases systematically and record information

6. Perform descriptive epidemiology

7. Develop hypotheses

8. Evaluate hypotheses epidemiologically

9. As necessary, reconsider, refine, and re-evaluate hypotheses

10. Compare and reconcile with laboratory and/or environmental studies

11. Implement control and prevention measures

12. Initiate or maintain surveillance

13. Communicate findings

Then, for this assignment complete these 6 questions related to your approved outbreak. In a word document, answer the following questions related to your approved outbreak.

1. Provide CDC link to approved outbreak

2. How did they prepare for field work?

3. How did they establish an existence of an outbreak including the analysis by time, place, and person?

4. What was the hypothesis?

5. What was the verified diagnosis?

6. How did they communicate the findings?

Outbreak investigation topic:

Bagged Salad Mix (contaminated food) Cyclospora (Germ)

Link:

https://www.cdc.gov/parasites/cyclosporiasis/outbreaks/2020/index.html

During week six and seven, review the steps of an outbreak investigation, Table 6.2- Epidemiologic Steps of an Outbreak Investigation (from the textbook) for information related to how to answer the questions.

1. Prepare for fieldwork

2. Establish the existence of an outbreak

3. Verify the diagnosis

4. Construct a working case definition

5. Find cases systematically and record information

6. Perform descriptive epidemiology

7. Develop hypotheses

8. Evaluate hypotheses epidemiologically

9. As necessary, reconsider, refine, and re-evaluate hypotheses

10. Compare and reconcile with laboratory and/or environmental studies

11. Implement control and prevention measures

12. Initiate or maintain surveillance

13. Communicate findings

Then, for this assignment complete these 6 questions related to your approved outbreak. In a word document, answer the following questions related to your approved outbreak.

1. Provide CDC link to approved outbreak

2. How did they prepare for field work?

3. How did they establish an existence of an outbreak including the analysis by time, place, and person?

4. What was the hypothesis?

5. What was the verified diagnosis?

6. How did they communicate the findings?

Outbreak investigation topic:

Bagged Salad Mix (contaminated food) Cyclospora (Germ)

Link:

https://www.cdc.gov/parasites/cyclosporiasis/outbreaks/2020/index.html

During week six and seven, review the steps of an outbreak investigation, Table 6.2- Epidemiologic Steps of an Outbreak Investigation (from the textbook) for information related to how to answer the questions.

1. Prepare for fieldwork

2. Establish the existence of an outbreak

3. Verify the diagnosis

4. Construct a working case definition

5. Find cases systematically and record information

6. Perform descriptive epidemiology

7. Develop hypotheses

8. Evaluate hypotheses epidemiologically

9. As necessary, reconsider, refine, and re-evaluate hypotheses

10. Compare and reconcile with laboratory and/or environmental studies

11. Implement control and prevention measures

12. Initiate or maintain surveillance

13. Communicate findings

Then, for this assignment complete these 6 questions related to your approved outbreak. In a word document, answer the following questions related to your approved outbreak.

1. Provide CDC link to approved outbreak

2. How did they prepare for field work?

3. How did they establish an existence of an outbreak including the analysis by time, place, and person?

4. What was the hypothesis?

5. What was the verified diagnosis?

6. How did they communicate the findings?

Outbreak investigation topic:

Bagged Salad Mix (contaminated food) Cyclospora (Germ)

Link:

https://www.cdc.gov/parasites/cyclosporiasis/outbreaks/2020/index.html

During week six and seven, review the steps of an outbreak investigation, Table 6.2- Epidemiologic Steps of an Outbreak Investigation (from the textbook) for information related to how to answer the questions.

1. Prepare for fieldwork

2. Establish the existence of an outbreak

3. Verify the diagnosis

4. Construct a working case definition

5. Find cases systematically and record information

6. Perform descriptive epidemiology

7. Develop hypotheses

8. Evaluate hypotheses epidemiologically

9. As necessary, reconsider, refine, and re-evaluate hypotheses

10. Compare and reconcile with laboratory and/or environmental studies

11. Implement control and prevention measures

12. Initiate or maintain surveillance

13. Communicate findings

Then, for this assignment complete these 6 questions related to your approved outbreak. In a word document, answer the following questions related to your approved outbreak.

1. Provide CDC link to approved outbreak

2. How did they prepare for field work?

3. How did they establish an existence of an outbreak including the analysis by time, place, and person?

4. What was the hypothesis?

5. What was the verified diagnosis?

6. How did they communicate the findings?

Outbreak investigation topic:

Bagged Salad Mix (contaminated food) Cyclospora (Germ)

Link:

https://www.cdc.gov/parasites/cyclosporiasis/outbreaks/2020/index.html

During week six and seven, review the steps of an outbreak investigation, Table 6.2- Epidemiologic Steps of an Outbreak Investigation (from the textbook) for information related to how to answer the questions.

1. Prepare for fieldwork

2. Establish the existence of an outbreak

3. Verify the diagnosis

4. Construct a working case definition

5. Find cases systematically and record information

6. Perform descriptive epidemiology

7. Develop hypotheses

8. Evaluate hypotheses epidemiologically

9. As necessary, reconsider, refine, and re-evaluate hypotheses

10. Compare and reconcile with laboratory and/or environmental studies

11. Implement control and prevention measures

12. Initiate or maintain surveillance

13. Communicate findings

Then, for this assignment complete these 6 questions related to your approved outbreak. In a word document, answer the following questions related to your approved outbreak.

1. Provide CDC link to approved outbreak

2. How did they prepare for field work?

3. How did they establish an existence of an outbreak including the analysis by time, place, and person?

4. What was the hypothesis?

5. What was the verified diagnosis?

6. How did they communicate the findings?

Outbreak investigation topic:

Bagged Salad Mix (contaminated food) Cyclospora (Germ)

Link:

https://www.cdc.gov/parasites/cyclosporiasis/outbreaks/2020/index.html

During week six and seven, review the steps of an outbreak investigation, Table 6.2- Epidemiologic Steps of an Outbreak Investigation (from the textbook) for information related to how to answer the questions.

1. Prepare for fieldwork

2. Establish the existence of an outbreak

3. Verify the diagnosis

4. Construct a working case definition

5. Find cases systematically and record information

6. Perform descriptive epidemiology

7. Develop hypotheses

8. Evaluate hypotheses epidemiologically

9. As necessary, reconsider, refine, and re-evaluate hypotheses

10. Compare and reconcile with laboratory and/or environmental studies

11. Implement control and prevention measures

12. Initiate or maintain surveillance

13. Communicate findings

Then, for this assignment complete these 6 questions related to your approved outbreak. In a word document, answer the following questions related to your approved outbreak.

1. Provide CDC link to approved outbreak

2. How did they prepare for field work?

3. How did they establish an existence of an outbreak including the analysis by time, place, and person?

4. What was the hypothesis?

5. What was the verified diagnosis?

6. How did they communicate the findings?

Outbreak investigation topic:

Bagged Salad Mix (contaminated food) Cyclospora (Germ)

Link:

https://www.cdc.gov/parasites/cyclosporiasis/outbreaks/2020/index.html

During week six and seven, review the steps of an outbreak investigation, Table 6.2- Epidemiologic Steps of an Outbreak Investigation (from the textbook) for information related to how to answer the questions.

1. Prepare for fieldwork

2. Establish the existence of an outbreak

3. Verify the diagnosis

4. Construct a working case definition

5. Find cases systematically and record information

6. Perform descriptive epidemiology

7. Develop hypotheses

8. Evaluate hypotheses epidemiologically

9. As necessary, reconsider, refine, and re-evaluate hypotheses

10. Compare and reconcile with laboratory and/or environmental studies

11. Implement control and prevention measures

12. Initiate or maintain surveillance

13. Communicate findings

Then, for this assignment complete these 6 questions related to your approved outbreak. In a word document, answer the following questions related to your approved outbreak.

1. Provide CDC link to approved outbreak

2. How did they prepare for field work?

3. How did they establish an existence of an outbreak including the analysis by time, place, and person?

4. What was the hypothesis?

5. What was the verified diagnosis?

6. How did they communicate the findings?

Outbreak investigation topic:

Bagged Salad Mix (contaminated food) Cyclospora (Germ)

Link:

https://www.cdc.gov/parasites/cyclosporiasis/outbreaks/2020/index.html

During week six and seven, review the steps of an outbreak investigation, Table 6.2- Epidemiologic Steps of an Outbreak Investigation (from the textbook) for information related to how to answer the questions.

1. Prepare for fieldwork

2. Establish the existence of an outbreak

3. Verify the diagnosis

4. Construct a working case definition

5. Find cases systematically and record information

6. Perform descriptive epidemiology

7. Develop hypotheses

8. Evaluate hypotheses epidemiologically

9. As necessary, reconsider, refine, and re-evaluate hypotheses

10. Compare and reconcile with laboratory and/or environmental studies

11. Implement control and prevention measures

12. Initiate or maintain surveillance

13. Communicate findings

Then, for this assignment complete these 6 questions related to your approved outbreak. In a word document, answer the following questions related to your approved outbreak.

1. Provide CDC link to approved outbreak

2. How did they prepare for field work?

3. How did they establish an existence of an outbreak including the analysis by time, place, and person?

4. What was the hypothesis?

5. What was the verified diagnosis?

6. How did they communicate the findings?

Outbreak investigation topic:

Bagged Salad Mix (contaminated food) Cyclospora (Germ)

Link:

https://www.cdc.gov/parasites/cyclosporiasis/outbreaks/2020/index.html

During week six and seven, review the steps of an outbreak investigation, Table 6.2- Epidemiologic Steps of an Outbreak Investigation (from the textbook) for information related to how to answer the questions.

1. Prepare for fieldwork

2. Establish the existence of an outbreak

3. Verify the diagnosis

4. Construct a working case definition

5. Find cases systematically and record information

6. Perform descriptive epidemiology

7. Develop hypotheses

8. Evaluate hypotheses epidemiologically

9. As necessary, reconsider, refine, and re-evaluate hypotheses

10. Compare and reconcile with laboratory and/or environmental studies

11. Implement control and prevention measures

12. Initiate or maintain surveillance

13. Communicate findings

Then, for this assignment complete these 6 questions related to your approved outbreak. In a word document, answer the following questions related to your approved outbreak.

1. Provide CDC link to approved outbreak

2. How did they prepare for field work?

3. How did they establish an existence of an outbreak including the analysis by time, place, and person?

4. What was the hypothesis?

5. What was the verified diagnosis?

6. How did they communicate the findings?

Outbreak Investigation of a Multistate Outbreak of Cyclosporiasis Linked to Bagged Salad Mixes – United States, 2020

Introduction

An outbreak of Cyclosporiasis caused by the parasite Cyclospora cayetanensis was identified across several states in the United States during the spring and summer of 2020. Public health officials at the Centers for Disease Control and Prevention (CDC) and local health departments conducted an investigation to identify the source. This paper summarizes the key steps and findings of that outbreak investigation.

Methods

The CDC and local health departments began monitoring reports of Cyclosporiasis infections and identified clusters of cases across multiple states over successive weeks from May-August 2020. Case reports were analyzed to identify common exposures or risk factors. Epidemiological and laboratory investigations were initiated, including collection of information and stool samples from infected individuals. Regulatory agencies and the food industry were engaged to provide product and distribution records to aid the trace back.

Results

Descriptive epidemiology found that case-patients reported similar exposures to bagged salad mixes purchased from grocery stores. The initial hypothesis was that bagged salad mixes were a likely vehicle of infection based on the clustering of cases by time, location, and reported food histories. Laboratory testing of stool specimens confirmed the diagnosis of Cyclosporiasis caused by Cyclospora cayetanensis. Traceback investigations identified that bagged salad mixes containing romaine lettuce, carrots, and dill were implicated.

Conclusion

This investigation confirmed that bagged salad mixes were the source of a multistate outbreak of Cyclosporiasis in 2020. Public health advisories and recalls of implicated products were issued to prevent further illnesses. Ongoing surveillance and coordination between public health and industry partners helped control the outbreak and protect consumer health.