FDA finds Cyclospora in two Mexico samples; Mexico disputes it

The U.S. FDA closed on October 2 its investigation into the cyclosporiasis outbreak linked to iceberg lettuce from Taylor Farms de México. In inspections in Mexico, two environmental samples tested positive for the *Cyclospora* parasite: one from a wastewater tank at the plant and one from a drainage ditch at a supplier farm.

The agency acknowledges there is not enough evidence to determine how the contamination happened. It maintains that the samples show the parasite was present in the environment where the lettuce was grown and processed. This is an outbreak investigation, not a randomized study; genotyping of the positive samples is still under way.

Mexico's Health Secretariat and Cofepris, its health regulator, maintain, according to Expansión, that those findings are not conclusive evidence that Mexican farm products were the source. They recall that their own July 23 analysis, using real-time PCR on 10 samples of raw material and finished product, came back negative. It is an earlier and different sampling from the FDA's.

The FDA's figures: 12 883 (12,883) people sick in 21 U.S. states, 570 hospitalizations and two deaths in Michigan, both of people with prior medical conditions. Taylor Farms de México recalled product on July 17, and the CDC declared the outbreak over on September 11. According to Infobae, which draws on The New York Times, the plant remains closed.

The CDC describes cyclosporiasis as an intestinal infection with watery diarrhea as the main symptom, and says seeing a health professional for persistent or severe diarrhea is the appropriate step. That guidance comes from the institution and does not replace a medical consultation.

The outbreak cases are in the United States; Mexico's Health Secretariat reports three in Mexico in July. The CDC guidance applies to the general population.