No cases here of severe diarrhoea bug, say authorities

Barbadian farming and public health authorities are monitoring the potential impact of a parasitic infectious disease outbreak in the US that has been linked to severe, or ‘explosive’ diarrhoea.

The US Centers for Disease Control and Prevention (CDC) reported on Tuesday that at least 1 645 people across 34 American states have been infected by the cyclosporiasis outbreak, resulting in 141 people being hospitalised.

Cyclospora is a parasite that causes intestinal illness and is transmitted through contaminated food and water, causing severe diarrhoea. It is not thought to be transmissible from one infected person to another. 

Past outbreaks of cyclosporiasis have mainly been linked to fresh produce, such as raspberries, basil, cilantro, fruit mixes, snow peas, snap peas, lettuce and salad mixes, according to US officials.

In Barbados, the ministries of agriculture and health have issued assurances that they are closely monitoring developments to ensure measures are in place to mitigate potential risks to Barbados, which imports fresh produce from the US.

Chief Medical Officer Dr Kenneth George confirmed on Thursday that his ministry is also monitoring the US outbreak of the disease, which he said is spread by contaminated food, usually fresh fruit and uncooked vegetables.

Dr George issued a caution to Barbadians, particularly food vendors who will be out in their numbers during the Crop Over Festival:

“The ministry takes this opportunity to remind the public of measures to prevent foodborne illness: thorough washing of fruits and vegetables; maintaining general hygiene in the food preparation areas; no mixing of raw foods with cooked foods during food preparation; washing hands before preparation of food; hot foods kept hot at 140 degrees F or higher; and cold foods kept cold at 40 degrees F or less.” 

He insisted that this must be done “particularly as it is expected that during Crop Over, there will be higher levels of preparation and selling of food. Food vendors are asked to ensure they have a valid Food Handling Certificate and maintain good food handling practices”.

The government’s top public health official has also urged vendors who have additional questions to call the Environmental Health Department at their respective polyclinics.

He also disclosed that there have been no cases of cyclosporiasis in the region as reported by the Caribbean Public Health Agency (CARPHA), nor are there any suspected or confirmed cases in Barbados.

He said the cyclospora condition is self-limiting with the symptoms of acute diarrhoea, abdominal pain and vomiting, usually confined to five to seven days. 

Confirming the joint surveillance efforts by both agriculture and health officials, Deputy Chief Agricultural Officer Michael James told Barbados TODAY: “What we normally do is to look to see if there are any problems with lettuce, for example, with respect to pests, to see if they have any insects and so on. The Ministry of Health would test… Cyclospora is a disease…an infection that infects humans. So, they are the ones that would do the testing for it. 

“The Ministry of Agriculture … would take note of produce like lettuce, as I said already, to see if there are any pests. But in terms of the health aspect, that falls under the Ministry of Health. But we are still monitoring exactly where they are coming from, so we would have that to know what level, in terms of if we are bringing any lettuce into Barbados from those sources or those areas. So, that is something we would be monitoring from our side, and I am sure the Ministry of Health would also be monitoring.”

The agriculture ministry’s role is to ensure that produce comes from a destination that is safe from plant pests, he said.

James added: “The other role is to ensure that the particular commodity meets our standards. When I say our standards…so, we have a number of things: that they are clean, obviously, in terms of free of pests; that they would not have used any deleterious type of pesticides. So, we would ask questions like: ‘When last did you spray? What did you spray with?’ So, those types of things that would be of import to us.

“But a lot of the lettuce that we use right now come from Barbados. And, obviously, through good agricultural practices, you tend to reduce that level of infection going onto your lettuce. From our end, we have not seen any increase in insect pests or anything like that on lettuce.” 

He explained that the risk of contamination may be highest for picked fruits:

“Any of those sorts of things that are picked that people come in contact with. It comes down to hygiene practices, too. You go to the bathroom, and you didn’t wash your hands, and you take the produce, or they use the water that might have the particular organism.”

Cyclosporiasis – What to Know

• 34 US states report nearly hundreds of cases of cyclosporiasis, an intestinal illness causing explosive diarrhea, so far this year, mostly since last month.
• Cyclospora is a tiny parasite that causes severe intestinal illness, including explosive diarrhoea. It often spreads through food or water contaminated with faeces, with past outbreaks linked to fresh produce.
• The source of the US outbreak has not yet been confirmed by officials.
• The infection is treatable with antibiotics, though it can also clear up on its own in healthy individuals.
• Health authorities recommend washing hands and produce thoroughly to help prevent infection.

(EJ)