Parasite outbreak in baby salad leaves left 40 people ill



The parasite Cryptosporidium was likely caused by the consumption of baby salad leaves that were supplied in salad leaf boxes to many restaurants.

A diarrhea-causing parasite left 40 people ill with GI symptoms, including 14 who required hospitalization.

The youngest impacted by the food-borne parasite outbreak of cryptosporidium was three, and the oldest was aged 74.

Along with the 14 who required hospitalization, a further seven presented at hospital emergency departments but were not admitted.

The parasite outbreak was likely caused by the consumption by the people concerned about baby salad leaves that were supplied in salad leaf boxes to many restaurants.

A new paper documents the painstaking detective work undertaken by a group of HSE public health officers and colleagues in a race against time to identify the probable source of the outbreak and thereby prevent more people from falling ill.

Traced back to a single farm

The paper entitled ‘A Foodborne Outbreak of the parasite Cryptosporidium Likely Linked to Salad Leaves’ in this month’s Irish Medical Journal (IMJ) shows the salad leaves were traced back to a single farm which led to the Food Safety Authority (FSA) putting in place a precautionary product recall of salad leaves from the farm on August 4 last year.

The first confirmed cryptosporidium case came to light on July 16 last, and the outbreak reached a peak on July 23, when more than 10 confirmed or possible cases were recorded on that day.

Thirty-one of the 40 cases concerned people from south Dublin and Wicklow. The authors state that cryptosporidium species can be found in water, soil, food, or any surface contaminated with human or animal feces.

The paper reports that the July 2020 outbreak compares to 91 cases for the Greater Dublin Area for the 12 months of 2019.

The risk of developing the severe disease may differ depending on each person’s degree of immune suppression.

As part of the investigation to identify the outbreak’s source, the public health ‘detectives’ last July carried out inspections of 110 food premises to collect food and water samples.

The outbreak control team undertook an extensive cross-check of restaurants, suppliers, and salad products (OCT).

A cluster of nine cases

The OCT had first convened the same day a cluster of nine cases were notified by a single lab in the south Dublin/Wicklow area on July 28th.

The investigation found that of the 40 cases, 31 ate at restaurants that sourced salad from the same supplier farm.

The paper states that testing of salad samples from the farm did not detect cryptosporidium.

The authors state, however: “Given the three-day shelf life of the salad box and the symptom onset of cases, negative food sample testing cannot rule out contamination of previous salad batches which were not captured in these samples.”

The authors from the Department of Public Health East, the Department of Environmental Health, and the Health Protection Surveillance Center state: “Ultimately, no microbiological link between the cases and the farm was established.”

The farm that produced the baby leaf salad was a mixed enterprise with livestock in adjoining fields.

The farmer told the OCT that the crop field didn’t receive any slurry, straw, or organic manure, was not at risk of flooding, and there were no obvious sources of contamination on inspection.

The HSE recommended that the farmer fence off the salad crop field, remediation work to a well-head on the farm, installation of UV disinfection equipment, and the washing of salad produce by food premises before use.

1. What is Cryptosporidium?

Cryptosporidium is a microscopic parasite that causes the diarrheal disease cryptosporidiosis. Both the parasite and the disease are commonly known as “Crypto.” There are many species of Cryptosporidium that infect humans and animals.

2. Symptoms of Cryptosporidium.

Symptoms of cryptosporidiosis generally begin 2 to 10 days (average 7 days) after becoming infected with the parasite. The most common symptom of cryptosporidiosis is watery diarrhea. Other symptoms include:

  • Stomach cramps or pain
  • Dehydration
  • Nausea
  • Vomiting
  • Fever
  • Weight loss

Some people with Crypto will have no symptoms at all.

Symptoms usually last about 1 to 2 weeks (with a range of a few days to 4 or more weeks) in persons with healthy immune systems. Occasionally, people may experience a recurrence of symptoms after a brief period of recovery before the illness ends. Symptoms can come and go for up to 30 days. While the small intestine is the site most commonly affected, Cryptosporidium infections could possibly affect other areas of the digestive tract or the respiratory tract. People with weakened immune systems may develop a serious, chronic, and sometimes fatal illness. Examples of people with weakened immune systems include:

  • people with AIDS;
  • those with inherited diseases that affect the immune system; and
  • cancer and transplant patients who are taking certain immunosuppressive drugs.

3. Tests and prevention.

If you suspect that you might have worms or any other parasitic infection, purchase our Full GI Panel Test.

Our Full GI Panel consists of our Comprehensive Stool Analysis (CSA) and our Swab Culture. The combination of these two tests provides full coverage screening of all intestinal pathogens and is recommended for anyone experiencing GI symptoms.

For treatment of parasitic infections, we recommend our Freedom, Cleanse, Restore Herbal Remedy.

Visit Parasitology Center inc. for more info.


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