141 hospitalised as 'explosive diarrhoea' outbreak grips US

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Cyclosporiasis, a parasitic infection that spreads through contaminated food or water usually during the summer, has now hit 34 states, according to the Centers for Disease Control and Prevention (CDC).

The main symptom of the gastrointestinal illness is frequent, watery diarrhoea with "sometimes explosive bowel movements", which presents typically one week after exposure.

141 people have been hospitalised as a result of the outbreak and, so far, no one has died.

Given the scale, public health experts have said there are likely to be multiple points of contamination in the food supply - another factor making investigations more complex.

Michigan is the hardest hit state, with over 3,300 cases, followed by New York.

On Tuesday, the Washington Post reported that CDC investigators identified a likely epidemiological link among cases in at least four Midwestern states - Michigan, Ohio, West Virginia and Kentucky - marking the agency’s clearest public indication yet that many of the illnesses are connected by a common source.

Don Prater, the FDA’s acting deputy commissioner for food, said officials are aware of Michigan identifying leafy lettuce as a leading suspected outbreak source.

“What I can say at this point is that we’re continuing our traceback investigation on multiple produce items, including the lettuce,” he said.

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Taco Bell said on Tuesday it had removed limited items from some restaurants as a precaution.

However, health officials have not linked the widening outbreak of cyclosporiasis to the chain or any specific food product.

Outbreaks of cyclosporiasis in the past have been linked to contaminated raw fruit, vegetables and herbs such as basil, coriander, berries and spinach.

Federal officials urged consumers to follow safe food handling practices, including washing hands and any fresh produce thoroughly under running water before eating, cutting or cooking, to reduce the risk of infection.

It is also recommended to avoid certain foods such as raspberries and cook vegetables before consuming.

Symptoms of cyclosporiasis

• loss of appetite
• weight loss
• bloating
• nausea
• fatigue
• low-grade fever
• vomiting