Cyclospora Outbreak Update – Nine States are now on the Government’s Map. Fifteen Thousand People on the States’ Own Books.

For days it has been the “Explosive Diarrhea” outbreak. Today, a new phrase slid into the lexicon – “Poopy Pants Parasite.” Neither is pleasant.

The CDC moved this morning and the FDA moved this afternoon, and for the first time in a week the two agencies are publishing the same numbers: 1,947 people, nine states, 98 hospitalizations, no deaths. Illinois, Kansas, Oklahoma and Pennsylvania have joined Indiana, Kentucky, Michigan, Ohio and West Virginia. The four additions were reported first by the Washington Post at five o’clock this morning, hours ahead of either agency.

The FDA did not update its advisory. It built a new one at a new address, titled a nine-state outbreak. The old five-state page is still live, still carrying 1,644 cases and 94 hospitalizations, and the new page opens with a banner telling readers that an update is available — linked back to the old page.

The outbreak also got shorter. Both agencies now say illnesses began on June 22 and ran through July 20. Until today both said May 13 through July 13. You can watch it happen on a single FDA page: the current update reads June 22, and the preserved July 16 entry three screens below it still reads May 13. Roughly six weeks of illnesses were inside the outbreak definition yesterday and are outside it today. The FDA attributes the rise in cases in part to the four new states, and repeats that it can take as long as six weeks to determine whether a sick person belongs to this outbreak.

The distribution list grew from twenty-seven states to twenty-eight. The state added is West Virginia — which has been one of the named outbreak states since July 16, and which spent the week since then absent from the list of places the recalled lettuce was sent. That gap is now closed.

The FDA also broke retail out from foodservice for the first time. Recalled Marketside product went to Walmart stores in fifteen states: Alabama, Arkansas, Florida, Georgia, Indiana, Kansas, Kentucky, Louisiana, Missouri, Mississippi, Oklahoma, Tennessee, Texas, Virginia and West Virginia. Michigan and Ohio, which between them account for more than ten thousand of this year’s cases, are not on the retail list. And under a new heading the agency discloses that the recall reaches outside the United States, and that the firm’s own customer records show recalled product was sold to consumers in Mexico — the day after Mexico’s health ministry announced that its samples from the plant were negative.

On the retracted border sample, the FDA is now unusually blunt: the false positive, it says in capital letters, does not change the basis for its investigation or the epidemiological data supporting the recall, and traceback and outbreak data continue to converge on shredded iceberg lettuce from central Mexican growers.

Michigan reported 8,176 cases today, up 512 in a day, with 160 hospitalized as of yesterday and cases in 70 of its 82 counties. Ohio’s statewide count, stuck at 1,316 since July 16, has moved to 2,596. Illinois is at 408 with 31 hospitalized, Kansas at 289, Oklahoma at 172. Add up what all fifty states publish about themselves and you get roughly 14,800 people. The official outbreak number is 1,947. CNN counted more than 12,000 in the nine outbreak states alone.

Below is where each state stands tonight, with the source for every number. The nine states now in the outbreak are shaded.