As cases of cyclosporiasis continue to be reported in Boone County, nursing homes are taking extra precautions to help protect older adults, who can face more serious complications from foodborne illnesses.
The diarrhea illness is caused by the parasite known as cyclospora.
According to the Columbia/Boone County Department of Health and Human Services, Boone County has now seen at least 13 cases of the diarrhea illness. The Missouri Department of Health and Senior Services has reported at least 80 cases statewide.
Nathan Koffarnus, epidemiologist for the department's Bureau of Communicable Disease Control and Prevention said cyclosporiasis season happens every year — May through August is when they see the most cases.
"Most of these cases are associated with international travel, so this is a major cause of traveler's diarrhea," Koffarnus said. "Occasionally, every few years or so we do see larger outbreaks like we're seeing in the United States this summer, ... (which) is most often associated with imported produce products that are eaten fresh."
Koffarnus said the exposure comes from fruits or vegetables that have been irrigated or watered with water that contains human waste.
Dr. Joshua Stilley, an emergency medicine doctor with MU Health Care, said vulnerable populations are more prone to contracting the disease.
"Patients that (are immunocompromised, have) chronic illnesses, or otherwise susceptible to normal infections, are more susceptible this new disease that is spreading around," Stilley said.
The Bluffs, a nonprofit nursing home, said it is trying to protect its residents from the illness.
Anthony Chitwood, a cook at the facility, said they have even gone as far as to change recipes to keep residents safe.
"I know that they are a lot more prone to diseases and foodborne illnesses and airborne illnesses," Chitwood said. "So, we need to be taking precautions and taking the right steps to make sure that doesn't happen."
Chitwood said once they were notified of the parasite, the kitchen threw out all of its produce.
"It was an immediate (reaction). We (knew) we had to do it right then and there as soon as we heard about it," Chitwood said.
While The Bluffs works to protect its residents, the state Health Department is working to figure out who has the disease.
Koffarnus said that the department's system is "a little bit strained right now" due to the influx of cases and tedious tracking process.
"When we identify somebody that we suspect was exposed in the United States instead of internationally, and that we think might be part of this outbreak, there is a 15-page questionnaire involved," Koffarnus said.
In Missouri, if someone's diagnosed with cyclosporiasis or the reportable conditions, an investigation process begins that is handled by local public health agencies, Koffarnus said.
Koffarnus said the department is not sure of the source that brought the parasite to the state, but they are planning to do comparative genetic testing of the parasite in other states to see if they are the same or different, but closely related.
