The agency said 358 people are ill with most (199; 56%) reporting onset of illness on or after May 1, and no international travel.
Clusters of illness linked to restaurants or events have been identified in Texas, Wisconsin, and Georgia.
Investigations in Wisconsin and Texas have preliminarily identified cilantro as a suspect vehicle as it was supplied to restaurants at which some of those who have become ill ate.
Previous outbreaks of cyclosporiasis have been linked to imported fresh produce, including cilantro from the Puebla region of Mexico.
Annually recurring outbreaks (in 2013 and 2014) have been associated with fresh cilantro from the state of Puebla.
Fresh cilantro checked at border
The Food and Drug Administration (FDA) issued an import alert to detain samples of fresh cilantro from Puebla from 1 April to 31 August.
It comes after the FDA, the government of Mexico’s National Agro-Alimentary Health, Safety and Quality Service (SENASICA) and Federal Commission for the Protection from Sanitary Risks (COFEPRIS), investigated farms and packing houses.
The agencies inspected 11 farms and packing houses that produce cilantro in Puebla from 2013 to 2015, five linked to past C. cayetanensis illnesses, and found objectionable conditions at eight of them, including all five linked through traceback to the illnesses.
Conditions at multiple firms included human feces and toilet paper found in growing fields and around facilities; inadequately maintained and supplied toilet and hand washing facilities or lack of them and water used for washing cilantro vulnerable to contamination from sewage/septic systems.
Shipments of fresh cilantro from other states in Mexico will be allowed to enter if sufficient documentation is submitted demonstrating it was harvested and packed outside of Puebla.
Public Health England (PHE) has also warned of an outbreak linked to contaminated food in Mexico.
24 cases were reported in England and Scotland in June and July, of which 21 were associated with travel to Mexico, it said.
Salmonella investigations
Meanwhile, the outbreak of Salmonella linked to pork products has grown to 90 cases in Washington.
State health officials have asked the CDC to send a special team to help with the investigation.
The US Department of Agriculture’s Food Safety and Inspection Service (USDA-FSIS) issued a public health alert due to concerns about illnesses caused by Salmonella associated with pork products, specifically whole pigs used for pig roasts.
FSIS was told of Salmonella I 4,[5],12:i-illness clusters on July 15 and suspects there is a link between the illnesses associated with whole pigs used for pig roasts and eight illness clusters based on information gathered with the Washington State Department of Health and the CDC.
Case-patients have been identified with illness onset dates ranging from April 25 to July 21.
FSIS advises consumers to safely prepare raw meat products, including fresh and frozen items, and only consume pork products cooked to a minimum internal temperature of 145° F with a three minute rest time.
The CDC is also investigating two separate outbreaks of Salmonella Enteritidis infections linked to raw, frozen, stuffed chicken entrees caused by different strains of the pathogen.
In one investigation, nine people have been reported from four states: Illinois (1), Minnesota (6), Oklahoma (1), and Wisconsin (1) and three have been hospitalized.
This work involves Barber Foods, which expanded a recall of 1.7 million pounds of frozen, raw stuffed chicken products on July 12. This expanded the initial recall of chicken Kiev on July 2 and on July 13 Omaha Steaks recalled stuffed chicken breast entrees as they were manufactured by Barber Foods and sold under the Omaha Steaks label.
The second investigation involves three people infected from Minnesota with two hospitalizations.
Illnesses occurred after people had eaten Antioch Farms brand cordon bleu stuffed chicken breast, produced by Aspen Foods.
Aspen Foods recalled 1.9 million pounds of frozen, raw, stuffed, and breaded chicken products on July 15.