A cluster of parasitic illnesses have hit Johnson County in the past week, leaving several ill; they were apparently caused by unpasteurized apple cider. Beginning in the week of Oct. 21, 11 outbreaks of cryptosporidiosis — also known as crypto — have been reported in Johnson County by people who have consumed the tainted cider.

One of the 11 infected consumers has been hospitalized, and all cases have been epidemiologically confirmed — linked because of symptoms. As of Monday, there had not been any more reported cases. Crypto is a parasite contracted through a fecal-oral route that causes watery diarrhea, nausea, vomiting, stomach cramps, and low-grade fever.

The source of the apple cider is still undetermined, but Doug Beardsley, the director of Johnson County Public Health, said the cause of contamination most likely came from apples not being washed thoroughly enough or non-sanitized equipment. “We want people to eat fresh fruits and produce, but they need to be washed to get rid of any contamination,” Beardsley said.

He also said as far as treatment goes, there are medications to treat crypto, but it is up to health-care providers whether to prescribe them. Otherwise, he said, the parasite will be cleared on its own with time. “You can become dehydrated pretty quickly,” he said. “It can last a long time, it’s usually not deadly, but young people, people who are immunocompromised and medically frail, they’re at higher risk for serious consequences.”

The first reports of crypto to the Iowa Department of Public Health began in 1994. Since then, there was a peak in 2007 of 612 reported cases in the state. According to a recent report, there were 328 reported cases in 2012. Licensing and pasteurization, Beardsley said, are important for ensuring cider is not contaminated. Licensed vendors follow standards from various health organizations of sanitation for food production. Unpasteurized apple cider can be sold, he said, but it must be labeled as unpasteurized so consumers are aware of the health risks associated with the product.

“We don’t have a place to pinpoint right now, so it’s just a general reminder to the public, if [the cider is] unpasteurized, it’s an additional risk,” Beardsley said. “You need to know whose doing [the making of the cider] and do they have a license.” Paul Rasch, owner of Wilson’s Orchard, 2924 Orchard Lane N.E., said his facility pasteurizes all of its products and follows a systematic, preventative approach to food safety, outlined under the Hazard Analysis and Critical Control Points.

The likelihood of contaminated cider in Johnson County coming from a large distributor would be slim because of strict regulations, Rasch said. “Every commercial producer is going to be bound to that [regulation] in the state of Iowa,” he said. “It’s not possible for someone to produce that kind of problem.”

Rasch said cider often becomes contaminated from using apples that have dropped off of trees and have had contact with fecal matter from deer or other animals. Buying locally is a central theme of New Pioneer Co-op. In light of the parasite outbreak in Johnson County, Sue Andrews, the purchasing lead at the Co-op said ensuring quality and safety of its products is important to New Pioneer.

“We like to visit the facilities when we set up our contracts for produce during the late winter, early spring,” she said. Andrews said New Pioneer has a specific produce coordinator who visits each farm to verify production processes. 

According to the Centers for Disease Control and Prevention, in 2011, there were more than 47 million food-borne illnesses nationwide. Andrews said with so many outbreaks in the past few years, this verification has become increasingly important. “One of the first things we look for is sanitation and cleanliness and basically the procedure of how they handle their produce,” she said. “By having local produce and being able to visit your vendors really ensures your quality.”