Thousands of individuals across 34 states are experiencing severe and prolonged diarrhea due to a parasitic disease transmitted through food and water. This situation has led health experts to recommend extra care when preparing food.
No specific produce, grower, or supplier has been linked to the outbreaks in each state, with officials noting that multiple sources may be involved.
In Michigan, where over 3,700 residents have been reported infected, leafy greens are possibly under scrutiny as a contributing factor in the outbreak.
Additionally, some Taco Bell locations in Michigan are being probed after the chain voluntarily halted sales of lettuce, cilantro, onion, pico de gallo, and guacamole due to a nationwide recall.
Even though the outbreaks are mainly occurring in the Midwest and East Coast, experts encourage residents in California and throughout the U.S. to remain vigilant about their produce and take measures to minimize the risk of infection.
California has logged 41 cases of cyclosporiasis from January to June, none linked to the ongoing outbreak. This is lower than the usual average of 100 cases reported annually in the state, primarily between May and August, according to Robert Barsanti from the California Department of Public Health.
“It’s important to recognize that California sees cases of cyclosporiasis every year, often from international sources,” noted Erica Pan, the agency’s director. “Current cases are well within expected limits for the state.”
Experts maintain that rising cases of cyclosporiasis shouldn’t deter Californians from consuming fruits and vegetables. Rather, it’s a prompt to adopt additional precautions to avoid contracting the parasite.
Which produce are potential sources of cyclosporiasis
In the U.S., food-related outbreaks of cyclosporiasis have been linked to various types of fresh produce from Latin America, including raspberries, cilantro, basil, snow peas, and mixed salad, according to the California Department of Public Health.
A major outbreak in North America in 1996 was tied to imported raspberries from Guatemala, resulting in over 1,400 cases across 20 states, the District of Columbia, and Canada, as shared by Dana Mordue, an associate professor at New York Medical College.
How to reduce your risk of contracting cyclosporiasis
The first step is to wash your hands thoroughly with soap and water before handling any produce.
Then, health experts suggest:
- Washing all fruits and vegetables thoroughly under running water before consuming, cutting, or cooking.
- Removing and discarding the outer leaves of lettuce and leafy greens.
- Cooking vegetables and herbs whenever feasible, especially for vulnerable groups like young children, pregnant women, and immunocompromised individuals.
- Preventing cross-contamination by using clean cutting boards and utensils, and keeping ready-to-eat foods separate from raw produce during preparation.
- Refrigerating cut, peeled, or cooked fruits and vegetables as quickly as possible (within two hours).
- Avoiding food or water that might be contaminated with human feces, particularly when traveling in areas where tap water or food may be unsafe.
If your produce is labeled as “pre-rinsed,” experts still recommend rinsing it again yourself.
Will a simple rinse of all types of fruits and veggies reduce my risk?
Some fruits and vegetables require rinsing, while others need scrubbing, depending on their type, according to Britanny Saunier, executive director of the Partnership for Food Safety Education.
All produce should be rinsed under running water, even those with skins or rinds that aren’t eaten.
“For firm-skinned fruits and vegetables, such as cucumbers or melons, we recommend rubbing them by hand or scrubbing with a clean brush while rinsing,” Saunier explained.
After cleaning, drying the produce with a clean cloth or paper towel is important.
Some supermarkets provide “produce washes” in spray bottles that claim to clean dirt and bacteria; however, the U.S. Food and Drug Administration does not endorse these products, citing the untested safety of their residues.
“Fresh produce is porous and may absorb these products, potentially altering their safety and flavor,” Saunier pointed out.
Washing and scrubbing is the best way to reduce the risk of contracting the disease, but it doesn’t eliminate it completely. The parasite has a tough outer shell, making it challenging to remove, according to Dr. Norman Beatty, a professor of medicine at the University of Florida College of Medicine.
The parasite tends to stick to produce due to contamination from soil or water that has been inadequately treated or handled, he advised. “It’s uncertain how to effectively remove these parasites once they have contaminated soil or plants, as washing with just water likely won’t suffice.”
Are there any types of produce I should avoid entirely?
Given that lettuce and bagged salad greens are being investigated as potential sources in Michigan, Mordue suggests being cautious with bagged leafy greens. As someone living in New York, a state currently facing an outbreak, she has a bag of pre-packaged greens in her fridge that she intends to discard.
Californians might have slightly different advice, as the state currently isn’t reporting an outbreak. Rinsing leafy greens is acceptable, but if you can manage without them for a while, it’s advisable to do so. Cooking packaged spinach can also lower the risk of infection.
How does this type of outbreak end?
Predicting when the outbreak will conclude is tricky until the source of the parasite is pinpointed.
Once local and federal health authorities identify a specific cause, they can typically resolve the situation quickly. A recall will be issued for any contaminated produce, clearly indicating what to avoid, according to Mordue.
“The sooner they identify the source, the sooner it can be contained,” she said. “However, if they struggle to find the source, this could drag on for a while.”
What are the symptoms and remedies for cyclosporiasis?
A person infected with the parasite may experience severe, watery diarrhea that can last for about a week, which is quite unpleasant. Other symptoms may also include loss of appetite, weight loss, cramping, bloating, increased gas, nausea, and fatigue.
If someone experiences debilitating diarrhea along with fatigue, it’s advised to seek medical attention. Healthcare providers will likely test a stool sample to check for cyclosporiasis and may treat it with an antibiotic called Bactrim among other options.
