Cyclospora Outbreak Declared Over: What To Know In MI

This summer’s cyclospora outbreak that sickened thousands with explosive diarrhea across Michigan is over, according to federal health officials.

Michigan state officials reported 14,718 of cases on Thursday, by far the most cases across the country. More than 300 of those cases required hospitalization, including the two deaths.

Michigan or federal officials never identified a source of the outbreak, but suspect it was packaged iceberg lettuce that was sold at some Taco Bells and grocery stores.

They specifically pointed to iceberg lettuce from Taylor Farms de Mexico as the source. The company initiated a nationwide recall in mid-July after its products were linked to illnesses reported by people who had eaten at Taco Bell. The recall also covered Marketside iceberg lettuce sold at Walmart.

Michigan health officials lifted their warnings on eating lettuce and other salad mixes early last month, deeming it safe again to eat the produce.

The Food and Drug Administration added last week that it "remains confident" all recalled iceberg lettuce related to this multistate cyclospora outbreak is off the market. Also, the agency said the “best by” dates on the recalled products have passed.

"Since the start of this outbreak, MDHHS has remained committed to providing timely, transparent information and clear recommendations to Michigan residents," Chief Medical Executive Natasha Bagdasarian said. "As new data has emerged, our guidance has evolved to reflect the best available evidence, helping ensure that prevention recommendations are accurate, actionable and responsive to the changing situation."

Cyclospora is a parasite that causes cyclosporiasis, whose symptoms include “explosive” diarrhea. Cases of cyclosporiasis reached 12,883 in 21 states for the week ending Aug. 27, according to the Centers for Disease Control and Prevention. Roughly 570 people have been hospitalized, including those two Michigan deaths.

Three new states have been added to those with outbreaks. They now include Arkansas, Georgia, Illinois, Indiana, Iowa, Kansas, Kentucky, Maine, Massachusetts, Michigan, Missouri, Nebraska, New Hampshire, North Carolina, Ohio, Oklahoma, Pennsylvania, Tennessee, Texas and West Virginia.

The CDC said the outbreak may not be limited to states with known illnesses, and the true number of sick people is likely much higher than the number reported to local health officials. Many people recover without medical care and were not tested, the agency said.

Cyclosporiasis infections typically increase during the spring and summer months because the microscopic parasite thrives in warm, humid weather when seasonal produce is harvested. The cyclosporiasis season in the United States is May 1 through Aug. 31. Food and water become tainted when exposed to microscopic amounts of human fecal matter, often via agricultural runoff or irrigation, according to officials.

“In terms of the risk to consumers now, if today for dinner you wanted to go out and eat a salad, you’re pretty safe from cyclospora at this point, as far as we know,” Matthew Moore, an associate professor of food science at the University of Massachusetts Amherst, told CNN.

Dr. Colleen Kraft, a professor of infectious diseases at Emory University School of Medicine, told CNN she’s “comfortable with people eating iceberg lettuce that is currently being sold. I would distinguish between the specific recalled product and iceberg lettuce as a category. The implicated lettuce is no longer expected to be on the market. There is always some baseline risk associated with eating raw produce, but there is not currently a recommendation to avoid all iceberg lettuce because of this outbreak."

How To Wash Produce

Rinsing lettuce and other produce under the faucet may reduce the risk of cyclospora and other foodborne illnesses, but washing alone cannot guarantee that the parasite is gone, federal health officials caution. And there’s a right and wrong way to wash produce.

The FDA recommends discarding the outer two or three layers of leafy greens, then rinsing the remaining leaves thoroughly under clean running water. Do not use soap, bleach or commercial produce washes. Cyclospora can resist chlorine-based sanitizers, and soap or detergent can be absorbed by porous produce and make people sick.

The advice extends well beyond lettuce. Previous U.S. cyclospora outbreaks have been linked to raspberries, cabbage, basil, cilantro, parsley, broccoli, snow peas, sugar snap peas and other leafy greens. The parasite can settle into the folds, crevices and rough surfaces of produce, making it difficult to wash away completely.

The CDC recommends washing hands with soap and water before and after handling raw produce, removing bruised or damaged areas, and rinsing all fruits and vegetables before eating, cutting or cooking them. That includes melons, cucumbers and other produce with peels that will not be eaten because a knife can carry contaminants from the surface into the flesh. Firm produce should be scrubbed with a clean produce brush.

Berries and delicate herbs should be rinsed gently under running water rather than soaked, which can spread contamination through the water. Produce labeled “prewashed” or “ready to eat” generally does not need another rinse, although the FDA warns that commercial washing may not remove cyclospora.

Cooking produce to at least 158 degrees is the most reliable way to kill the parasite. Cut, peeled or cooked fruits and vegetables should be refrigerated within two hours.

Related

• How To Wash Lettuce, Berries And Herbs To Reduce Cyclospora Risk
• How New Barcodes Could Help Limit The Next Cyclospora Outbreak