Experts say it’s unclear when this summer’s cyclosporiasis outbreak will end and people can more confidently eat lettuce.
Cyclospora is a microscopic parasite that is transmitted through human fecal matter. It can contaminate food through infected groundwater that is used to irrigate crops or flooding. Plants that grow low to the ground, such as lettuce or some herbs, are more susceptible to contamination.
Cyclospora outbreaks typically occur during the summer and are often tied to fruits and vegetables that aren’t cooked before eating, such as lettuce, basil or soft berries. Eating contaminated produce can cause “explosive diarrhea.” This year’s outbreak has resulted in much higher numbers than normal.
Recent investigations found that this summer’s outbreak could be partially tied to contaminated lettuce from Mexico. On July 17, Taylor Farms de Mexico recalled iceberg lettuce from central Mexico. That lettuce was distributed and sold in at least 27 states, including Indiana. Experts are urging consumers who purchased that lettuce to throw it out or return it. If that lettuce was in contact with any items or surfaces, they should be washed with hot soapy water.
According to the Centers for Disease Control and Prevention, between May 1 and July 27, there have been 6,707 laboratory-confirmed domestic cases of cyclosporiasis across 45 states. Two deaths were reported in Michigan this week.
As of today, there have been 1,524 cases reported in Indiana. According to a press release from the Monroe County Health Department, since May 1, eight cases have been reported in Monroe County.
Shandy Dearth, director of the Center for Public Health Practice at the Richard and Fairbank School of Public Health in Indianapolis, said current case counts don’t fully represent the actual number of cases. That’s because many people don’t seek medical care for foodborne-related illnesses or are tested properly. It may also be hard for a test to detect the parasite in a single stool sample.
“A lot of times, the basic panels that they might do for a stool sample or a fecal test might not run a test for this parasite,” she said. “It might not look for it, and also someone could have the parasite, and one stool sample will show that you don't have it, and then the next one will. And so sometimes they have to take multiple samples over several days.”
The U.S. Food and Drug Administration is still investigating the cause of other cyclospora clusters across the country. Until there is more clarity on the cause, Dearth recommends people avoid eating iceberg lettuce. If eating it, people should remove the outer layers and wash it well.
“We're getting to the point where eventually that salad's just going to get old enough, people aren't going to want to eat it anyway, just because of a food quality timing issue with it just getting so old,” Death said. “So, it has been removed from shelves, which is good.”
