Food Safety Alert: First Cyclosporiasis-Related Deaths Reported

The Cyclospora parasite that has spread rapidly in the United States, including a multi-state cluster that includes Illinois, Indiana, Kansas, Kentucky, Michigan, Ohio, Oklahoma, Pennsylvania and West Virginia, has now been linked to two deaths. The two individuals in Michigan both had underlying health conditions, and both had become ill before the voluntary recall of iceberg lettuce that was announced July 17. 

As of July 30, Michigan has 11,234 reported cases of cyclosporiasis, according to the Michigan Department of Health & Human Services, well more than any other state. The state also reports 193 hospitalizations.  

The source of the multi-state Cyclospora infection was identified in mid-July. The U.S. Centers for Disease Control and Prevention, which has now confirmed more than 6,707 cyclosporiasis cases in those states, said the FDA traced the issue to shredded iceberg lettuce sourced from Central Mexico by Salinas, Calif.-based Taylor Farms. Many of the cases were traced to lettuce served at Taco Bell locations in that Midwestern region. On July 17, Taylor Farms recalled iceberg lettuce served at restaurants and sold in retail stores. The CDC acknowledges that many more cases have been reported than the agency has been able to confirm in the laboratory.

Event professionals who don't rely on Taco Bell in those nine Midwestern states for F&B can breathe a bit easier, particularly after the recall, but the CDC has specified that the alert and recall do not apply to all of the many cyclosporiasis cases that have been reported in more than 30 states across the country. Experts caution there might be other sources.

Symptoms include sudden and ongoing severe diarrhea, fatigue and weight loss, and can appear anywhere from two days to two weeks after being infected. According to Michigan state officials, cyclosporiasis is best treated with antibiotics coupled with rest and drinking lots of fluids to maintain hydration.

Cyclosporiasis typically grows in frequency over the summer months, but the case numbers this year far exceed the average.

Precautions for food preparation

As cases have grown particularly quickly in Southeast Michigan, the Department of Health and Human Services has issued precautions for restaurants, commercial kitchens and basically anyone who is serving raw produce in the region. While the primary source of this outbreak has been identified, the following should be kept in mind as case numbers remain high.

Cooking produce is the only surefire way to kill the parasite.

• Lettuce and leafy greens: Purchase whole heads of lettuce rather than prewashed, bagged greens. Remove the outer two to three leaves and wash the remaining leaves under running water. Cook leafy greens when possible.
• Cilantro and basil: Separate the leaves and wash thoroughly under running water. Cooking is the safest option.
• Green onions: Trim the root end, remove the outer layer and wash thoroughly under running water. Cooking is the safest option.
• Raspberries: Their surface is difficult to clean. Consider using cooked raspberries or frozen raspberries. Freezing might reduce but does not entirely eliminate the parasite.
• Snow peas: Wash thoroughly under running water while rubbing the surface. Cooking is the safest option.