2,640 cyclosporiasis cases in Michigan; 43 counties, 44 hospitalized. Wash produce, cook raspberries, heat food to 158 degrees.
- The state health department announced Monday, July 13, that some patterns are emerging from its investigation of a cyclosporiasis outbreak that has infected 2,640 people in Michigan.
- Investigators are zeroing in on the possibility that lettuce and/or salad greens could be the sources of the outbreak of the parasitic gastrointestinal illness in Michigan.
“Although we do not have a definite product identified as the source of the outbreak, we want to let Michiganders know what we have learned so far so they can take steps to protect their families,” said Dr. Natasha Bagdasarian, the state’s chief medical executive, in a statement issued Monday, July 13. “Early information has shown lettuce as a common product that regularly comes up during the investigation. We will continue to provide updates as we learn more.”
Other types of food items cannot be completely ruled out, the state health department said, and no specific type of produce, grower or supplier has been identified as the source.
Cyclosporiasis is caused by a parasite known as cyclospora cayetanensis, which can cause watery diarrhea, nausea, stomach cramps and fatigue that can last for weeks if untreated. In some cases, it also can cause nausea, loss of appetite, low-grade fever, weight loss and vomiting.
People can become ill within two days to two weeks after eating or drinking something contaminated with the microscopic parasite.
The Michigan Department of Health and Human Services along with staff at local health departments have interviewed more than 1,000 people who’ve been sickened in the outbreak and are working with other state and federal agencies to continue traceback investigations. But health officials say it will take time to complete the investigation, as food distribution networks are complex and given the long incubation period for this parasite.
Cyclospora doesn’t easily spread from person to person and recreational water exposure, such as swimming in lakes, is not a recognized risk factor. While people should always avoid swallowing untreated water from lakes, rivers and streams, MDHHS said it continues to focus on foodborne exposure, especially from fresh produce, as the likely source.
Reduce risk with these tips
To reduce the risk of infection, MDHHS recommends:
- Avoiding all pre-packaged, bagged lettuce and salad greens. Instead, it suggests purchasing whole heads of lettuce and other greens.
- Discarding the two or three outer layers of leaves when preparing lettuce and other greens. Thoroughly wash the inner leaves under clean, running water. Keep in mind that washing reduces risk but isn’t a guarantee that you won’t get sick.
- Prioritizing cooking, which is the safest option for preparing fresh produce. Cook greens to a temperature of at least 158 degrees, which kills cyclospora.
- Peeling produce with removable skin as the parasite lives on the outer surface of fruits and vegetables.
- Washing all fresh produce under clean running water, even if you plan to peel it.
State health leaders say following these recommendations are especially important for anyone who is at higher risk of dehydration, people with weakened immune systems, such as those who are taking chemotherapy, organ transplant recipients, infants and young children and older people.
Previous outbreaks tied to produce
In the past, outbreaks in the United States and Canada have been tied to bagged salad mixes and kits, such as precut lettuce blends with romaine, iceberg, red cabbage and carrots; fresh cilantro, basil, raspberries, snow peas and green onions.
Among them were outbreaks identified:
- In 2019, when more than 2,400 people in 37 states and the District of Columbia became ill after eating imported basil from Mexico.
- In 1997, when more than 1,000 people in the United States and Canada were sickened by contaminated raspberries imported from Guatemala.
- In 2005, when people got sick after eating basil imported from Brazil, Peru, Mexico and Costa Rica.
- In 2018, when lettuce served at McDonald’s restaurants was the source of a multistate outbreak of cyclosporiasis infections.
What to do if you become sick?
Michiganders with frequent, watery diarrhea that lasts more than a couple of days should contact a health care provider and specifically request testing for cyclospora. Cyclosporiasis can be treated with antibiotics.
Contact Kristen Shamus: kshamus@freepress.com. Subscribe to the Detroit Free Press.
