Remember me
The 'explosive' parasite sickening thousands in the US may have spread to other fruits and vegetables, a former CDC director has warned.
Health officials have been scrambling to find a source of the cyclosporiasis outbreak after initially linking it to shredded lettuce sold at Taco Bell and other stores.
Now, Dr Robert Redfield, speaking in a TV interview, has warned that other commonly consumed US produce may also be carrying the parasite.
Speaking to NewsNation, he said: 'They have pulled this suspected lettuce off the marketplace. We are seeing some outbreaks linked to parsley and cilantro, particularly in North Carolina.'
'The only way you get cyclosporiasis is you have to eat vegetables... that were contaminated with human feces.
'Lettuce is a big one [source of cyclosporiasis], cilantro, parsley, [but] we've seen it with blueberries, raspberries and snowpeas [too].'
He added: 'Most of the times we've seen these outbreaks in the last ten years, they've come from imported produce.'
Redfield, who led the CDC from 2018 to 2021, urged people to eat locally grown produce, saying there was no current sign that local produce was contaminated.
Former CDC Director Dr Robert Redfield warns the cyclospora outbreak may not be contained to lettuce, as cases surpass 22,000 nationwide
Nationwide, more than 22,000 people across 47 states have been sickened with cyclosporiasis and 500 have been hospitalized so far this year.
Yesterday, the CDC expanded the major outbreak of cyclosporiasis linked to shredded lettuce from Taylor Farms, imported from Mexico, that was sold at Taco Bell and other stores to 15 states.
Health officials have been scrambling to find the cause after tests on lettuce from Taylor Farms returned a false positive.
Redfield's warning came after health officials in Michigan, the state at the center of the outbreak, linked a wide list of produce to the outbreak.
In an alert released last month, the state's health officials, who are tracking thousands of cases and have reported two deaths from the parasite, said they were probing lettuce and leafy greens as the likely source of the infections.
But they also warned that raspberries, snow peas, green onions, cilantro and basil could also be linked.
In North Carolina, health officials have said their outbreak of cyclosporiasis, which is separate from the main outbreak linked to Taco Bell, may have been caused by leafy greens, basil or cilantro.
Last month, frozen blueberries sold at Publix stores in Florida and Georgia were recalled after they were linked to an outbreak of E.coli that sickened 12 and led to four hospitalizations. The blueberries were grown in Chile.
Blueberries may also be linked to the outbreak, Redfield said
In 1996, blueberries were also involved in an outbreak of cyclosporiasis in Canada, after health officials found infections were caused by consuming a contaminated strawberry flan that also contained blueberries and raspberries. Investigators later linked it to contaminated raspberries in the flan that were imported from Guatemala.
Health officials are also now tracking a separate outbreak of salmonella linked to Chipotle that has sickened 345 people across 27 states. It has been linked to jalapenos that were also imported to the US from Mexico.
Cyclospora, the parasite that causes cyclosporiasis, can become lodged in produce if they are irrigated with water that is also contaminated with human feces. In these cases, the parasite is very hard to wash off.
Speaking on NewsNation, Redfield added: 'I think the best thing obviously is to be cautious about the raw vegetables you are eating right now.
'The safest thing to do is to get locally-grown vegetables because the real risk [for an infection] is these internationally imported vegetables right now.
'You have to get those vegetables that were contaminated with human fecal material [to get infected]. It's not something we see a lot in the US.'
He added: 'Most of the times we've had these outbreaks [of cyclosporiasis] over the last ten years, they've come from imported produce.
'So, if people can go and support their local farmer and get their produce locally, I think they will be totally safe.'
Cyclosporiasis causes explosive watery diarrhea, abdominal cramps, bloating, nausea, and vomiting that can last for weeks and often return just when you think you're better
Federal officials have identified six separate outbreaks of cyclosporiasis across the country.
The major outbreak has been linked to the following 15 states, up from nine last week. The newly added states are: Arkansas, Iowa, Missouri, Nebraska, New Hampshire and North Carolina.
Nationwide, the CDC has confirmed 6,707 laboratory-confirmed domestic cases, but the agency acknowledges the true number of infections is likely more than 22,000, with over 11,500 additional cases still awaiting investigation and confirmation.
On Monday, Michigan health officials reported the first two deaths linked to the outbreak, both individuals had underlying health conditions that made them vulnerable to severe dehydration from the illness.
The outbreak has hit Michigan and Ohio hardest, with Michigan alone reporting more than 11,200 cases and 193 hospitalizations as of late July. Nationwide, at least 517 people have been hospitalized, with patients ranging in age from one to 98 years old.
Health officials are particularly concerned because cyclosporiasis symptoms can be debilitating.
The infection causes frequent bouts of watery diarrhea, abdominal cramps, bloating, nausea and vomiting that can last for weeks and often return just when patients think they've recovered.
Unlike norovirus or routine food poisoning, the illness follows a relapsing course, meaning patients may feel better for a few days before symptoms return with a vengeance.
The microscopic parasite behind the illness, Cyclospora cayetanensis, spreads through food or water contaminated with human feces – typically when fresh produce is washed or irrigated with contaminated water.
Previous outbreaks have been linked to cilantro, basil, raspberries and bagged salad mixes.
A major challenge in containing the outbreak is that cyclospora has a one- to two-week incubation period before symptoms appear, making it extremely difficult for patients to remember what they ate, and for investigators to trace the source.
In Michigan, public health nurses have been calling hundreds of sickened residents to piece together their food histories, often relying on fast-food receipts to identify common exposures.
The CDC notes that it can take up to six weeks for federal and state officials to determine if a sick person is part of an outbreak.
Cyclosporiasis can be diagnosed using a routine test that detects the parasite's DNA in feces. The test detects cyclospora DNA in stool samples and typically requires one to three specimens.
The infection can be treated effectively with antibiotics.
Redfield: ‘It’s actually susceptible to an antibiotic we call Septra or Bactrim. So rather than take two to four weeks to get better, you might get better in five to seven days.’
Without treatment, symptoms can persist for weeks or recur repeatedly.
Health officials recommend that consumers thoroughly wash all fresh produce under running water, though washing alone may not eliminate the parasite. The only reliable way to kill cyclospora is to heat produce to at least 158 degrees F.
Until the source is fully contained, experts expect cases to continue rising.