Cyclosporiasis outbreak possibly tied to salad greens, lettuce, MDHHS says

(FOX 2) - Michigan health officials are pointing to lettuce or salad greens as a potential source behind the outbreak of cyclosporiasis that is spreading throughout the state.

As case loads spike to 2,640, adding hundreds from the previous total before the weekend, the Michigan Department of Health and Human Services is recommending consumers take special care when purchasing salad greens, including purchasing the whole head of lettuce instead of the bagged variety, and discarding the outer layers.

They also ask that people cook when possible, heating the food to temperatures that kill cyclospora, the parasite responsible for the gastrointestinal illness.

Cyclosporiasis Illness Source

MDHHS says its preliminary investigation into the growing health crisis is citing lettuce or salad greens as the potential source.

They did not name other food items that could be ruled out and have not identified a grower or supplier as the source of the infections.

"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, chief medical executive. "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."

By the numbers:

Typically, Michigan only records between 40 and 50 cases of Cyclosporiasis a year. The illness is caused by a parasite that is responsible for water diarrhea, nausea, and stomach cramps.

But on Monday, the health department said 2,640 cases had been reported.

However, because the incubation period of the illness is up to two weeks, it's likely that more people have contracted the illness and symptoms could begin to show elsewhere.

Avoiding the parasite

MDHHS released several recommendations to reduce the possibility of being exposed to the illness.

Lettuce and Salad Greens

• Purchase whole heads: Buy whole heads of lettuce rather than pre-washed, bagged lettuce or pre-mixed salad kits.
• Discard outer layers: Before preparation, throw away the outer two to three layers of leaves.
• Wash inner leaves: Thoroughly wash the remaining inner leaves under clean running water.
• Prioritize cooking: For any greens that can be cooked, cooking to a temperature of at least 158 F (70 C) is the safest option, as the parasite is resistant to routine chemical disinfection and washing alone cannot guarantee its removal.

Previous Outbreaks

The following foods have been specifically linked to previous cyclospora outbreaks in the United States and Canada:

• Bagged salad mixes and kits.
• Fresh cilantro (coriander leaves).
• Fresh basil.
• Rasberries.
• Snow peas.
• Green onions (scallions).

Swimming

One activity that is not a risk to contracting cyclosporiasis is recreational swimming.

While people should always avoid swallowing recreational water, foodborne exposure – particularly exposure to contaminated produce – remains the primary focus of this outbreak investigation.

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