More than 200 people in five states have developed an intestinal illness known as cyclosporiasis after eating vegetable trays produced by Fresh Del Monte Produce, federal health officials said last week. Cyclosporiasis is caused by a microscopic parasite called Cyclospora cayetanensis and can cause diarrhea, cramps, bloating, and other common stomach-bug symptoms.
As of July 5, the Centers for Disease Control and Prevention (CDC) had reported 212 laboratory-confirmed cases of the illness in Iowa, Indiana, Minnesota, Michigan, and Wisconsin, seven of which involved hospitalizations. Health officials have traced the illnesses to store-bought trays of broccoli, cauliflower, carrots, and dip sold at Kwik Trip and Kwik Star locations in four of those five states. (The two people sickened in Michigan bought their veggie trays in Wisconsin.)
The first reports of illness involved in this outbreak started back in May, and Fresh Del Monte Produce withdrew several varieties of vegetable trays from the market on June 8 and June 15. But the FDA warns that some customers may have purchased veggie trays before then and may still have them in their refrigerators at home.
Here’s what you need to know about this unpleasant and potentially dangerous form of food poisoning, and the parasite that causes it.
What is cyclospora?
Cyclospora is a microscopic, single-celled organism that can be spread when people eat or drink something contaminated with feces. For example, commercial produce can become tainted with animal feces as it’s growing in a field, Academy of Nutrition and Dietetics spokesperson Cordialis Msora-Kasago, RD, tells Health. Or it could be contaminated by an employee preparing or packaging the food who did not wash his or her hands after using the bathroom.
Most people infected with cyclospora develop watery diarrhea “with frequent, sometimes explosive, bowel movements,” according to the FDA. The parasite can also cause loss of appetite, weight loss, stomach cramps and pain, bloating, increased gas, nausea or vomiting, fatigue, and other flu-like symptoms.
Symptoms can last anywhere from a few days to a month or longer, and sometimes they go away and return several times. “You might start to wonder if you’re coming down with the flu,” says Msora-Kasago. “Or you might feel well today and think it’s gone, and then tomorrow the same symptoms come back.”
In some parts of the world, like certain tropical and subtropical regions, cyclosporiasis is endemic. In the United States, the illness is not as common, but outbreaks linked to imported fresh produce do occasionally occur.
If someone close to you develops cyclosporiasis, you don’t have to worry about catching it from them directly: Typically, the parasite needs at least a week to become infectious after it’s passed in a person’s stool, according to the FDA, so it’s unlikely to pass from person to person. (Still, to avoid other, more contagious germs, it’s a good idea to wash your hands frequently and regularly disinfect surfaces whenever there’s a sick person in your home.)
It also takes about a week for a person to become sick after being exposed to cyclospora, says Msora-Kasago, which is one reason the illness can be so hard to diagnose and keep track of. “By the time the symptoms manifest, it can be hard to know what exactly caused it,” she says.
How can you protect yourself?
Fresh Del Monte Produce has recalled vegetable trays distributed to Kwik Trip, Kwik Star, Desmond’s, Sentry, Potash, Meehan’s, Country Market, FoodMax Supermarket, and Peapod locations in Illinois, Indiana, Iowa, Michigan, Minnesota, and Wisconsin. They all have a “Best If Enjoyed By” date of June 17 or earlier.
The FDA says it has not identified which component of these vegetable trays is responsible for the outbreak, so they are warning consumers not to eat any produce from trays that match this description. If you happen to have one of these trays in your fridge, throw it away ASAP.
Consumers can also protect themselves from foodborne illnesses by cooking raw produce, which kills most pathogens including parasites like cyclospora. The CDC also recommends washing hands with soap and warm water before and after handling food, and washing cutting boards, dishes, utensils, and countertops with soap and hot water before and after food prep.
That being said, raw produce is still a healthy source of vitamins and minerals and a great, easy snack (especially on hot summer days)–so you shouldn’t avoid it altogether, says Msora-Kasago. “The benefits of eating fruits and vegetables—especially when eating an item that is not on any recall list—certainly outweigh the risks,” she says.
Health officials recommend thoroughly washing fruits and vegetables under running water (and scrubbing firm produce like melons and cucumbers with a clean produce brush) before eating or cutting them. This can help remove surface dirt as well as some germs and bacteria, although the FDA points out that it may not remove microscopic parasites like cyclospora. You also don’t have to wash pre-packaged fruits and veggies labeled “pre-washed” or “ready-to-eat,” the CDC says.
Finally, consumers should refrigerate cut, peeled, or cooked produce as soon as possible, and definitely don’t let them sit out for more than two hours. Fruits and vegetables should be stored separately from raw meats, poultry, and seafood, which also have a higher risk of contamination.
And if you do develop diarrhea or other intestinal symptoms that last for more than three days, see your doctor. He or she can test a stool sample for cyclospora and other parasites, which can help health officials keep track of outbreaks and determine the appropriate treatment for you. If you do have cyclosporiasis, a course of antibiotics—along with rest and plenty of fluids—should help you feel better faster.
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