Learning to cope with cyclospora outbreak

By JANE SIMS

It’s a confusing time for consumers seeking to eat healthy fruits and vegetables without getting sick as much-publicized outbreaks of the microscopic cyclospora parasite emerge around the U.S.

The good news is that reported cases in Westchester are not out of the ordinary, and there are ways to protect against the food-borne illness. The Recorder talked with local public health experts, growers and grocery sellers for insight. 

Since May 1, the federal Centers for Disease Control and Prevention has received reports of 4,173 laboratory-confirmed domestic cases of cyclosporiasis and is tracking more than 7,400 additional cases in the U.S. that

require further investigation. 

So far, Westchester County is not showing case levels beyond what is typical for this time of year. 

“We are concerned about cyclosporiasis and we are monitoring the situation in our Divisions of Disease Control and Environmental Health,” said Christopher Ericson, deputy commissioner of environmental health at the Westchester County Department of Health. “Although there is an uptick of caseloads in surrounding communities such as New York City, we have not yet seen an uptick in Westchester. As of July 22, we have had 52 cases this year. Last year at this time we had 75 cases.”

“There has been no connection made between the current national outbreak and what we are seeing in Westchester County,” Ericson said.

“Cyclosporiasis is a parasitic infection and it’s typically waterborne and foodborne,” said Dr. Neil Modi, an infectious disease physician for Northwell Health Physician Partners Primary and Specialty Care at Chappaqua Crossing. “In the past, we’ve seen it associated with contaminated salads, basil, raspberries, leafy greens, lettuce, and sometimes drinking water and recreational water. This disease typically doesn’t spread from human to human because it takes quite a long time for the parasite to mature in the environment. Even though cases of cyclosporiasis in Westchester are not higher than normal for this time of year, it’s something to be vigilant about as we see cases rise elsewhere in the country.”

Not-so-subtle symptoms

The symptoms of cyclosporiasis include watery diarrhea, abdominal pain, cramping, bloating, nausea, vomiting, low-grade fever and weight loss.  Most people can recover from the infection without medical intervention, although it may take longer. 

“People should be aware of the symptoms and see their provider if symptoms persist beyond a few days,” Modi said. “Individuals in poor health and those who are immunocompromised are at a higher risk for severe or long illness. However, this disease has been around for a while, and fortunately we have good treatment options for it.”

If a stool test confirms a cyclosporiasis, a doctor can prescribe an antibiotic, he said. “In the meantime, rehydration with electrolytes is important.”

Although previous outbreaks of cyclosporiasis in the U.S. have been linked to fresh produce including basil, cilantro, mesclun lettuce, raspberries and snow peas, health officials are advising people to keep eating fruits and vegetables but take extra precautions by washing their hands with soap and water before handling food and cleaning their produce.

“When you buy leafy greens, salads, fruits and vegetables, make sure you wash them thoroughly, and if possible, you should cook them because cyclospora die at 158 degrees Fahrenheit,” Dr. Modi said. “Chemical disinfectants may not get rid of cyclospora, but washing produce thoroughly with water and firmly scrubbing fruits and vegetables will be helpful. And you should wash prewashed or prepackaged salads again before consuming.”

“Produce that does not have a smooth surface, such as raspberries or leafy greens, pose a higher risk because they are harder to clean,” said Ericson of the county Health Department.

Trusted sources sought

Safety concerns might push some consumers to shop at farmers markets or local grocery stores they know well and feel confident the food is handled safely. 

“One of the outcomes of this national cyclosporiasis outbreak is people are going to be shopping from local food suppliers who really care about food safety and take how things are grown very seriously,” said Adam Choper, farm director at Hilltop Hanover Farm and Environmental Center in Yorktown Heights. “At Hilltop Hanover, food safety is paramount to what we do. We use on-site well water to water our plants, we always wash our hands before harvest, and we follow strict food safety practices.” 

“At The Market at Pound Ridge, we practice all of the requirements for safe food handling and we provide good quality products,” said Billy Fortin, owner of The Market at Pound Ridge Square. “If there is a problem with anything we carry, we get recalls immediately and the company will tell us within days. Our industry is on top of any problems. I’m proud to be part of this industry. We are on it.”

Was your produce

“My advice to customers is wash your produce,” Fortin continued. “Some of it comes in packaging that says ‘triple washed,’ but I don’t know if I trust that claim. Those items come into the store already packaged, so it’s out of our control. The only control we have is if there is a recall, we would just pull it off the shelves.”

Because cyclosporiasis cases are normal for this time of year, safe food handling protocols for restaurants and food handlers in Westchester remain unchanged.  

“As a department, we continue to inspect thousands of food service facilities across the county and are recommending the same food handling protocols for restaurants and food handlers to follow,” Ericson said. “If we identify a source of contamination in the food supply, we will put out more specific messaging to everyone, including restaurants.”

“If there is no active outbreak of cyclosporiasis in the nearby vicinity, the risk of getting sick is probably very low for the everyday person,” Modi said. “Cyclosporiasis is not a new infection and we have a lot of information about it, so a little vigilance and food safety practices can go a long way.”