Safest way to protect against cyclospora outbreak, ex-CDC director says

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Anna Skinner

By Anna Skinner

Associate News Editor

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As a nationwide cyclospora outbreak continues to expand, a former Centers for Disease Control and Prevention (CDC) director is urging Americans to remain vigilant about the produce they consume, particularly raw fruits and vegetables.

The CDC said this week that an outbreak linked to recalled iceberg lettuce has now been connected to 15 states and more than 6,300 confirmed illnesses, with 278 hospitalizations and two deaths reported among people with underlying health conditions. The agency also emphasized that it is investigating other cyclospora illnesses nationwide that may be unrelated to the lettuce outbreak, with nearly 23,000 cyclosporiasis cases either confirmed or being investigated.

While federal investigators have linked the multistate outbreak to recalled iceberg lettuce sourced from central Mexico, former CDC Director Robet Redfield cautioned that lettuce may not be the only food involved and urged Americans to purchase their produce locally to prevent exposure, according to a recent interview Redfield did with NewsNation.

What Is Cyclospora?

Cyclospora is a microscopic parasite known as Cyclospora cayetanensis that infects the small intestine and causes an illness called cyclosporiasis. People become infected after consuming food or water contaminated with the parasite, often through contact with human fecal material.

Fresh produce has been implicated in past outbreaks because fruits and vegetables are often eaten raw. Unlike many common stomach bugs, cyclospora is not generally spread directly from person to person. The parasite requires time in the environment after being shed in stool before it becomes infectious.

Investigations can be particularly challenging because symptoms may not develop until days or even weeks after exposure. By the time patients become sick, they often struggle to remember exactly what they ate, making traceback efforts more difficult. Public health officials have also noted that detecting cyclospora in food samples remains technically challenging.

Redfield noted that cyclospora contamination is difficult to remove from produce once it is present.

"If you wash your lettuce and you put it in a lettuce spinner and you have cyclospora in that lettuce, it's still going to be there," he said in the NewsNation report. "You can't wash it off."

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Where Should Consumers Buy Produce?

For shoppers wondering where to buy fruits and vegetables during the outbreak, experts say there is no need to stop eating produce altogether. Fresh fruits and vegetables remain an important part of a healthy diet, and federal officials have not recommended avoiding produce broadly.

However, Redfield said consumers should prioritize locally grown produce when possible. His concern centers on produce imported from regions where contamination with human fecal matter may occur during growing, harvesting or processing.

"People can go support their local farmer, get their produce locally, and I think they’ll be totally safe," Redfield said.

Foods with protective peels or skins may also present lower risk because the edible portion is separated from the exterior surface. Food safety experts previously said that fruits such as bananas, avocados, mangoes and pineapples can be peeled before eating, limiting potential exposure. Produce that is cooked rather than eaten raw may also reduce risk because heat can inactivate the parasite if it is cooked to 158 degrees Fahrenheit.

Consumers should continue checking recall notices, avoid recalled iceberg lettuce products and follow FDA guidance regarding affected foods.

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Dr. Robert Redfield on Cyclospora Outbreak

However, Redfield has repeatedly suggested that additional contaminated foods could also be contributing to illnesses. In the interview with NewsNation, he said he was not convinced the outbreak could be fully explained by lettuce alone and that cyclospora has previously been associated with other produce, including berries and certain vegetables.

"The safest thing to do is get locally grown vegetables because the real risk is these internationally imported vegetables right now," Redfield said, adding that the parasite has previously been found in foods including blueberries, raspberries and snow peas.

The CDC similarly notes that while the current outbreak has been tied to recalled lettuce, cyclospora can spread through many types of fresh produce.

“The only way you get cyclosporiasis is you have to eat vegetables," Redfield said. "Lettuce is a big one, cilantro, parsley, we've seen it with blueberries, raspberries, snow peas. But you have to get those vegetables that were contaminated by human fecal material."

Most outbreaks have been associated with imported produce, he added.

Latest on U.S. Cyclospora Outbreak

The CDC, Food and Drug Administration (FDA) and state health departments continue to investigate the outbreak, which has been linked to recalled iceberg lettuce distributed by Taylor Farms de Mexico, although a spokesperson for Taylor Farms previously told Newsweek that there were no positive tests for cyclospora associated with its products. On July 17, the company voluntarily recalled all iceberg lettuce sourced from central Mexico after epidemiological and traceback evidence pointed to the product as a likely source of infections.

Cyclospora Symptoms: When to Seek Medical Care

The hallmark symptom of cyclosporiasis is prolonged watery diarrhea, which can sometimes be explosive. The CDC says patients may also experience fatigue, loss of appetite, stomach cramps, bloating, nausea, gas and weight loss.

Symptoms typically begin about one week after exposure but can appear anywhere from several days to more than two weeks later. Without treatment, illness can persist for weeks and may relapse even after symptoms initially improve.

People should consider seeking medical attention if they experience severe or persistent diarrhea, signs of dehydration, significant weight loss, worsening abdominal pain or symptoms lasting more than a few days. Individuals with weakened immune systems, older adults and people with underlying medical conditions may face a greater risk of serious complications.

Redfield said the illness is generally treatable with the antibiotic trimethoprim-sulfamethoxazole, commonly sold under brand names including Bactrim and Septra. The medication can shorten recovery time considerably for eligible patients.

For now, health officials continue searching for the full source of this summer's outbreak. While recalled lettuce remains the primary focus of the investigation, experts say the possibility of additional contaminated produce has not been ruled out, underscoring the importance of ongoing surveillance and consumer awareness.

Cyclosporiasis Outbreak

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Contact Newsweek editors on this story: Anna Skinner and Dave Siminoff.

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