Cyclospora: What to know about the current status of the outbreak

Cases of cyclospora — a diarrhea-inducing parasitic infection — continue to rise nationwide.

The increase comes despite the recall of potentially infected lettuce from a major supplier. Health experts recommend staying alert for future recall announcements and, as always, washing all fruits and vegetables before eating.

Here are some questions and answers about the outbreak and how consumers can protect themselves and their families.

What is the current state of the outbreak?

There are multiple outbreaks across the United States, the largest of which was linked last month to Taylor Farms de Mexico’s iceberg lettuce sourced from central Mexico, according to the U.S. Food and Drug Administration. As of Thursday, nearly 11,000 cases related to that Taylor Farms lettuce have been reported across 17 states, including two fatal infections in Michigan, according to the Centers for Disease Control and Prevention.

The FDA is investigating three other cyclospora outbreaks, none of which have been linked to a particular contaminated product.

From May 1 through Aug. 17, 939 cases of cyclospora were reported across New York, according to the state health department. As of Monday, 75 cases, including five hospitalizations, had been reported in Suffolk, a county health department spokesperson said in an email. Up-to-date figures for the number of cases in Nassau County were not immediately available late Monday.

Is it safer to buy lettuce in the grocery store or at a farm stand?

While cases have been linked to lettuce sold at Walmart and other retailers, that's no reason to assume produce from a farm stand is safer.

The impacted iceberg products are "very likely already off the market," Donald Schaffner, chair of the Department of Food Science at Rutgers University, told Newsday. Taylor Farms previously announced it was voluntarily removing all possibly impacted products from the American market. All of its recalled products expired by Aug. 3 or even earlier.

"If you want to shop locally that’s great," Schaffner added, "but do that because you believe in shopping locally, not because you believe it’s going to make you safe."

Is it safe to eat lettuce or salad at restaurants?

It's as safe as it normally is, given the FDA-linked lettuce has been out of circulation for several weeks, according to experts.

The fast food giant Taco Bell announced last month that it had pulled impacted Taylor Farms lettuce from its supply chain across the country.

"Avoiding places to eat is up to families," Dr. Sharon Nachman, chief of the Division of Pediatric Infectious Diseases at Stony Brook Children’s Hospital, said in an email to Newsday. "But remember, these restaurants are now on high alert and have instituted practices to wash vegetables and fruits."

Should I worry about other produce?

No more so than usual. Historically, there has been a "concern" that cyclospora could contaminate "fragile fruit that grows close to the ground," Nachman said.

The suggestion about washing produce "is a reasonable one," she added. "Fragile fruit includes strawberries and raspberries, but not fruits like apples or grapes that don’t grow close to the ground."

However, Schaffner said past outbreaks should not be used to determine future risk.

How much of a difference does washing produce make?

Washing produce is "a reasonable approach to keeping your family safe," Nachman said.

But it has its limits, according to Schaffner.

"I don’t want anyone to think that by doing those things that they’re actually going to make themselves safe from cyclospora," Schaffner said.

Water can knock away debris on fresh produce but won't kill parasites.

"Do it because you don’t want to eat dirt," Schaffner said. "But don’t do it thinking that it’s going to keep you safe from cyclospora."

Have we seen the worst?

It’s not clear when any of these outbreaks might end. The largest lettuce-linked outbreak is "probably over" given that the linked products are out of circulation, according to Schaffner. However, cases will continue to climb.

"We may still see the outbreak numbers rise as additional people that have already been exposed and who are already sick get added to the outbreak," he added. "But that doesn’t mean that the outbreak is active and ongoing at this time."