Cyclospora outbreak reaches North Carolina: What to do

GABRIEL MIHALCEA | UNSPLASH

With the national cyclaspora outbreak moving into Mecklenburg County, medical professionals advise thorough washing of fruits and vegetables to prevent spread of the parasite, which causes intestinal illness.

The cyclospora outbreak has expanded to nine states, including North Carolina.

Cyclospora Cayetanensis is the main parasite contaminating fresh produce, commonly lettuce, berries and fresh herbs. The parasite causes an intestinal illness called cyclosporasis, which includes stomach cramps, fatigue, nausea and watery diarrhea.

People usually feel sick about one week after exposure to the parasite. 

See a doctor if you think you may have cyclosporiasis. The disease can be treated with antibiotics. It is also important to prevent dehydration by drinking lots of water or drinks with additional electrolytes.
According to Mecklenburg County Health, there were 29 cyclosporiasis cases and four hospitalizations in Mecklenburg as of July 21. Around 75% of cases were linked to domestic or international travel outside of the county.

“Cyclosporiasis is not new, and we typically see cases every summer when more people travel,” interim health director Dr. Kimberly Scott said in a statement. “With the current multi-state outbreak, it’s important to take steps to protect your health by washing your hands and practicing safe food handling.”  

Novant Health registered dietician Kelly Homesley offered a few tips to reduce risk of contracting the illness and still enjoy fruits and vegetables. 

1. Buy local and wash properly

“I am encouraging my patients to avoid pre-bagged salads all together at this point,” Homesley said. ... “But let’s face it, this is the time of year when a lot of people want salads. I do recommend going to the farmers market, get locally grown produce. It is not typically tied to the produce that you buy locally.”

Homesley added that by removing the first few layers of lettuce is also a wise choice, then soak and clean every other layer.

“I recommend one part vinegar to three parts water,” she said. “It will not kill it but the acid in the vinegar can help break the bond between the parasite and the actual produce itself. Then you really want to scrub it well. Make sure you’re pulling each head of lettuce out of the soak and rinsing it really well and not just putting it back in the water. That can put the parasite back on it even if you’ve already scrubbed it.” 

2. Avoid salads when eating out for now

Restaurants often source produce from larger wholesale companies that pre-bag their salad mix. 

“You never know for sure, and a restaurant maybe won’t know for sure even though it is a specific brand where it came from,” Homesley said. “I am personally recommending avoiding raw salads, particularly at restaurants. … It can be hard to remember because we are just so used to it, but right now it is probably best to stay away from salads at restaurants.”

3. Eating healthy is still possible

While salads are generally a healthy option, avoiding them in the meantime doesn’t have to be disruptive.

“To be very honest, a lot of restaurant salads have more calories than a hamburger,” Homesley said. “I just tell patients in general to order a protein. There will always be a protein on the menu, just ideally not a fried one. So, a grilled protein and a cooked vegetable. You can typically find that anywhere and then you don’t have to worry about the parasite because it has been cooked.”

Homesley said a misconception about grilling lettuce to eliminate the parasite won’t work unless you grill every leaf. 

“If you grill your lettuce, like if you do a grilled Caesar salad or something, that will kill it because a grill does get that hot,” she said. “But it’s not really possible to make sure that every actual leaf or every part of the leaf gets warm enough during that grilling process before you pull it off to make sure that that is a proper way to kill it.”

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