Cyclospora Outbreak Update: Is Lettuce Safe to Eat Again?

Salad lovers will be glad to know that the threat of cyclosporiasis seems to be abating. Here is the latest on the status of the cyclosporiasis outbreak and what experts say about the safety of eating lettuce.

Latest on the Cyclospora Outbreak

The U.S. Food and Drug Administration (FDA) released an update last week detailing that it “remains confident that all recalled iceberg lettuce related to this specific Cyclospora outbreak is off the market," noting that the “product should no longer be available in stores or restaurants.”

Although iceberg lettuce is now considered safe to eat, be sure to check all expiration dates to ensure that you are not inadvertently eating a product that was part of the massive recall. All of the iceberg lettuce should have been removed from shelves by now. However, some of the recalled products could still be in home refrigerators, albeit with expiration dates that have already passed.

There are still a good deal of questions surrounding where the outbreak started. The initial data signaled that the tainted lettuce came from Taco Bell locations concentrated in the Great Lakes and the Midwest. The FDA was able to trace the impacted lettuce to Taylor Farms facilities in Mexico.

Taylor Farms de Mexico announced on July 17 that it had removed all of the iceberg lettuce grown in central Mexico from the U.S. market. The impacted lettuce had best-if-used-by dates ranging from July 18 to August 3.

The FDA is still investigating the outbreak that has been blamed for two deaths. According to the FDA and the U.S. Centers for Disease Control and Prevention (CDC), there have been 11,458 confirmed cases spread across 20 U.S. states. Nearly 500 people were hospitalized as a result of the symptoms. The bulk of the illnesses happened prior to the lettuce recall on July 17.

Is the Outbreak Over?

The big question now is whether the outbreak is over. According to Dr. Colleen Kraft, a professor of infectious diseases at Emory University School of Medicine, “The most recent reported illness onset is August 15. But this is an important distinction: a newly reported case is not necessarily a newly acquired infection." Kraft went on to say that “There can be a substantial delay between someone becoming ill, being diagnosed, being interviewed by public health officials, and ultimately having their illness linked to an outbreak.”

The lengthy incubation period for cyclospora complicated the tracing efforts needed to determine the source of the infected produce. The CDC said that it can take from two days to two weeks for symptoms to appear after ingesting produce infected with the microscopic parasite.

In addition, it can take as long as six weeks for public health agencies to determine if an illness is part of a broader outbreak. The cases that are still coming in likely happened several weeks ago, potentially even before the lettuce was recalled. The lag in reporting means that it is challenging to ascertain if the infected lettuce is still circulating in the food supply.

Kraft said federal health officials will likely decide to declare the outbreak over once they are confident that no new illnesses are emerging. So while the immediate risk to consumers is likely over, the FDA is continuing to inspect lettuce samples, interview patients, and go through the lab testing data.

Experts believe that the outbreak could be declared officially over in a few weeks. These types of foodborne pathogen outbreaks are typically declared over when there are no more confirmed cases for several weeks and when investigators are certain that all of the impacted product has been removed from the nation's food supply.

How to Protect Yourself from Cyclosporiasis

It is understandable if you feel wary of eating lettuce so soon after the outbreak. While all signs are pointing to the outbreak being over, there are strategies that you can employ to reduce your risk even further.

Cooked vegetables are inherently a safer alternative to fresh produce. This is because the heat from the cooking kills the parasite that causes the illness.

As with any type of product, it is always important to practice good hygiene by washing your hands before preparing or eating food. Washing all fresh produce thoroughly, discarding foods after the date of expiration, and avoiding cross-contamination with different types of fresh produce are also good safety strategies.

If you want to take the food safety one step further, you can consider avoiding all bagged lettuce kits. It is a better strategy to buy whole heads of lettuce, remove the outer leaves, and wash the insides under running water.  Firm-skinned produce such as apples and cucumbers can be scrubbed with a clean produce brush.

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