Cyclospora is a parasite so small that it can only be seen under a microscope. When people eat food or drink water contaminated with Cyclospora, they can get an intestinal disease called cyclosporiasis. To date, Cyclospora is thought to infect only humans and is spread through human faecal matter.

Cyclospora generally transmitted when infected faeces (faeces) contaminate food or water. It is unlikely to be transmitted directly from person to person because Cyclospora the parasite needs time (days to weeks) after being passed in feces to become infectious.

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Who is at risk?

Anyone can get cyclosporiasis, but people with weakened immune systems (such as those taking immunosuppressive drugs or living with HIV), the elderly, or children may experience more severe illness or complications from severe dehydration and may need longer treatment.

People can become infected with Cyclospora if they live or travel to an area where cyclosporiasis is endemic (regularly found) or by consuming food or water that has been contaminated with the parasite. However, there have been illnesses associated with produce grown in the United States in recent years.

What are the symptoms?

The time between being infected and becoming ill is usually about a week, although it can vary from 2-14 days or more. Cyclospora infects the small intestine (bowel) and usually causes watery diarrhea with frequent bowel movements. Other common symptoms include loss of appetite, weight loss, abdominal cramps/pain, bloating, increased gas, nausea and fatigue. People may also experience vomiting, body aches, headaches, low-grade fever and other flu-like symptoms. However, some people who are infected with Cyclospora have no symptoms. If left untreated, the disease can lead to dehydration and serious complications that may require higher levels of care. These complications can last from a few days to a month or longer, and can be more severe in those with weakened immune systems. Symptoms may appear to go away and then return one or more times (relapse).

Cyclosporiasis is treatable. A healthcare provider can prescribe the correct antibiotics to treat the infection. It is important to seek care promptly, especially if you are immunocompromised, as longer treatment may be necessary.

What foods and water sources have been linked to US outbreaks of cyclosporiasis?

Previous cyclosporiasis outbreaks in the United States have been linked to fresh produce such as raspberries, cabbage, basil, cilantro, parsley, broccoli, snow peas, sugar snap peas, and leafy greens. Cyclosporiasis can also be acquired when people eat or drink contaminated food or water while traveling outside the United States. Cases acquired in the United States tend to occur between May and August.

What can consumers do?

Consumers should follow these steps:

• During the summer months, consumers should monitor illness reports from their state public health agencies, the FDA, and the CDC for notices of foods that have been linked to Cyclospora outbreaks that consumers may want to avoid.
• Consumers should also consider the following when consuming products below Cyclospora season:
  • Discard the outer layers. Whenever possible, discard the outer layer of fruits and vegetables. For example, discard the outermost two to three layers of leafy greens.
  • Rinse the products thoroughly. Rinsing produce is an appropriate first step, but may not reliably eliminate the parasite. Rinse all fresh fruit and vegetables under clean running water, even before peeling them. Use a clean vegetable brush to scrub solid produce. Note that Cyclospora parasites are resistant to standard chlorine-based disinfectants. Consumers should not Use soap or bleach to rinse products.
  • Be careful with pre-washed or pre-cut products. Commercial washing processes may not be sufficient to remove the parasite.
  • Avoid cross contamination. Clean kitchen worktops, cutting boards, utensils, etc. with warm, soapy water.
  • Prioritize cooking. For all products that can be cooked, cooking to a temperature of at least 158 ​​°F (70 °C) is the safest option, as the parasite is resistant to routine chemical disinfection and washing alone cannot guarantee its removal. Cyclospora cannot survive at these high temperatures.
• As always, wash your hands with warm water and soap for at least 20 seconds before and after handling food.

Who should be contacted if you get sick?

If you think you have become ill from eating potentially contaminated food, you should contact your doctor, especially if you have diarrhea or other severe symptoms that last more than three days.

The FDA encourages consumers with questions about food safety to send an inquiry to www.fda.gov/fcic for further information.

What should restaurants and retailers do?

Based on currently available information, Cyclospora may be resistant to routine chemical disinfection methods, such as those using chlorine. However, restaurants and retailers should still follow basic food safety practices:

• Cyclospora is generally spread through human faecal material, so people with symptoms of vomiting or diarrhea should not handle food in retail establishments or at home as a way to reduce contamination.
• Retailers, restaurants and other food service operators should always practice safe food handling and preparation. It is recommended that they wash and clean utensils and surfaces before and after handling food. Wash and disinfect display cases and refrigerators where potentially contaminated products were stored.
• Wash and disinfect cutting boards, surfaces and utensils used to prepare, serve or store potentially contaminated products.
• Wash hands with hot water and soap for at least 20 seconds before and after handling food and after any cleaning and sanitation process.
• Regular, frequent cleaning and sanitizing of food contact surfaces and utensils used for cooking can help minimize the likelihood of cross-contamination.

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