Sunday, December 15, 2013
Cyclospora Outbreak Caused by Fecal Contamination
I’ve been idly following the news of the Cyclospora outbreak for the last few days… according to the latest report, there are 425 reported cases across 16 states (I don’t live in any of them, knock on wood!). It appears that salad mix produced by Taylor Farms de Mexico and served in Darden-owned chain restaurants (Olive Garden, Red Lobster) was ID’d as the primary source in Iowa and Nebraska, two of the states hardest hit by the outbreak.Cyclospora cayetanensis is a microscopic parasite that causes a nasty gastrointestinal illness (aka Cyclosporiasis) that can last from a few days to more than a month. While its normally found in tropical/subtropical regions outside the US, cases of infection from imported fresh produce – raspberries, basil, snow peas and mesclun lettuce – have occurred here before.One thing I’ve found irksome about the current reports, however, is the… delicacy of the language used to describe the nature of the outbreak. Most beat around the bush, saying that the outbreak has been “linked” or “traced” to the salad mix. A few go so far as to use the “C word” – “contaminated” but don’t go much further than that. For example…CBS News:“Cyclospora parasites, found in contaminated food and drinking water, cause the gastrointestinal infection cyclosporiasis.”ABC News:“Because the illness doesn’t spread from person to person, it’s possible it came from contaminated food or water, said Dr. Nicole Bouvier, an infectious diseases professor at the Icahn School of Medicine at Mount Sinai in New York City.”Hmmm… for some reason, the stories don’t quite answer the question, “Contaminated with what???” It’s a good question, though. After all, Cyclospora cayetanensis is a single-celled parasite, so it just doesn’t get into food/drinking water on its own.Out of all the mainstream/online media reports I’ve eyeballed, only one – from Consumerist.com – answers the question directly:“Hundreds of people in the Midwest got very sick from a bagged salad mix contaminated with a nasty little parasite called cyclospora. That’s how many cases authorities were able to confirm: there are probably many more who didn’t see a doctor or let the health department know they were sick. What no one will tell the public is where the fateful poo-contaminated salads were served.”Emphasis mine. Yes, you read that right: “poo” – aka “feces.” Cyclospora has a rather interesting life cycle: infected people shed non-infective, “unsporulated” oocysts into the environment (soil or water) in their feces. Once excreted, the oocysts sporulate over a period of days – weeks. Once they sporulate, they’re capable of infecting a human. If the sporulated oocysts happen to be on/in water or food that’s ingested, the cycle starts all over again.So wassup with those news reports? Guess they don’t want to reveal that parasites from human excrement were being served up in restaurant salads. Admittedly, that’s a pretty gross detail, but I really think this is something that people need to understand, particularly at a time when imported food inspections are declining. According to the New York Times, the FDA inspects only 2.3 percent of the 10 million+ shipments of imported food, due to limited resources. IMHO, being graphic about the nature of the problem is one way to combat complacency.At this point, I think that the next time I find myself in a chain restaurant, and the server asks “soup or salad?” – I’ll take the soup, lol. I’m no purist: the notion that food isn’t always clean or hygienic to the nth degree doesn’t automatically gives me the vapors. For example, when the pro-vegan Physicians Committee for Responsible Medicine tried to gross people out over fecal (E. coli) contamination on supermarket chicken, I didn’t even raise an eyebrow… after all, I clean my chicken, take precautions to avoid any cross-contamination during handling/preparation and cook it thoroughly before eating it. But foods normally eaten raw, like fresh vegetables and fruits, are a different story – there’s much less margin for error, especially for fecal organisms like Cyclospora, that can cause disease in very low doses.