Cyclosporiasis is surging: 8 foods to avoid

Steer clear of these foods as the parasitic diarrhea outbreak grows, says Dr. Sohaib Imtiaz, Chief Medical Officer at PEOPLE Inc.

NEED TO KNOW

• Nearly 7,000 cases of cyclosporiasis have been reported nationwide, with raw produce like lettuce suspected as a possible source
• Dr. Sohaib Imtiaz advises avoiding precut fruits, bagged lettuce, and leafy greens due to higher contamination risks
• Cooking, peeling, or freezing produce can reduce the risk of infection while still providing essential nutrients

As cases of cyclosporiasis continue to skyrocket to nearly 7,000 nationwide, the source of contamination has still not been identified, although it may be linked to raw produce such as lettuce. With so many unknowns, people are wondering if they should avoid fruits and vegetables entirely.

“The good news is that health officials are not recommending people stop eating fruits and vegetables,” Dr. Sohaib Imtiaz, Chief Medical Officer at PEOPLE Inc., tells PEOPLE. “Fresh produce remains an important part of a healthy diet.”

But at this stage of the outbreak, Imtiaz urges people to take precautions. Here are the foods to avoid.

Prewashed, Bagged Lettuce and Salad Mixes

These salad mixes are especially risky, Imtiaz explains. “Since produce from multiple farms is washed, chopped, and packaged together, contamination can spread across a much larger batch.”

Precut Fruit and Vegetables

With produce, the skin or peel is a “natural protective barrier,” says Imtiaz. But with precut fruit and veggies, the fleshy interior is exposed, giving the parasite a surface to hold onto where it “cannot be effectively rinsed away.” And similar to bagged lettuce, the cutting process allows cross-contamination, as “a single contaminated item processed on shared equipment can spread oocysts [the parasite’s eggs] across an entire batch.”

Leafy Greens

These are high risk, he says, because they grow low to the ground, “in direct contact with soil and irrigation water — the two primary vehicles for Cyclospora oocyst contamination,” according to Imtiaz. If the water used on crops is contaminated with feces, it can spread the parasite. And leafy greens offer easy places for the parasite to hide, thanks to “their large, textured leaf surfaces with folds, veins, and irregular edges.”

Fresh Herbs (Specifically, Basil and Cilantro)

“Cilantro has been the single most frequently identified vehicle in U.S. cyclosporiasis outbreaks,” says Imtiaz. Along with basil and other fresh herbs, these are usually eaten raw, or added as a garnish. Their complicated leafy structure offers ample places for the parasite to hide. They’re “often grown in regions where water sources may be contaminated” — and they are heavily irrigated plants.

Snow Peas

They’re often eaten raw and may appear smooth, but as Imtiaz explains, “their flat pod shape with a seam along the edge can harbor oocysts.”

Raspberries

Raspberries are “uniquely vulnerable” due to their shape, Imtiaz says. They’re “too fragile and replete with crevices” to really be washed thoroughly. That, along with their hollow interior, creates ideal harbor for the parasite. Once contaminated water or soil gets into those crevices, “they cannot be rinsed out.”

Mangoes

At first, the tropical fruit may seem like an outlier, as the skin is not eaten — but as Dmtiaz points out, they’re often imported from regions where the Cyclospora parasite is endemic. Like other common vehicles for the parasite, mangoes “have a textured skin,” which can harbor parasite eggs that will “transfer to the flesh during cutting.”

Onions

Admittedly, this addition “may seem surprising,” Imtiaz says, but they are often eaten raw. And while people don’t eat the papery skin, it can “trap contaminants that transfer to inner layers during peeling and chopping.”

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If you’re confused about what’s safe, Imtiaz advises looking at “the unifying theme across all of these items.” Risky foods generally are eaten raw or minimally cooked, have surfaces that can trap the parasite, and they may be “imported from regions where fecal contamination of water and soil is more common.”

If you’re at high risk of severe illness, due to a compromised immune system or other concerns, Imtiaz recommends “choosing foods that are cooked, canned, frozen (preferably cooked before eating), or peeled at home.” As he explains, this can offer “the greatest peace of mind while still providing the nutritional benefits of fruits and vegetables.”

Read the original article on People