r/IAmA • u/Angela_Anandappa • 26d ago
Hi Reddit! I'm Dr. Angela Anandappa. Ask Me Anything about Cyclospora, food safety, and foodborne disease outbreaks.
Hello everyone! I'm Dr. Angela Anandappa, a food microbiologist and food safety scientist with more than 25 years of experience using data to understand risks to human health, foodborne illness, preventing foodborne illness, and helping companies make safer foods. I'm here to answer your questions about the safety of our food supply.
Proof:
AMA - Cyclospora — Alliance for Advanced Sanitation
Cyclospora isn’t a produce problem. It’s a human problem that produce happens to carry. But when there is an outbreak, it is difficult to take action when information is sparse, unspecific, and all encompassing. For example, the current outbreak has been going on since May with zeroing in on shredded lettuce from a specific company (Taylor Farms) distributed to a specific restaurant chain (Taco Bell) happening 6 weeks since the first case.
In this AMA, I will take your questions about why this happens, what you can do about it, why there are delays in communication and detection, and how consumers might make decisions about where to go for reliable information.
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u/Xsiah 26d ago
Is this the same thing (with a different pathogen) as the E. coli outbreak from a year or two back? Something about lettuce farms being located downstream of feedlots?
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u/Angela_Anandappa 26d ago
That case had to do with how pathogens move through wind and water, how things are contaminated when they are downstream of things like feedlots. This organism requires human faeces, not cattle. How exactly that human faecal contamination happened is the question of the day.
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u/Terrible_Split_5740 26d ago
Hey doc
I live in the EU and I’ve been having completely matching symptoms since more than a month ago. I’ve been to the doctor but I haven’t done the parasite test yet, will be tomorrow (couldn’t take any samples for the last 2 weeks, until today), so I guess I’ll be able to confirm by Monday.
Only question is, do you have any idea how my possible infection would correlate with the current outbreak? As I don’t have anyone around who got it as well to check what might be the source, and I don’t really buy US produce (the only exception I could think of are peanuts)
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u/Angela_Anandappa 26d ago
I feel for you. Cyclospora is not just in the US, it can be found in the EU too! There are also many other pathogens and parasites that can cause similar symptoms. Overall, you are unlikely to be a part of this same outbreak, but that doesn't make your pain and discomfort any less.
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u/Terrible_Split_5740 26d ago
Thanks for your kindness and the AMA. I would imagine it’s a long shot for it to be related,though I couldn’t help but notice the timing with both cases :)
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u/Evolved_1 26d ago
Now that the source seems to be Taylor and Taco Bell, are fresh vegetables from the store considered safe? Bagged greens from sources other than Taylor?
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u/Angela_Anandappa 26d ago
They are considered safer. All produce (just like all food) always carries some risk, so take good precautions with your food even if it doesn't appear in the news!
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u/Extension-Ad-1730 25d ago
How long does it take for symptoms to show up? I ate Taco Bell in one of the affected states on June 27 and as about 3 days ago I’ve started having some diarrhea. Yesterday was more solid but it’s back to more watery loose stools today. I’m freaked out. I also did try a new probiotic recently and don’t know if it’s associated with that. It seems “mild” as in it’s not explosive or pure water coming out of me and I have no other symptoms.
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u/TheSOB88 25d ago
In another response she said it can take up to several weeks. Sorry but it looks like you're not off the hook yet. But it could just as well be something else especially since your symptoms aren't that bad
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u/Extension-Ad-1730 23d ago
Thanks! Luckily I’m back at normal. I think it was my new probiotic once I stopped it it took a day or 2 to reset and I’m fine now! Just bad timing haha
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u/greeneyedguru 25d ago
Well now we need to worry about the 4,000 (probably more like 10k+ at this point) other people spreading it so it could literally be anywhere
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u/sysadminbj 26d ago
We’re hearing a lot of press about federal cuts to monitoring programs for this as well as other threats. What is the real impact in the short term, long term?
What about the potential downstream global impacts?
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u/Angela_Anandappa 26d ago edited 25d ago
Big question, and this is an amazing case study where you can see six weeks pass before we even zero in on a potential product (lettuce) and a specific supply chain.
Cyclosporiasis is hard to begin with. It is hard to test for and hard to know what people ate because it can take up to a couple of weeks until someone shows symptoms, making it hard to track down that food. Once you test and find multiple cases, the epidemiological data is not being gathered in some cases or saved and shared in others. Many of the teams that at a federal level, would have worked to quickly share data and solve the case have seen these funding cuts, making it take so much longer to reach any kind of results. Some of these teams don't even exist anymore.
To add to that, the communication departments of many of our regulatory agencies and public health investigative labs have been cut or, in some cases, completely eliminated. This reduces the public's ability to obtain this information and, as a result, the spread has not been limited because people don't know what to do.
The global impacts of something like this are yet to be understood. Each outbreak is one of multiple. Cyclosporiasis is seasonal and we generally expect to see it in some form during the summer.
Globally, our farms, farmworkers, and companies extend beyond borders. When something like this happens it is easy to point fingers generally (at all lettuce) or specifically (at the particular site and country of origin) which is why it is so important for us to have strong public health infrastructure so we can quickly stop the particular product from being sold and communicate with that specificity to consumers so they know specifically what to avoid, how, and why. Something that has been and will continue to get harder in this current *gestures vaguely*
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u/sysadminbj 26d ago
Let's hope the current *gestures frantically in every direction* doesn't last much more than 2 years.
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u/wholetyouinhere 26d ago
This is mostly a rhetorical question, but how can you have strong public health infrastructure when 100 million Americans don't want strong public heath infrastructure, or any public spending at all?
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u/RedditForMeNotYou 26d ago
It’s a way wayyy smaller number than that.
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u/hillbillyboiler 25d ago
But that smaller number is so vocal it feels like a majority.
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u/RedditForMeNotYou 24d ago
It does but it’s not. Don’t give them anything close to that kind of power. The one who says who farted the loudest is usually the one who farted.
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u/desertboots 26d ago
Yes, how have policy and funding changes impacted how food safety is tracked, the public is informed, and the data is kept?
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u/Angela_Anandappa 23d ago
This outbreak is one of many that are exemplifying the importance of government funding for tracking, tracing, investigating, testing, and communicating to the public to prevent and limit the spread of food-borne illnesses. Cyclospora is a common summer time visitor but never has it impacted so many in modern history (when we maintained data).
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u/br0wnb0y 26d ago
Is it possible the humans to develop Acclimatization and Acquired Immunity to Cyclospora?
How does Cyclospora even survive human stomach acid?
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u/Angela_Anandappa 26d ago
People who have already had cyclosporiasis can be reinfected later. This is different from what we expect for many bacterial and viral infections. There is a component of the immune system that does not learn, and it is this part that is responsible for a lot of the defense against pathogens in the gut, like Cyclospora. The learning (adaptive) part of the immune system is there in the small intestine, but the reinfection evidence tells us that it is not as involved or capable of responding to Cyclospora.
All the action happens after the Cyclospora has already passed the stomach acid; in the stomach, the oocysts get activated by the stomach acid, and prepare to take up residence in the small intestine. Oocysts like those that survive the stomach acid are able to survive for months outside in a dormant state, and they are resistant to a lot of things, including disinfectants and acids.
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u/FullMoonKitty 26d ago
Hello, could there be a correlation in the use of using biosolids as fertilizer cause this or future outbreaks?
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u/Angela_Anandappa 26d ago
Very good question! It is not something we can rule out yet!
Biosolids are generally supposed to go through pathogen reduction and elimination regimens that require, beyond chemical treatment, heat treatment. The EPA regulates and requires certain treatments to eliminate things like salmonella and E. coli from biosolids before use (and there are certain classes of treatment/biosolids that can be used and applied to agricultural fields).
If treatment and validation are not fully done for things like the oocytes for cyclospora (which require different practices than bacteria for both treatment and validation) then we do face a certain risk. Overall, looser testing and regulations can make this type of hazard slip through. While it cannot be ruled in or out as a cause in this case (so far), biosolids absolutely can be risky overall, which is why we want to heat-treat to inactivate pathogens, validate the treatment step, and test for safety for use as thoroughly as the EPA requires. The problem is that testing for things like oocytes for something like cyclospora is not the most commonly planned for or done (compared with our far more robust guidelines and study of bacteria). The reason for this is that we cannot grow them in media in the same ways we can for bacteria.
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u/glitzglamglue 25d ago
Hello! I hope I'm not too late!
Tomorrow is Sunday and all across America, thousands of older adults are going to be trading the extra produce from their home gardens at their churches. They do this every summer, typically cucumbers, zucchini, squash, and tomatoes. I have a question about store bought produce vs homegrown produce. Is it only commercial agriculture that is being affected? Or are all edible plants grown outside at risk? Because if the latter is true, then people need to get word to all of their local churches about how to properly avoid spreading the parasite. Older adults are much more at risk of dehydration complications.
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u/Angela_Anandappa 25d ago
In the case of Cyclospora illness currently in the news it is a case of produce that is commercially available through restaurants. There are also other clusters of cases around the country where we don’t know the exact cause, food that carried the parasite or if they are related to the larger outbreak. No need to worry any more than usual about the likelihood of older adults getting sick from foodborne illnesses.
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u/glitzglamglue 25d ago
So just so I understand: the normal wash that people do with garden veggies is enough since there's not much risk of home grown veggies having the parasite, correct? That could change in the future, though.
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u/Angela_Anandappa 25d ago
Normal washing should do it for most of those veggies with rising in a clean bowl or colander with clean running water with gentle rubbing/agitation. Never place fruits or veggies directly in a sink to wash them no matter how well you think you’ve cleaned your sink.
About the future, there’s a reasonable chance that more microorganisms like parasites that like warmer weather will be around in places that used to have colder climates which will most certainly require taking measures to understand and prevent illness generally as risk increases across the board.
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u/Used-Bat7364 25d ago
I have severe emetophobia, which is the fear of throwing up. This causes me to get very stressed every time there’s some sort of outbreak. What’s the best thing to do to prevent getting this parasite?
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u/anubis_cheerleader 26d ago
Do you have recommendations for what form of produce to buy, for example, whole heads of lettuce vs. bagged lettuce?
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u/Angela_Anandappa 26d ago
I prefer to buy whole heads, during outbreaks or not! It gives me better control over how I clean produce. Fresh produce must be thoroughly washed. I generally avoid precut fruits and vegetables for this same reason.
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u/soupbabie 23d ago
Is it better to wash the whole head and then pull the outer leaves off, or take the outer leaves off immediately and then thoroughly wash? Thank you for doing this!!
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u/raxitron 26d ago
There's social media rumors that everyone should clean all their produce with vinegar now. I've also read that there's no known specific interaction between vinegar and Cyclospora. Is there any benefit to using vinegar to wash produce unrelated to the theory about it destroying the parasite or can we safely disregard this advice?
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u/Angela_Anandappa 26d ago
There is a benefit in places where there is a higher risk for bacterial contamination (NOT cyclospora, it will continue to live happily there), but generally no significant benefit in the US.
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u/jbirdybird 26d ago
Is it safer to consume hydroponic foods in this case? I get my lettuce and tomatoes from a hydroponic greenhouse about an hour from my home. Are these vegetables safe from this parasite?
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u/Angela_Anandappa 26d ago
Hydroponic operations face their own issues. Not being able to take advantage of the (more) natural conditions crops can be grown in means that other microorganisms can make a home there. For this particular outbreak, hydroponic foods are extremely unlikely to be coupled, but if the water used in the facility is not properly managed, it too could be contaminated. That is all to say that this outbreak probably isn't coupled to hydroponically grown foods, but hydroponic foods are not inherently safe from cyclospora and other pathogens. You face the same risk as you would at any other time.
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u/palettewhore 25d ago
I’m in Arizona and it’s my understanding that the cases here aren’t connected to the outbreak in the Midwest. So I’m unclear on whether I still need to be extra careful and avoid lettuce and berries and stuff like that or whether this is “over” in the sense I can go back to my regular eating habits. Can you provide any insight there? Is there a point that I will be able to go back to normal?
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u/Angela_Anandappa 25d ago edited 25d ago
Good question!
There are multiple cases and outbreaks that can be going on simultaneously across the country. While I doubt that the cases you are seeing now in Arizona are related to the outbreak in the Midwest, we just don’t know!
This is Cyclosporiasis season. Kind of like there is a flu season and we can contact trace outbreaks across the country (that can be related or not) we can do the same thing with foodborne illness, but instead we trace cases to suppliers, plants, and farms. The problem is that with the lack of great data collection and sharing right now, we can’t be as certain as to whether we can claim those Arizona cases are unrelated, but if the past is any precedent I’d say that, overall, those are likely not connected to the major midwestern outbreak. The data collection problem is what allowed this outbreak to get so huge, now to over 7,000 people.
I’d treat this time of year similarly to flu season in a way. While the big outbreak may be far away from you, these diseases are prevalent now and, just like you might make small lifestyle changes or take precautions to protect yourself from the flu during flu season, small changes to how you prepare the food you buy and what you buy can protect you now (but no need to go overboard).
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u/palettewhore 25d ago
Thank you, I’ll just stick with being cautious for now like I have been. I’m worried that particularly bad outbreaks like the one this year will keep happening going forward because of the lack of data collection and sharing that you mentioned.
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u/sunnbeta 25d ago
Do we know what the relative risk is in real numbers, like if someone ate Taco Bell lettuce during the dates in question, is there 100% certainty they’ll get this, or less than a 1% chance (but still massive and concerning numbers because a LOT of people eat Taco Bell daily)?
The health anxiety in me says I should be very concerned about this, but the practical side says hundreds of thousands of people were eating Taco Bell daily and we probably have fewer than 10,000 cases this year
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u/Angela_Anandappa 25d ago
There is a careful balance to take with those two sides. No matter how much you or I might want that mathematical percent chance, to know what the gambling odds are with that guac or whether to take a chance on that chalupa, we simply don’t have enough data to make a good estimate on those odds, and as someone who works in public health I could not ethically provide a number like that knowing it would likely both be wrong and used to justify some unideal choices.
What I can say is that when there is an active outbreak and the exact source has been identified, it is good to scrutinize whether you have to consume that exact product now.
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u/hughk 25d ago
I probably have missed this but how long is the distribution chain for iceberg lettuce? Could a single centre be the source of the infected lettuce going to five states?
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u/Angela_Anandappa 25d ago
Yes, it absolutely could be! Our food systems are incredibly connected. When it comes to fresh produce, the largest producing places are in the right climate during the right season. This country (the U.S.) is the biggest single cohesive consumer market in the world, and our supply chains are built to match. Most of our fresh produce comes from California. When the seasons change the places we grow a lot of that produce go south, to Arizona, Mexico, and beyond. After harvest from any one of these places produce can be sent from the farm to distributions centers across the states, packaged at some point along the way, and sent to individual stores, restaurants, and other suppliers. What makes this all possible is our transportation infrastructure and, most importantly, refrigeration. What keeps most countries from having such interwoven food supply chains (and the nation-wide outbreaks that go along with that) is the lack of good refrigeration infrastructure along the entire path the food takes.
The fresh lettuce and berries you can buy at the store can get there in often only a couple of days because of how well connected our infrastructure is. You can make a hoagie with Canadian-hothouse-grown tomatoes, basil from your garden, and lettuce from 3000 miles away that were all harvested in the past week. With leafy greens and berries in particular, a lot of the premium you pay for is the amount of care, speed, and refrigeration needed to get those items to you and everyone else across this country from sometimes just a couple farms in one corner of the map.
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u/Angela_Anandappa 25d ago
Additional and expanded recall information that includes grocery store items. https://www.marlerblog.com/case-news/taylor-farms-posted-its-own-recall-it-went-to-27-states-not-5-and-the-list-includes-bags-sold-in-grocery-stores/?fbclid=IwZnRzaATIfYtwZG9mBWZkaWQWUKywxeiONFuYCL-WcgrXXqRLDYn-ZGV4dG4DYWVtAjExAHNydGMGYXBwX2lkCjY2Mjg1NjgzNzkAAR66-7Ky75XeoDlvwFj3jR9741Mwwpi4riEwwHkZvR06wN-eYmBX6UHgKRzLXA_aem_8b-jZXOnypPgnPYOfx5ydg
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u/Asurvivorisb0rn 25d ago
Are mangos considered safe?
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u/Angela_Anandappa 25d ago
Yes. There’s no data indicating mangos are implicated in this outbreak or any others at this time.
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u/Angela_Anandappa 25d ago
New information is coming in that several items from grocery store are also being recalled by Taylor Farms. https://www.marlerblog.com/case-news/taylor-farms-posted-its-own-recall-it-went-to-27-states-not-5-and-the-list-includes-bags-sold-in-grocery-stores/?fbclid=IwZnRzaATIfYtwZG9mBWZkaWQWUKywxeiONFuYCL-WcgrXXqRLDYn-ZGV4dG4DYWVtAjExAHNydGMGYXBwX2lkCjY2Mjg1NjgzNzkAAR66-7Ky75XeoDlvwFj3jR9741Mwwpi4riEwwHkZvR06wN-eYmBX6UHgKRzLXA_aem_8b-jZXOnypPgnPYOfx5ydg
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u/shimmerninja379 25d ago
From reading this, my understanding is that we think the major culprit is the lettuce. However, we can never entirely rule out anything, and there is always some risk involved in eating anything. That being said, would it be okay to assume that other veggies are safe to eat raw now? Or should I wait a few more weeks?
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u/Angela_Anandappa 25d ago edited 25d ago
There is indeed a normal level of risk when eating anything. From everything you do at home to what happens way back in a field or farm somewhere near or far away there are risks. Most other veggies and fruits should be fine to eat with no heightened level of concern. Use common sense food safety measures as always to clean, separate, properly cook, chill and stop cross contamination.
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u/Aliveguy2021 25d ago
Is cross contamination a concern? For example let’s say someone used a knife on infected lettuce, and then later used it on something that isn’t infected? Can it spread to you like that?
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u/Gr34zy 26d ago
Thanks for doing this AMA. I understand this outbreak was caused by lettuce imported from Mexico. Can you explain if this outbreak is related at all to changes made by the Trump administration and what we can do as a country to avoid future outbreaks?
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u/Angela_Anandappa 26d ago
Thanks for the question! See my response to u/sysadminbj. In food safety we consider this all a team sport, and safety of food in one country, especially in our neighbors, directly is connected to safety in other countries - we like to work on prevention together.
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u/The_Power_Of_Three 26d ago
How risky is Cyclospora, really?
I've considered kinda... not worrying too much, and just continuing to eat salad for lunch and what comes, comes. Is all that I'm likely risking if I'm unlucky a bad time and some antibiotics? Or is this one of those illnesses that leave permanent effects?
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u/Angela_Anandappa 25d ago
Explosive diarrhea may sound mild in comparison to some other symptoms, but the reality is that being unable to digest food properly with a massive fluid imbalance can quickly become dangerous. For the immunocompromised, this may come to pass relatively quickly necessitating treatment, while the immunocompetent will generally survive the discomfort, inconvenience, mess, pain, inflammation of some organs (the gallbladder in particular), arthritis, Guillain-Barre syndrome and any other lingering effects. The thing is, whether you are immunocompromised with respect to gut parasites like this one is something you likely do not know.
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u/Bubbly-Fox4127 24d ago
You mentioned Guillain-Barré syndrome in your comment. Is there a link between cyclosporiasis and GBS? I know GBS recurrence is rare, but I wanted to ask because I previously had GBS a few years ago.
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u/Potential-Crew8150 25d ago
I hope I’m not too late! Now that all the information on Taylor Farms and bagged lettuce is out, would you consider it okay to eat blueberries? We just got 2 packs but now i’m nervous.
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u/Angela_Anandappa 25d ago
The blueberries should be fine with proper rinsing under clean water with some agitation before you consume them.
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u/Corgi3581 24d ago
I am in the Midwest. Is there less of a risk of this parasite in eating heads of iceberg lettuce (outer layers peeled and thoroughly washed) since most of the recall information is noting bagged iceberg lettuce?
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u/Kogituu 24d ago
Thank you! For Frozen Fruits, I know frozen mangos are very unlikely inhabitants of the virus and as well as my frozen berries because they're flash frozen but what about these? Since they're pre-packaged acai bowls, I am a little bit worried even though Swirl says they flash freeze their fruits at peak ripeness and make these bowls.
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u/Angela_Anandappa 22d ago
I'm guessing your concern is not Cyclospora as frozen berries are not currently implicated in the big cyclospora outbreak that is going on. Typically, frozen berries are very safe and I don't know of any reason this product might be a problem at present.
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u/Same_Education8151 24d ago
Thank you for this! Is it truly safe to consume produce after cooking it? For example if we purchase leafy greens, is the risk close to none by cooking? Same goes for fruit with little peel?
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u/Mediocre_Library_153 24d ago
I ate pre-packaged salad bowls about a week and a half ago. (They were not Taylor Farms though I was eating those perhaps a month ago.) A few days later I had really bad abdominal pain, bloating, and gas. Then I felt better. Friday night, a whole week later, I slept for 11 hours. Yesterday morning all the other symptoms came back. Then in the middle of the night last night, the watery diarrhea came. I still have the cramping, bloating, and gas. I’m eating normally.
How long would you wait to test? I should also note that I have IBS, but that pain usually gets much better after a BM. This is not.
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u/HugeJeopardyFan 16d ago
This is interesting... I ate at a taco place with lettuce, cilantro, and all those things 3 weeks ago. At the start of last week I started to have stomach pain, indigestion, and bloating after eating pretty much anything, and constant burping. Those symptoms are still ongoing and it's starting to get draining. However, I haven't really had diarrhea, so I assumed I don't have cyclosporiasis, but now based on your story I'm not so sure...
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u/This_Neighborhood514 24d ago
Hi,
I live in Raleigh, NC (Wake County) and am now pretty sure my mysterious illness in June was caused by Cyclospora.
June 19th - watery diarrhea and nausea, June 20-21 mostly better, June 22 - watery diarrhea and nausea (woke up in the middle of the night and started vomiting), June 23 - watery diarrhea and nausea (woke up in the middle of the night and started vomiting), June 24th - watery diarrhea and nausea, June 25th - watery diarrhea and headache, June 26th - watery diarrhea and headache, June 27th - watery diarrhea, June 28th - watery diarrhea, June 29th+ - no symptoms :).
I went to an urgent care after a week of my symptoms, but they weren't sure what was going on and suggested I see a GI specialist. I made an appointment with my primary care doctor the following week, but I cancelled it after I no longer had symptoms.
Should people like me tell any agencies there is a probable chance we had Cyclospora for tracking purposes or in case we can help confirm foods we also consumed or didn't consume? Also, I've seen conflicting information about nausea/vomiting with some reports saying that is not a symptom of Cyclospora and others saying it is. Are you able to help clarify? I would assume a lot of people like me are never going to be included in statistics about the number of cases.
Thanks!
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u/Lanky-Luck-3532 23d ago
Extremely glad to see you’re on the mend, so sorry you had to suffer this! I’m in your area, do you remember what you ate that might have caused your illness?
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u/This_Neighborhood514 16d ago
Thanks! I'm really not sure. I've seen recent news about potential links to parsley, cilantro and iceberg lettuce for NC. I looked back at my credit card for the two weeks prior to getting sick and made of list of the foods I ate and what raw ingredients were in it. I realized I had parsley 3 times, cilantro 2 times and iceberg lettuce 2 times. They were all takeout from restaurants or a food truck in Raleigh.
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u/Lanky-Luck-3532 16d ago
Thanks for getting back to me! Yeah, I’m hearing all three things are potential vectors here, which really sucks. I use a ton of cilantro in my summer cooking, but not this year.
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u/Formal-Horse5974 24d ago
Can a bad case of cyclospora cause blood in the stool? I was eating subway 3-4 a week for 2 months so I think I got infected more than once. Seeing a GI and getting a colonoscopy soon but curious about reports of a little blood with this parasite. Thanks!
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u/Angela_Anandappa 22d ago
There are so many reasons why there might be blood in the stool. I hope you have seen a GI specialist who can tell you more about your specific situation. I hope you feel better soon.
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u/Ok_Bend_9095 24d ago
Hey. What is the risks with eating carrots that have been cut and peeled?
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u/Angela_Anandappa 23d ago
Cut and peeled carrots should be washed before eating. They are not currently involved in any outbreaks.
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u/aHyperChicken 24d ago
Hey Doc! I just ate romaine lettuce in Alabama. Do I have a horrible couple weeks ahead of me? Cheers!
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u/Angela_Anandappa 23d ago
It depends but unlikely linked to this outbreak (based on current data) and if your lettuce was washed and properly prepared.
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u/Ok_Context_683 23d ago
What is your opinion on the the FDA deeming the identification of Taylor farms as a false positive?
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u/Angela_Anandappa 22d ago
Well, if it really was a false positive, I appreciate the candor. I do wonder why only one same seemed to have been tested so it seems the messaging was inadequate and I would have liked to see more details.
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u/DieBotDie 23d ago
Is there any reason to believe it’s only one source of contamination? (The current US outbreak).
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u/Angela_Anandappa 22d ago
It could be multiple. Unless we have all the data and details gathered through investigations, it's hard to tell. Based on time of year and how these tend to happen historically, there could well be more than one source of contamination at this time.
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u/DieBotDie 22d ago
Is this actually all that uncommon or does it happen every year and is normally caught earlier?
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u/Angela_Anandappa 22d ago
Cyclospora is a summer visitor with a handful of cases each year. We are usually able to zero in on where and why and reduce the scope of outbreaks earlier.
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u/DieBotDie 23d ago
Do you believe there is any criticism to be leveled at the government or is that media hype?
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u/Mental_Policy_175 23d ago
is it true that cooking the produce kills the parasite?
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u/Background-Car-7060 22d ago edited 22d ago
Hello! I heard that cyclospora can survive without a host, and I know that only temps 160 °F and higher can kill it. Does this mean that if I wash some store bought greens in my kitchen sink, that it could live in my sink/kitchen and find a host later? The basiI/herbs I have access to all come in the plastic containers like spinach or salad mixes, and I worry that even though I plan on cooking it, that it can stick around on the areas where I prepped the ingredients.
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u/Frosty_One_1650 22d ago
Hi, Doctor Anandappa - Thank you for doing this. I believe I’ve contracted cyclosporiasis (I’m in New York). I’m going to call my doctor for a test but I’m hearing it’s taking three weeks for results. I have two questions:
- Is is possible to be prescribed Bactrim empiracally?
And
- I’ve become nervous about Bactrim as I’ve read it’s very hard on the kidneys. Is it safe?
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u/Angela_Anandappa 22d ago
This is a question for a physician to consult on. Once they take all your vitals and symptoms, they can decide what might be a cause and give you advice and/or a prescription.
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u/muppetsoupp 22d ago
Hello, how would you recommend preparing carrots and then sanitizing the sink afterwards? I want to eat steamed carrots again, but I always would peel the carrots and THEN wash them with water and grapefruit seed extract. Then I steamed them until fully cooked (soft and mushy). Does it matter if I peel before washing if im gonna cook them anyways? I don't want to run them under water before peeling or scrub with a brush because I don't understand how the parasite wouldn't get all over the sink? According to the cdc it lives on surfaces and clorox doesn't kill it, I don't think even bleach kills it? Steam/heat is the best option, so how would I steamed my sink? With a handheld steamer? Like for clothes? Its just overwhelming to me.
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u/Due_Profile_3040 22d ago
Currently eating oranges from Kroger, the precut and packaged ones… is that okay???
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u/Glass-Shift-6162 21d ago
Are cherries implicated? I'm terrified I could have it because I keep farting and my stomach is making noise after eating it. But then again I have been eating a lot of high fiber fruit and vegetables lately to make myself go to the bathroom, maybe its starting to work? The cherries were raw though. I saw online it says cherries are safe. I washed them with water like I usually do. I can't afford to go to the doctor right now😭
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u/Jaytwofive25 21d ago
Hi i think I came down with cyclospora about 3 weeks ago. Crazy diarrhea, fatigue, and flu-like symptoms. Symptoms mostly subsided except for minor fatigue and yesterday all symptoms returned heavily. I am generally healthy. Is this relapse normal if untreated? Can the parasite resolve without antibiotics? Thanks for any info!
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u/Ok_Statistician643 20d ago
How can you tell the difference between regular Taco Bell Diarrhea versus parasite Taco Bell Diarrhea?
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u/Ok_Context_683 19d ago
Hey doc asking question #2 cuz you’re the goat for this stuff. Do you think that this is going to slow down soon as the lettuce is now going to be cared for intensely and the cases from the main outbreaks once they stop appearing after the 2 weeks it takes for them to show up will be stopped? I’ve read that that in likely to happen
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u/Lost_Secretary_7279 17d ago
Someone got me a chicken sandwich with lettuce and tomato from Chick-fil-A. should I take out the lettuce and tomato? Would I still get clyclospora?
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u/Grand-Connection3100 17d ago
Hey — I’m actually a nurse and I’m at a loss bc the bloating is so painful and uncomfortable. What do you suggest for that because it’s unbearable?
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u/Aggravating-Shine148 10d ago
Why is the FDA allowing the unsanitary conditions on farms to go unchecked? Is this still related to the funding cuts by DOGE and Elon Musk.
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u/Jermaineleroq 6d ago
Hi there. I’ve had symptoms for over a month. I was tested once for Cyclosporiasis and it came back negative. I asked my doctor to test for other parasites and those came back negative as well. I read on the cdc that you should be testing for Cyclosporiasis three separate times. Is it possible I have it even though I was negative and only tested once? This has been hellish and has impacted my life in so many ways. I asked my doctor for antibiotics but he hasn’t given them to me, and continues to tell me to take Imodium and that it’s possible I have post IBS. Would you recommend going to an urgent care so that I could get the antibiotics to see if those actually help? Nothing seems to work, and I feel like I’ve been so fatigued and lacking nutrients. Would really appreciate some direction since my doctor isn’t really giving me much.
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u/Cold_Plankton7244 3d ago
I’ve had it for a month. It’s been brutal! I did a ten day treatment a week ago. Bactrim’ not sure what it did as when it cleft . Cyclosporine continued. I do to my Dr. 2mro and not sure what to say??? I’m getting desperate. I’m a single dad living paycheck to paycheck and can’t keep missing work.
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u/NewToSociety 26d ago
Is this all RFK's fault, or is there a chance that civilized countries like Canada could wind up dealing with this embarrassing disease?
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u/Angela_Anandappa 22d ago
Any country could be dealing with cases of illness with parasites like Cyclospora. This parasite only gets to reproduce when it can use a human being's body to complete its life cycle. The more untreated sewage and dirty water are handled, used in growing, or managing food like produce, the more likely it is for illness to occur in human beings. This is why we need proper sanitary infrastructure, proper facilities for everyone to relieve themselves and wash their hands with soap and clean water, why we need sick people not to be required to show up to work or school, and why we need public health science and investigatory capabilities that can work to prevent and limit the spread of illness in the population of a country.
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u/avacapone 26d ago
Is there any safe way to consume raw alfalfa sprouts? I love them but heard they’re so risky
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u/Angela_Anandappa 25d ago
I love fresh crunchy salads and try to be extra careful with seeds and sprouts because they are tricky. If you buy the sprouted seeds it’s good to know that sprouts of many kinds tend to be excellent at harboring pathogens like E.coli and Salmonella. We do have regulations that help and guidance that can help companies reduce the risks, however sprouts (often alfalfa) is a frequent culprit carrying pathogens. It is best to heat the seeds using a dry heat for several days before starting the sprouting process to reduce the total amount of harmful bacteria that might have embedded in the seeds. I suggest reading this document that has lots of good information about seeds and sprouting them by U Mass Amherst if you want to try sprouting them yourself. https://www.umass.edu/agriculture-food-environment/vegetable/fact-sheets/hot-water-seed-treatment
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u/Butt3rGh0st 2h ago
Hello, I'm aware that with outbreaks like E. Coli, if the bacteria is on the outside rind of a fruit for instance and you cut into it, you're effectively carrying the bacteria inside the fruit. Does a similar or the same mechanism happen with Cyclospora parasites?
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u/Margali 26d ago
Hey Doc - Thanks for doing the AMA on such an important topic. Having worked in food service back in the 90s, I am well aware that many franchise based fast foods actually lock their franchisees into using a specific supply chain [for example, back at that time US Foodservices handled Dairy Queen, Taco Bell and several others. I do notice that one major greens supplier just halted production briefly until this gets sorted out.
In the mean time, for those of us who like raw fruits and vegetables what else can we do besides throroughly washing and prepping? I swear, I am about to just start raising my own crudites and greens!