Infectious Disease Outbreaks

This is an active and evolving situation, these recommendations may change as more information becomes available.

Recommended actions for individuals who think they may have cyclosporiasis:

People experiencing gastrointestinal illness, such as sudden and ongoing diarrhea, are encouraged to contact their health care provider for testing and treatment. For general questions about the cyclosporiasis outbreak, contact your local health department. Cyclosporiasis is treated with antibiotics along with rest and drinking plenty of fluids to maintain hydration.

Recommended practices for all individuals serving, preparing or consuming lettuce and salad greens in impacted counties:

Given early information from the investigation, MDHHS recommends the following lettuce and salad green safety measures:

• Purchase whole heads: Buy whole heads of lettuce rather than pre-washed, bagged lettuce or pre-mixed salad kits.
• Discard outer layers: Before preparation, remove and discard the outer two to three layers of leaves.
• Wash inner leaves: Thoroughly wash the remaining inner leaves under clean running water.
• Prioritize cooking: For greens that can be cooked, cooking to an internal temperature of at least 158°F (70°C) is the safest option. The parasite is resistant to routine chemical disinfection, and washing alone cannot guarantee removal.

General practices to reduce your risk of cyclosporiasis and other foodborne illnesses:

• Cook when you can. Heating food to 158°F (70°C) or higher kills Cyclospora.
• Peel produce. Peeling is highly effective for food items with removable skin as the parasite sits on the outer surface.
• Wash all fresh produce under clean running water, even if you plan to peel it.
  • “Pre-washed” does not guarantee safety and rewashing bagged lettuce is unlikely to remove cyclospora. While washing alone may not fully eliminate cyclospora, it enhances protection when combined with cooking or peeling. 

Additional food safety reminders:

• Wash hands with soap and water before and after handling or preparing food.
• Scrub firm fruits and vegetables, such as melons and cucumbers, with a clean produce brush.
• Cut away any damaged or bruised areas on fruits and vegetables before preparing and eating.
• Wash and sanitize utensils and surfaces before and after handling food. Wash and sanitize display cases and refrigerators where fresh produce is stored.
• Wash and sanitize cutting boards, surfaces and utensils used to prepare, serve or store fresh produce.
• Refrigerate cut, peeled or cooked fruits and vegetables as soon as possible.