100+ reports of Cyclospora in Massachusetts

Posted on July 23, 2019 by

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BOSTON — The Massachusetts Department of Public Health (DPH) is urging residents to practice safe food handling practices following an increase in reported infections of Cyclospora, a foodborne illness that causes gastrointestinal symptoms, mainly diarrhea, that can sometimes be severe.

Since May 1, 2019, there have been more than 100 reports of Cyclospora infection cases in the state, when, over the past three years, DPH has received between 18 and 33 reported cases. Most cases this year have occurred in greater Boston, but infections have been reported in residents across the Commonwealth.  Other states have also reported increases in the number of cyclosporiasis cases; the cause of the outbreak is not yet known.

Cyclosporiasis is the medical name for the disease caused by accidentally consuming the parasite, Cyclospora cayetanensis. Individual cases are usually associated with travel to warmer countries where the parasite is more common. However, only a small number of the recent Massachusetts cases have been tied to international travel.

Historically, outbreaks of this illness in the US and Canada have been linked to imported fresh produce including Guatemalan raspberries and snow peas (2000 and 2004); Thai basil (2001); Mexican bagged salad mix (2013); and prepackaged commercial fresh vegetable trays (2018).  Outbreaks involving restaurants have also been reported. At this time, no particular food item has been linked to the cases of Cyclospora infection occurring this year in Massachusetts.

“Individuals usually become symptomatic approximately one week after eating contaminated food,” said Public Health Commissioner Monica Bharel, MD, MPH. “Symptoms typically include watery diarrhea, loss of appetite, abdominal cramping, nausea, and prolonged fatigue. Immunocompromised people may have more prolonged symptoms. Many infections will resolve on their own, but people with symptoms should seek medical care as the infection is best treated with an antibiotic prescribed by a healthcare provider. “

DPH is working with local Boards of Health, other states, the U.S. Centers for Disease Control and Prevention and the U.S. Food and Drug Administration to trace the cause of the outbreak.

“This illness is not spread person-to-person like many other food-borne diseases, like salmonella or E.coli,” said Dr. Larry Madoff, Medical Director. “When a specific contaminated food item is identified, prevention involves removing that product from distribution. In the absence of a specific food item linked to the outbreak, prevention, in this case, means using safe food handling practices. ”

To best prevent all foodborne illnesses, consumers and retailers should always follow safe fruit and vegetable handling recommendations:

Wash: Wash hands with soap and warm water before and after handling or preparing fruits and vegetables. Wash cutting boards, dishes, utensils, and countertops with soap and hot water between the preparation of raw meat, poultry, and seafood products and the preparation of fruits and vegetables that will not be cooked.

Prepare: Wash all fruits and vegetables thoroughly under running water before eating, cutting, or cooking. Scrub firm fruits and vegetables, such as melons and cucumbers, with a clean produce brush. Cutaway any damaged or bruised areas on fruits and vegetables before preparing and eating. Cooking produce will eliminate the risk of Cyclospora and other foodborne infections.

Store: Refrigerate cut, peeled, or cooked fruits and vegetables as soon as possible, or within two hours. Store fruits and vegetables away from raw meat, poultry, and seafood.

More information is available on our Public Health Fact Sheet, which is available in English, Spanish and Portuguese, or by calling the DPH Division of Epidemiology at 617-983-6800.


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