Dirty Lettuce

Good morning. I’m going to start today with something really gross. (Sorry, it’s important.)
Dirty lettuce
People across the country are looking at their lettuce fearfully these days. They’re scared of their raspberries. They’re anxious that the cilantro on their tacos is going to knock them down, potentially for a long time. That little iceberg salad that comes with your meal on a flight west? Hard pass.
This collective freakout is tied to a summer surge in cases of cyclosporiasis, the intestinal illness caused by a parasite that travels in human feces and can end up in our food supply. As you may have heard (and fixated on), we’re in the middle of the largest recorded outbreak of the disease in United States history — more than 6,000 people in Michigan alone have gotten sick so far.
Alice Callahan and Caroline Hopkins Legaspi, reporters on our Well desk, have been covering the cyclospora outbreak since it began. Yesterday, I reached out to them for guidance and, I hoped, a little reassurance.
Sam: Let’s start with dinner. What’s safe to consume, besides cigarettes and bourbon?
Alice Callahan: Heat kills cyclospora, so anything cooked to at least 158 degrees Fahrenheit is safe. But you still have plenty of options for fresh produce. Firm fruits and vegetables like melon and cucumbers that can be scrubbed with a brush under running water and peeled before eating are much less likely to harbor the parasite.
Previous outbreaks also offer clues about how to reduce your risk of exposure. They have almost always been caused by lettuce or salad mixes, raspberries, basil or cilantro — and, sometimes, snap peas or snow peas. Culprits tend to be fresh produce often harvested by hand and consumed raw.
Outbreaks are also typically linked back to large suppliers, rather than farmers’ markets or backyard gardens. Those local sources may be a safer bet this summer.
Your reporting has frequently mentioned Taylor Farms. Has cyclospora been traced back to any produce not produced by that company?
Caroline Hopkins Legaspi: As of now, no. But we can’t interpret that to mean that other products are in the clear. Traceback investigations are very difficult and time consuming, and we may be looking at a number of disparate cyclospora outbreaks with different sources. There’s strong epidemiological evidence linking the Midwest-centered outbreak to iceberg lettuce that Taylor Farms sourced from central Mexico. But some other states are seeing their own cases increase, which could be unrelated.
Yikes. What steps can people take to stay safe?
Alice: First, check your fridge. If you purchased Marketside bagged iceberg or shredded lettuce from Walmart recently, throw it out. Those products were part of a recall of potentially contaminated iceberg lettuce from Taylor Farms. Taylor also sent the affected lettuce to a number of food service distributors and establishments, including Sysco and Taco Bell, but the company says it is now off the market.
Second, health officials recommend purchasing whole heads of lettuce, removing the outer two to three layers and rinsing the inner leaves well under running water. Bagged lettuce is more vulnerable to contamination, as it might have been washed with contaminated water.
Can we return to the raspberries? They’re a big part of my mornings. You wrote so chillingly about how they’re a tantalizingly ‘sticky’ host for the parasite. Am I done with them for the foreseeable future?
Alice: Based on what we know so far, experts doubt that berries are to blame for the current surge in cases. But if you’re worried, you can consider going with locally grown. That won’t eliminate your risk, but likely reduces it a lot.
Caroline: I’d add that risk tolerance is a personal choice, and that it may hinge on your health status. Severe diarrhea can lead to dehydration, which could be risky for pregnant women, young children, older adults and anyone who is immunocompromised.
One expert told me that she lost her 2-year-old son to a food-borne illness (E. coli, not cyclospora). That experience has left her with a much lower risk tolerance for this type of thing. (She also said, “Quite honestly, I don’t have time in my life for explosive diarrhea.” )
Is cyclospora ever going away, or is it going to be around for as long as we get fruit and vegetables from places that irrigate their crops with questionable water?
Alice: When I talked to Frank Yiannas, a former top official at the F.D.A., he compared cyclospora outbreaks to hurricanes: We may not be able to prevent them, but we can reduce their harm by detecting them early, improving agricultural and food safety practices, and making sure that public health officials have the resources they need to respond.
In this regard, the United States has room for improvement. Many local and state public health departments, which are on the front lines of responding to outbreaks, are short-staffed and have insufficient funding. Last year, the C.D.C. quietly scaled back one of its key surveillance systems for food-borne illnesses. And the F.D.A. delayed the implementation of a federal “traceability” rule designed to improve record-keeping throughout the food supply chain, which would help investigators solve outbreaks and issue recalls more quickly. That rule had been set to go into effect in January but it has now been delayed until July 2028.
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