Lettuce. Put it away. At least for now.
The United States is wrestling with a rising tide of Cyclospora cases. The parasite Cyclospora cayetanensis hides in food or water. When you get infected the results are immediate and loud. Severe diarrhea. Sometimes, according to the CDC, “explosive bowel movements.” It’s not a bad stomach ache. It is a full-system emergency.
Michigan is ground zero. As of Wednesday, the state had reported 3,762 sick people. Forty-four were in the hospital by July 9. The rest of the country isn’t safe either. The CDC received reports from 34 states totaling 1,645 confirmed cases by July 13. But that number is likely a ghost of the truth.
Investigations to identify and confirm the sources are ongoing.
Right after those numbers came out, the agency admitted the real toll is much higher. There are another 5,100 suspicious cases pending analysis. State and federal partners are digging into it but the source remains hidden. Why? Two things. One: the incubation period stretches up to two weeks. By the time you’re sick, you’ve eaten everything twice. Two: U.S. food distribution networks are tangled knots of logistics.
Signs point to lettuce.
Rabia de Latour is a gastroenterologist at NYU Grossman. Her advice is blunt. Avoid lettuces entirely. Do you think washing your spinach in the sink is enough? It isn’t. De Latour says washing alone “will not get rid of this” as a reliable strategy. Water runs over the parasite but it doesn’t always wash it off. Or kill it.
The only way to truly kill the parasite is cooking at 158 Fahrenheit.
But we don’t usually eat cooked salads. So what’s left?
Officials advise against bagged prewashed lettuce. It’s too risky. Instead, buy a whole head. Strip the outer two or three leaves—they’re the most likely to carry soil contaminants. Wash what’s left hard. De Latour thinks this helps but insists it’s not a shield. You might miss spots. You definitely won’t kill every single microbe. “You cannot definitively say you have removed and/or killed it,” she warns.
The good news? No one has died yet. Cyclospora rarely kills healthy adults. It’s miserable. That’s the key. It strips weight and forces you to camp near a toilet. De Latour describes the physical toll clearly. Dehydration sets in fast. If you have heart or kidney disease, the strain on your body could be fatal.
For the rest of us? We’re just very uncomfortable.
Treatment exists. A drug called TMP-SMX (trimethoprim-sulfamethxazole) blocks the parasite’s folic acid production. Starve it out. It works. But avoiding the parasite in the first place is far more appealing. Especially when the outbreak’s origin remains a mystery. We eat what we’re given. Sometimes it gives us back. Hard.
Will we go back to our salads when the trace is complete? Maybe. Until then, the fork hovers over the greens. Suspicious. Quietly terrified. 🥗🚫
