Cyclospora cayetanensis, A Growing Food Related Parasite Problem Being Addressed By CDC and FDA

Cyclospora cayetanensis, A Growing Food Related Parasite Problem Being Addressed By CDC and FDA


The U.S. Food and Drug Administration (FDA) and the Centers for Disease Control and Prevention (CDC) are collaborating to protect consumers from Cyclospora cayetanensis, a parasite that has caused multistate outbreaks of foodborne illness in recent years. When people eat food contaminated with Cyclospora — mostly fresh produce — or drink contaminated water, they can get an intestinal illness called cyclosporiasis.

Cyclospora infections have largely surfaced in people who traveled in countries in tropical and subtropical regions where cyclosporiasis commonly occurs. Outbreaks of cyclosporiasis have been reported in the United States since the mid-1990s and have been linked to various types of imported fresh produce, including raspberries, basil, snow peas, mesclun, and cilantro. But last year marked the first Cyclospora was confirmed in domestically grown produce.


The number of reported cases has been rising in recent years, in part because of better diagnostic and detection methods. There were nearly 3,000 reported cases of cyclosporiasis in 2018 alone (including both travel-associated and domestically acquired cases), according to CDC estimates. But it is believed that many more cases may go unreported. In 2018, an outbreak tied to salads sold in a quick-service restaurant chain made more than 500 people sick in 15 states, and another associated with prepackaged vegetable trays made 250 people ill in four states.

•     Cyclosporiasis is an intestinal illness caused by the parasite Cyclospora cayetanensis(C. cayetanensis), which only occurs in humans, and the most common symptom is diarrhea.
•     Infected people shed the parasite in their feces.
•     When the parasite is found in water or food, it means that the water or food has been contaminated with human feces.
•     Other people may become sick by ingesting water or food contaminated with the parasite.
•     Good hygiene (including proper hand washing) is a critical component of ensuring the safety of fresh produce, but by itself it may not be enough to prevent infected employees from contaminating fresh produce.
•     The FSMA Produce Safety Rule requires that personnel on farms use hygienic practices (§ 112.32) and that ill employees are excluded from handling fresh produce and food contact surfaces (§ 112.31).

For Farmers;

    On farms, unhygienic practices can contaminate water and equipment, and farmers are looking for mitigation strategies. Last fall, the FDA created a webpage with information for farmers and a fact sheet on cyclosporiasis and fresh produce. Given the first detection of Cyclospora in domestic produce last year, the FDA has also stepped up outreach to the domestic industry and state partners to help them understand what to expect should additional incidents of domestic contamination occur. The FDA continues to emphasize the importance of worker health and hygiene controls for produce-related activities. For example, the Produce Safety Rule established by the FDA Food Safety Modernization Act stresses the importance of hygienic practices (including handwashing, and wearing intact and sanitary gloves).

For Healthcare Professionals;

    Every year before the start of the U.S. cyclosporiasis season, CDC reminds physicians to consider cyclosporiasis when diagnosing diarrheal illnesses. The degree to which physicians and public health officials test patients and collect samples varies throughout the country. Increased awareness among the medical community regarding cyclosporiasis (for example, time from exposure to initial onset of symptoms, seasonality, symptoms, and current available diagnostic methods) can help to more rapidly identify and address emerging outbreaks.

Food professionals, restaurants, and consumers;

    The FDA has created a webpage that includes information about what restaurants, retailers and consumers need to do to protect against Cyclospora contamination.

Read more at FDA