Cyclospora outbreak: experts available for interviews

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Cyclospora outbreak: experts available for interviews

Two Northwestern experts explain how to reduce risk without sacrificing a healthy diet

CHICAGO - More than 1,600 Cyclospora cases have been linked to shredded iceberg lettuce served at Taco Bell in five states, prompting Taylor Farms to recall all iceberg lettuce sourced from central Mexico that was distributed to restaurants and retailers. Health officials say they are also investigating other outbreaks in other states that are unrelated to the Taylor Farms cases.

Now the largest recorded Cyclospora outbreak in U.S. history, the surge in cases has prompted questions about symptoms and whether consumers should change what they're buying, cooking and eating.

The following Northwestern Medicine experts are available for interviews to discuss what people should know.

• Bethany Doerfler, senior clinical research dietitian at the Digestive Health Institute of Northwestern Medicine
• Dr. Stephen Chang, assistant professor of gastroenterology at Northwestern University Feinberg School of Medicine

Below is a Q&A with Doerfler and Chang, to assist in your reporting.

Q: What's the most important thing people can do to stay safe?
Doerfler: "Cook higher-risk vegetables, such as greens and fresh herbs. Heating to temperatures over 160 degrees F will kill the parasite. Grilling, steaming and turning vegetables into soups are important modifications."

Q: How can consumers balance food safety with maintaining a healthy diet?
Doerfler: "Keep eating your plants. Many fruits and vegetables have never been implicated in an outbreak. Aim to modify your plant choices and your cooking methods. Choose fruits and vegetables with thick skins that can be washed and peeled, like avocado, bananas and melons. Grill vegetables to use heat to kill parasites and bacteria."

Q: Are you making adjustments yourself at the moment when you shop?
Doerfler: "We are shopping at our farmers market now more than ever. We are also buying local greens, instead of bagged lettuce, and cooking them when it fits with the recipe. We continue to eat a variety of fruits, especially seasonal and local fruits."

Q: How are Cyclospora symptoms different from the average stomach bug?
Chang: "Cyclospora symptoms may not be all that different than the average stomach bug. The primary symptoms tend to be abdominal pain or cramping, diarrhea and decreased appetite. Additional symptoms might include nausea/vomiting, low grade fevers and fatigue. But these are also symptoms that can occur with many other acute gastrointestinal infections, and even non-infectious conditions like irritable bowel syndrome."

Q: Is Cyclospora more dangerous than other gastrointestinal infections?
Chang: "It may not necessarily be more dangerous, but it can cause longer-lasting symptoms before being diagnosed and treated. What's potentially different with Cyclospora, as opposed to more common viral or bacterial GI infections, is that it can cause symptoms that might go on for weeks or even sometimes months."

Q: Who is most at risk?
Chang: "Children, the elderly and immunocompromised people are probably at most risk for more severe illness."

Q: You said you're getting many questions from worried patients. What are you telling them?
Chang: "Patients are understandably concerned when they begin having diarrhea that they might have Cyclospora, and that it might have been from a salad they ate the day before. But we know that the incubation period from the time you ingest food contaminated with Cyclospora to when you start having symptoms is typically seven to 10 days. And we still have to consider more common and typical causes of acute diarrhea."

Q: What symptoms would make you think a patient should get evaluated for Cyclospora, and how would that evaluation work?
Chang: "If you are having persistent or worsening diarrhea lasting more than a few days, especially if with fever and with difficulty staying hydrated, you should contact your doctor or seek medical attention. The evaluation will include taking a history to see if there could be other causes of the diarrhea along with potentially stool tests to look for causes of diarrhea. The most reliable testing for Cyclospora involves stool-based testing."