NJ Health Officials Report Typical Seasonal Uptick of Cyclosporiasis Cases, No Outbreaks Amid Multistate Cyclosporiasis Activity

NJDOH continues to monitor multistate activity and reminds residents to wash produce thoroughly to minimize risk of illness

TRENTON, NJ - As several states report increases in cyclosporiasis cases, a gastrointestinal illness linked to contaminated fresh produce, New Jersey Department of Health (NJDOH) is reassuring residents that New Jersey has not seen an atypical increase in cases this season. NJDOH continues to closely monitor the situation and is urging residents to take simple food safety precautions to reduce their risk of illness.

"At this time, we are not seeing an increase in cyclosporiasis cases here in New Jersey, and our current numbers are in line with what we'd expect for this time of year," said Dr. Raynard Washington, New Jersey Health Commissioner. "At the same time, produce grown or packed in other states regularly ends up on New Jersey shelves, so contamination elsewhere can still reach us here. That's why we're encouraging everyone to take a few basic precautions - like thoroughly washing fruits and vegetables - to reduce their risk of getting sick. Our teams are in close contact with local health departments and federal partners, and we will continue to provide updates as the situation evolves."

Cyclosporiasis is caused by the microscopic parasite Cyclospora cayetanensis and is generally spread by eating contaminated food, most often fresh produce, or drinking water. It is not known to spread directly from person to person. Cases in the United States typically rise during the spring and summer, with New Jersey's cyclosporiasis season considered to run from May 1 through August 31.

At this time, no common food item or water source has been identified in connection with the national increase in cases, and traceback investigations are ongoing.

"The New Jersey Department of Agriculture emphasizes that no produce coming from New Jersey farms has been linked to the cyclosporiasis outbreak," said Ed Wengryn, New Jersey Secretary of Agriculture. "To date, no New Jersey-grown produce has been identified as a source of cyclosporiasis cases. Our Jersey Fresh farmers meet the high-quality standards imposed not only through compliance with the federal Food Safety Modernization Act but also with the quality-grading standards of the Jersey Fresh program."

Common symptoms include frequent, watery diarrhea (sometimes explosive); loss of appetite and weight loss; bloating and stomach cramps; nausea (vomiting is less common); low-grade fever; and fatigue. Symptoms typically begin about a week after exposure, though they can start as early as two days or as late as two weeks or more afterward. If untreated, illness can last from a few days to a month or longer and may go away and come back.

Cyclosporiasis is not usually life-threatening but can cause dehydration and, in some cases, requires medical attention. Anyone experiencing these symptoms, especially prolonged watery diarrhea, should contact their health care provider. Cyclosporiasis can be treated with antibiotics.

Cooking produce properly will kill cyclospora. Washing produce properly can help reduce risk but won't kill the parasite or eliminate your risk of illness.  

To help protect against cyclosporiasis and other foodborne illness, NJDOH recommends that you: 

• Wash your hands with soap and water before and after preparing fresh fruits and vegetables. 
• Wash all fruits and vegetables thoroughly under running water while gently rubbing the surface, even if you plan to peel or cook them.  
• Cut away any damaged or bruised areas on fruits and vegetables before preparing or eating. 
• Cook produce to an internal temperature of 158°F or higher when possible, especially for individuals at higher risk for severe illness. 
• Choose fresh, whole-head lettuce instead of bagged lettuce or salad mixes. Whole-head lettuces may be lower risk. If possible, cook leafy greens before eating.  
• Promptly refrigerate cut, peeled, or cooked fruits and vegetables. 

While cooking is the safest option, carefully washing produce can reduce risk: 

• Scrub firm produce, such as melons and cucumbers, with a clean produce brush. 
• Discard the outer 2 to 3 layers of head-forming vegetables like lettuce and cabbage, then wash the remaining leaves thoroughly under running water.  
• Separate the leaves of herbs like cilantro and basil and wash them thoroughly under running water. 
• Trim off the root end of vegetables like green onions, remove the outer layer, and wash thoroughly under running water.  
• Raspberries and blackberries are among the hardest fruits to wash thoroughly because of their bumpy surface. If possible, cook raspberries (for example, in pies, jams, or sauces). Frozen raspberries may be an alternative; freezing may reduce but will not eliminate the parasite. 

NJDOH is coordinating with local health departments and federal partners, including the U.S. Centers for Disease Control and Prevention (CDC), to monitor cyclosporiasis activity in New Jersey and track developments in other states. Health care providers are asked to consider cyclosporiasis in patients with prolonged watery diarrhea, particularly among those with recent travel to tropical or subtropical regions, and to report all cases to their local health department by the next business day.

Resources:

• NJDOH Cyclosporiasis Disease Page
• CDC Cyclosporiasis Information
• CDC Surveillance of Cyclosporiasis
• Report a Case (For Health Care Professionals)