Have you been looking at the lettuce aisle at your grocery store with a wary eye since the diarrhea outbreak began? You’re not alone. This is the summer, which should be high time for fresh produce. But the ongoing emergency has even doctors asking themselves unthinkable questions: Should I stop eating salad? Are any fruits and vegetables safe?
The disease in question, cyclosporiasis, is caused by the parasite cyclospora, which can infect people when it is attached to fresh produce and then consumed. Watery diarrhea — described by public health authorities as “frequent” and “sometimes explosive” — is the most common symptom.
Michigan health officials said this week that they suspect lettuce or bagged salad to be the culprit for the parasite-driven outbreak in the state that has sickened more than 4,300 people. But they have been searching for the specific products to blame. (On Thursday, the Washington Post, citing anonymous federal officials, reported the outbreak may trace back to Taylor Farms products that were used by Taco Bell. But we’re awaiting confirmation.)
I live in Ohio, where there have been 364 cases, and I love salad kits. The current outbreak is a major cramp on my lunch plans — and I know I’m not alone.
So, what do we do? I’ve consulted with a food safety expert and a dietitian this week to get the answers. The topline message is: Don’t stop eating your fruits and vegetables. They’re good for you. But be smart with your food hygiene.
“I don’t think we’re at that point of shying away from eating your green vegetables,” Francisco Diez-Gonzalez, director of the Center for Food Safety at the University of Georgia, told me. “The benefits overall still outweigh the risks.”
How can we still enjoy our summer produce in this time of cyclospora? Here’s a guide.
Here are the “red light” foods linked to prior outbreaks
While we don’t know for certain the cause of the current outbreak, cyclosporiasis has been linked with specific foods in the past. Let’s start with that list:
- Basil
- Bagged salads and salad mixes
- Cilantro
- Mesclun lettuce
- Parsley
- Raspberries
- Snow peas
- Sweet peas
These foods — either because of where they’re grown or their texture or both — have historically had a higher risk of carrying cyclospora. It might be wise to steer clear entirely for the time being — especially the prepackaged salad products.
The Michigan health department, for example, is urging people to avoid bagged lettuce and salad kits and to purchase whole heads of lettuce instead. And since the outbreak is impacting most states now, it’s advice we’d all be wise to heed.
Then there are “yellow light” foods that need careful cleaning
But for a lot of fruits and vegetables, including whole lettuce, you should still wash them thoroughly — because that’s always a good idea. If you need tips for washing your produce, we’ve got them. For heads of lettuce, for example, cut away the outer layers and wash in between each leaf as best you can.
“Fresh produce is still generally safe, delicious and nutrient-dense,” Rosemary Trout, a food scientist at Drexel University, told me over email.
But she gave a yellow light for any leafy greens or fruits and veggies that have textured edible skins. The more texture there is, the more of a risk there is because the parasite can stay attached more easily — even if it’s been diligently washed. Raspberries carry a higher risk than blueberries, for example, and those have been associated with earlier cyclosporiasis outbreaks.
Another point of emphasis: Several doctors have told me that, even if an item says it is prewashed, you should wash it again. And again.
But there are lots of “green light” foods you probably don’t need to worry about
Trout gave a green light to any canned fruits and vegetables, any produce that you cook — importantly, at high heat — at home, and any frozen fruits and veggies.
In general, these are Trout’s safety tips for prepping fruits and vegetables at this uncertain time:
- Be consistent and thorough — at least 20 seconds — when washing your hands and always use hot, soapy water.
- Peel or remove the outside layer of the fruit or veggies — the rind of a watermelon or cantaloupe, for example, or the outer layer of a head of lettuce.
- Don’t consume damaged, bruised produce.
- Keep produce cold in storage, ideally for a relatively short amount of time.
Get creative with your recipes
If you want to steer clear of any questionable produce or take the safest preparation route that you can, you might want to get a little creative with your recipes. With your lunch salad, for instance, “peeled, shredded carrots, thinly sliced radish, or thinly sliced cooked beets might be a nice substitute for leafy greens,” Trout said.
Heat remains the most surefire way to eliminate any cyclospora parasite that might be lingering on your produce. So look through your cookbooks for any dishes that feature grilled vegetables. Vox Even Better editor Rachel Miller (a more accomplished cook than I) suggested a few recent New York Times Cooking recipes, which you can check out via these gift links:
Peppers, eggplant, squash, and zucchini are your friends. They respond well to heat, and they are easy to clean. And even some leafy greens — like spinach — hold up nicely to sautéing.
Support your local farmer’s market
Right now is also a great time to check out your local farmer’s market for produce.
Dr. Kathleen Linder, who is the hospital epidemiologist at the Veterans Affairs hospital in Ann Arbor, Michigan, told me that she has been buying locally since the outbreak began. Prior outbreaks have been linked to produce that was grown elsewhere — whether in the US or internationally — and shipped long distances before it arrived on our grocery shelves. Summer is a crucial season for small farms and farmers’ markets; they shouldn’t be penalized for a health emergency that they had nothing to do with.
Buying locally could reduce the risk that your produce has been exposed to the parasite. Trout said you can ask your local growers about their water supply to make sure that what you are buying is safe.
“Single-source produce from a local farm with good manufacturing/farming practices in place, with a safe water supply, are good,” Trout told me. “Commercially processed, pre-packaged foods are likely combining produce from various farms, which may increase risk, despite good manufacturing practices in place.”
So while cyclosporiasis is an unwelcome concern as we plan our summer cookouts, it doesn’t need to stop you from enjoying fresh fruits and vegetables. Be a little more diligent about your food hygiene, get a little creative with what you’re preparing, maybe stop by a farmer’s market — and you’ll be fine.
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