Michigan health officials said on Aug. 6 that residents can go back to their usual lettuce-eating habits, ending a broad warning to avoid bagged salad mixes as the Cyclospora outbreak appears to be easing. The state also said the precautionary recommendation is no longer in effect and that people can make choices based on their own risk tolerance.
The timing matters because the outbreak has been unlike any other in the United States. More than 10,000 laboratory-confirmed cases had already been reported federally, with another 12,000 awaiting verification, and Michigan said it had confirmed 12,485 cases since May 1. The illness, cyclosporiasis, is a lettuce-linked parasitic infection that can cause debilitating diarrhea, which is why a simple change in guidance has become a national consumer question.
Michigan also said the first two deaths identified in the nationwide outbreak occurred in the state, even as new cases and associated hospital visits were on the downswing. That makes the update less a declaration of victory than a signal that the sharpest part of the outbreak may be passing. The largest outbreak was centered in Michigan and was traced by the Food and Drug Administration to recalled iceberg lettuce grown by Taylor Farms in central Mexico.
Taylor Farms said in July that it had immediately removed and recalled any potentially implicated lettuce and voluntarily suspended all iceberg lettuce sourcing and production from central Mexico. By now, Michigan said, the majority of the affected produce is likely no longer available to consumers. Dr. Bryan Quoc Le of New York Medical College said cyclospora generally does not survive much longer than a few weeks, and even in rare cases where it lingers on lettuce longer, the produce would likely spoil before it could still be eaten.
That is the reason the state can relax its advice without pretending the mystery is solved. Federal health agencies were still working to determine the source of several other clusters, and lettuce had been the only food identified so far. Dr. Dana G. Mordue of New York Medical College said that without knowing the source, saying the product is simply off the shelf is not very reliable. For now, Michigan says residents may resume usual food handling practices, but the unresolved clusters mean the outbreak is still being measured in questions as much as in cases.
