Cyclospora: It’s not one outbreak (and other misconceptions and peculiarities)

I’m no parasitologist but I have followed Cyclospora closely for about a decade. I hosted numerous produce industry webinars while at United Fresh Produce Assn (rip; now IFPA), served on various panels, and contributed to the 2019 Fresh Express Blue Ribbon Panel on this peculiar pathogen. Just this spring, Gretchen organized and moderated a panel at the Western Food Safety Conference- knowing “Cyclospora season” was about to begin. 

 Cyclospora fascinates me, it frustrates me, and I’ve found myself clarifying many misconceptions over the past week or so. Here are a few: 

• It’s a parasite not a bacterium. Subtle difference in terminology, but huge consequences in terms of understanding and managing this pathogen. 

• It’s not all one outbreak. Yes, there are thousands of cases. I’m quite confident they don’t all tie back to a single food or other exposure. (FDA has 4 on their current table, dated 7/8/26).  

• Before getting alarmed that there are likely multiple outbreaks happening at the same time, know that this happens for bacterial pathogens too—it’s just that they can quickly be sorted to distinguish one outbreak from another (that same FDA table shows a couple different Salmonella outbreaks—it’s easier to know they are separate).  

• A dramatic uptick in cases of cyclosporiasis in June/July is no surprise. Cases are seasonal, and this pattern repeats every year (which is part of the frustration). Granted, the magnitude of the uptick this year is alarming and unprecedented. CDC has a nice dashboard (for etiology select “Cyclospora”- you can also toggle between outbreaks- single or multistate; and illnesses) 

• Humans are the only known host. They only multiply in us. This means proximity to animals (important for other reasons!) is irrelevant here. This is a people problem. 

• Human waste is the key. It’s not rocket science. For produce, it’s GAPs. Ensure water (used for irrigation, cleaning, drinking, swimming etc.) isn’t contaminated with raw sewage. 

• Wash your hands, even though illness isn’t the result of direct fecal-oral contamination. As the parasite ‘exits’ the body, it’s not infectious. It seems to take a week or 2 before it transitions back to being infectious. (I’m super curious about this and if I were back in grad school would want to study this) 

• There’s no reason to avoid fresh produce categorically. A local café here in Maryland just removed all fresh produce from their menu. This is awful and unlikely to protect anyone. 

• Consumers can’t meaningfully undo contamination. Sure, wash produce thoroughly under running water. It’s a good idea. It’s not going to guarantee decontamination. Cyclospora seems to like to ‘stick’ to surfaces. 

• Industry can’t test its way to safety. This could be a whole blog. For many reasons routine testing is not useful and even if there’s a positive, it’s hard to interpret. The NACMCF report (rip) goes into detail on this, and I blogged about it a few years ago. Too bad it was never officially published. 

• As catastrophic as the dismantling of food safety systems--cuts to FoodNet, CDC, FDA, etc.- have been and will continue to be, I fear these illnesses would have occurred anyway. Would the investigation have progressed faster? Probably not (largely because these are initially handled at state and local levels anyway). Might communication from federal government agencies been better? Possibly (many criticisms I’m hearing today were expressed back in the 2019 report). 

  
  

If there’s anyway to make lemonade from this lemon, here’s my hope: 

• With so, so many cases, there’s an opportunity to collect Cyclospora for researchers to work with. It doesn’t grow in a lab, so our understanding is limited by not having Cyclospora to work with. There’s a lot of Cyclospora this year. I hope someone is collecting it. 

• They say there is no such thing as bad publicity. Despite some media misconceptions (especially the idea that this is one outbreak), hopefully the reporting reveals the tremendous research gaps, prompting more investment into better understanding this pathogen. 

• Several reporters have asked me about cuts to FDA and CDC. Even if this years Cyclospora season isn’t a direct result of the cuts, I hope it triggers reconsideration of the dissolution of NACMCF, the discontinuation of ¾ of the pathogens reported by FoodNet, and the overarching consequence of signaling that public health and food safety aren’t governmental priorities.  

My Facebook feed suggests that your average Joe finds Cyclospora captivating. Let’s hope they let their elected representatives know they want the US should lead the charge in figuring this pathogen out.