The Centers for Disease Control and Prevention (CDC) has reported a link between iceberg lettuce from Mexico and served through a Mexican quick-service restaurant.  

However, this may not represent the only outbreak, of which, others may not be of direct produce origin. Produce companies may continue to be contacted during traceback investigations. 

Key points for the fresh produce industry: 

• The suspected iceberg lettuce was grown in Mexico. During this time of year, most U.S. leafy green production is occurring in California, and there is limited evidence that domestically grown produce is associated with the parasite. 

• There is no reason to implicate all fresh produce, nor all leafy greens. This is not supported by the currently available information regarding the outbreak, nor advisable given what we know about the illnesses in the US. Overreactions and broad statements only perpetuate consumer confusion and should be avoided and/or corrected.   

• No food samples have tested positive for Cyclospora oocysts, and not all interviewed patients reported eating at the suspected restaurant. 

• Cyclospora oocysts may be removed during washing, but washing may not reliably eliminate all oocysts by routine washing or traditional produce antimicrobials. Companies should reinforce employee illness policies, GAPs, GMPs, sanitation and hygiene controls. Testing for Cyclospora is not recommended due to sampling and technological limitations that limit value and may provide a false sense of security. A greater emphasis should be to ensure existing food safety practices and assessment of potential risks within agricultural ecosystems and supply chains.  

• The reported 7,000-plus confirmed or suspected illnesses now reported the U.S. (from states, not the CDC) may reflect multiple outbreak clusters, exposure pathways or environmental contamination events and not a single produce source. 

Fresh produce can be an efficient vehicle because it is often consumed raw. The parasite originates in human waste, and after being shed, its oocysts must remain in the environment for approximately one to two weeks before becoming infectious. They must then reach food or water and be consumed by another person. 

Each illness therefore reflects a more complex and broader public health pathway: human waste enters the environment; oocysts survive and mature; contamination reaches water, soil, food or food-contact environments; and an infectious oocyst is consumed. 

Identifying a food item is important in any outbreak, but it does not identify or control the underlying source of contamination, nor explain all the illness currently being observed in the US. A meaningful response requires stronger disease surveillance, wastewater and sanitation controls, environmental monitoring, water-quality protection and source attribution. 

The produce industry has an essential role in prevention, but it cannot solve Cyclospora alone. This is a shared public health and environmental challenge that extends far beyond fresh produce food safety and is requiring infrastructure that both reduces contamination and gives growers timely information about when and where risks are elevated.