After finding human waste and toilet paper in Mexican cilantro fields that have been linked to U.S. Cyclospora outbreaks for three straight years, the U.S. Food and Drug Administration (FDA) has placed an import alert on cilantro from the Puebla region of Mexico. The alert, which covers fresh intact and chopped cilantro, allows U.S. officials to detain without physical inspection any cilantro shipments from the Puebla region from April 1 through August 31.
Cyclospora, a parasite that lives in subtropical regions, causes an infection called cyclosporiasis when ingested in its mature state. Symptoms of cyclosporiasis can last two months and include diarrhea, abdominal cramps, bloating, gas, nausea, fatigue, loss of appetite, weight loss, vomiting, body aches, low-grade fever, and other flu-like symptoms.
Normally, about 150 cases are reported nationwide each year, most of them are associated with travel to developing countries. But for the last three summers, a major outbreak linked to cilantro from the Puebla region has been reported.
So far this summer, 205 cases have been reported in Texas and at least eight cases have been reported in Wisconsin. In 2014, 126 people in Texas were sickened and a 2013 outbreak included 270 Texans. Hundreds of people in other states were also sickened by Cyclospora that year, but only the Texas cases were linked to cilantro. In Iowa and Nebraska, 227 cases were linked to a salad mix produced by Taylor Farms of Mexico and served at Red Lobster and Olive Garden restaurants.
Food safety attorney Ryan Osterholm filed a lawsuit on behalf of an Iowa woman who contracted cyclosporiasis after eating at an Olive Garden. She made three trips to the emergency room during her weeks-long illness. Health officials say anyone who has cyclosporiasis symptoms should see a doctor. Tests can confirm if there is a parasitic infection and antibiotics can help to clear it.
To identify the source of the outbreak, the FDA and Mexican regulatory officials investigated farms and packing houses in Puebla and other areas of Mexico to observe conditions and practices that may have led to contamination of the cilantro. Eleven Puebla farms and packing houses that produce cilantro have been inspected since 2013. Eight of them had “objectionable conditions.” Of those, five were linked to outbreaks in the United States.
The conditions observed included “human feces and toilet paper found in growing fields and around facilities; inadequately maintained and supplied toilet and hand washing facilities (no soap, no toilet paper, no running water, no paper towels) or a complete lack of toilet and hand washing facilities; food-contact surfaces (such as plastic crates used to transport cilantro or tables where cilantro was cut and bundled) visibly dirty and not washed; and water used for purposes such as washing cilantro vulnerable to contamination from sewage/septic systems. In addition, at one such firm, water in a holding tank used to provide water to employees to wash their hands at the bathrooms was found to be positive for C. cayetanensis.”
Based on those findings, the FDA concluded that cilantro was being contaminated when the parasite was shed in human feces left in the growing fields and processing areas.