A Food Safety Guide for Consumers, Educators, Food-Service Personnel, and Community Health Professionals

The United States is experiencing a substantial seasonal increase in cyclosporiasis. Cyclospora cayetanensis is a microscopic, single-celled parasite that infects the human small intestine. The illness caused by the parasite is called cyclosporiasis.

Since May 1, 2026, the Centers for Disease Control and Prevention (CDC), received reports of 1,645 laboratory-confirmed domestically acquired cases from 34 states. Among patients with available information, 141 people, or approximately nine percent, were hospitalized, and no deaths had been reported as of July 14, 2026. CDC is also reviewing more than 5,100 additional reports that require further analysis.

A large multistate outbreak involving more than 400 illnesses has been identified in Michigan, Ohio, West Virginia, and Kentucky. Illnesses associated with this cluster began on or after June 22, 2026. Investigators have not yet confirmed a specific food as the source.

As of July 20, the Connecticut Department of Public Health (DPH) confirmed 56 cases of cyclosporiasis in the state. Of these, 24 were believed to have been acquired within the United States, six were linked to international travel, and the source of exposure for 26 cases remained under investigation. Four Connecticut patients required hospitalization. (News 8 WTNH article Health officials report rise in cyclospora cases in Connecticut).

Connecticut officials have not identified a Connecticut-specific food, farm, grower, supplier, restaurant, or retailer as the source. The U.S. Food and Drug Administration (FDA), is conducting several active Cyclospora outbreak investigations involving products that have not yet been identified. Traceback and product or environmental sampling are underway in some investigations.

Because no specific product has been implicated for the principal multistate outbreak, consumers should not avoid all fresh produce or discard produce unless a recall or public health advisory identifies a particular product.

What Is Cyclospora?

Cyclospora cayetanensis is a microscopic, single-celled parasite that infects the human small intestine. The illness caused by the parasite is called cyclosporiasis.

People become infected when they consume food or water contaminated with the infectious form of the parasite. Cyclospora contamination is generally associated with human fecal contamination of food, water, equipment, hands, or the growing and handling environment.

Cyclospora is different from bacteria such as Salmonella or E. coli. It does not multiply in food, and routine chemical sanitizers used on food may not reliably destroy it.

How Does Cyclospora Become Infectious?

An infected person sheds Cyclospora oocysts in feces. However, the oocysts are not immediately infectious when they leave the body. They must remain in the environment, for several days or longer, and undergo a maturation process called sporulation before they can infect another person.

For this reason, direct person-to-person transmission is considered unlikely. Infection is more commonly associated with consuming contaminated food or water after the parasite has matured in the environment.

Nevertheless, proper handwashing, restroom sanitation, worker health policies, safe water, sewage management, and hygienic food handling remain essential, because infected people can introduce the parasite into the environment.

What Are the Symptoms?

The most common symptom is frequent, watery diarrhea (explosive). Diarrhea may be severe, prolonged, or appear to improve and then return.

Other symptoms may include:

• Loss of appetite;
• Unintentional weight loss;
• Stomach cramps or abdominal pain;
• Bloating and increased gas;
• Nausea;
• Fatigue;
• Low-grade fever;
• Muscle aches or general flu-like symptoms;
• Vomiting, which is less common.

Symptoms usually begin approximately one week after exposure, but onset may range from about two days to two weeks or longer. Without treatment, symptoms can last from several days to a month or longer and may recur one or more times.

Some infected people may have few symptoms or no symptoms.

When Should Someone Seek Medical Care?

Contact a healthcare provider when watery diarrhea:

• Lasts more than a few days;
• Is frequent, severe, or repeatedly returns;
• Is accompanied by substantial fatigue, loss of appetite, or weight loss;
• Causes signs of dehydration;
• Occurs in a person with a weakened immune system;
• Develops during a known outbreak or after possible exposure to an implicated food.

Dehydration affects overall health, including energy levels, digestion and mental clarity. Signs of dehydration can include dry mouth, dizziness, weakness, reduced urination, dark-colored urine, or unusual sleepiness. Other symptoms include confusion, mood changes, chapped lips, and/or muscle cramps.

Patients should tell their healthcare provider about recent foods, restaurant meals, catered events, travel, and possible outbreak exposures. Healthcare providers may need to specifically request testing for Cyclospora, because routine stool testing or a standard ova-and-parasite examination may not automatically include or reliably detect it.

How Is Cyclosporiasis Treated?

The recommended treatment is the prescription antibiotic combination trimethoprim-sulfamethoxazole, commonly abbreviated TMP-SMX. Treatment decisions and dosing should be made by a healthcare provider.

People who are allergic to sulfonamide medications should inform their healthcare provider. CDC notes that no consistently effective alternative treatment has been identified for people who cannot take TMP-SMX. Maintaining adequate hydration is especially important when diarrhea is frequent or severe.

Most otherwise healthy people eventually recover, but untreated illness may be prolonged or relapsing. People with weakened immune systems may require longer treatment and closer medical management.

There is currently no vaccine for cyclosporiasis.

Why Is Fresh Produce Frequently Involved?

Cyclospora outbreaks have often been associated with fresh fruits, vegetables, and herbs that are eaten raw or receive limited cooking.

Foods associated with previous U.S. outbreaks have included:

• Bagged salad mixes;
• Mesclun and other leafy greens;
• Cilantro;
• Basil;
• Green onions or scallions;
• Raspberries;
• Snow peas;
• Other fresh produce mixtures or garnishes.

The presence of a food on this historical list does not mean that every product in that category is contaminated or that it is responsible for the current outbreak.

Fresh produce may become contaminated through:

• Agricultural or irrigation water;
• Water used during harvesting, cooling, washing, or processing;
• Inadequately managed sewage or septic systems;
• Poor worker health and hygiene practices;
• Contaminated harvesting containers, equipment, or food-contact surfaces;
• Cross-contamination during processing, preparation, or distribution.

Because many fruits, vegetables, and herbs are eaten raw, there may be no final cooking step to destroy the parasite before consumption.

Should Consumers Stop Eating Fresh Produce?

No. Fruits and vegetables provide important nutritional and health benefits and should remain part of a balanced diet.

Consumers should continue to follow public health advisories and recalls from CDC, FDA, Connecticut DPH, and other responsible public health agencies. Do not avoid an entire produce category unless the responsible public health agency identifies a specific product, brand, lot, establishment, or source that should be avoided. During an active investigation with no identified food source, consumers can reduce—but not completely eliminate—risk through careful selection, washing, preparation, storage, and cooking when practical.

Can Washing Remove Cyclospora?

Washing produce under clean running water is recommended and can help remove soil, debris, and some microorganisms. However, washing cannot be relied upon to completely remove Cyclospora.

The parasite can adhere to irregular surfaces, folds, crevices, or damaged areas of produce. Commercial washing and ‘pre-washed’ labeling do not guarantee that Cyclospora has been eliminated. FDA also reports that chlorine and other routine antimicrobial treatments may not be effective against the parasite.

Recommended Washing Practices

• Wash hands with soap and water before and after handling fresh produce;
• Rinse fruits and vegetables thoroughly under clean, running water before eating, cutting, peeling, or cooking;
• Wash produce even when the package states that it is pre-washed or ready to eat during the current outbreak period, consistent with CDC’s July 2026 advice;
• Separate the leaves of whole heads of lettuce and rinse them individually under running water;
• Rinse herbs such as cilantro, parsley, and basil carefully, gently moving the leaves under running water;
• Scrub firm produce, such as melons and cucumbers, with a clean produce brush;
• Remove outer leaves and cut away bruised or damaged areas;
• Dry produce with a clean paper towel or clean cloth towel when appropriate;
• Keep washed produce away from raw meat, poultry, seafood, eggs, dirty utensils, and unwashed produce.

Do not wash produce with soap, dish detergent, bleach, household disinfectants, or non-food-grade chemicals. These substances can leave harmful residues, and are not approved for direct use on food.

Does Cooking Destroy Cyclospora?

FDA advises that, when produce can be cooked, heating it to at least 158°F or 70°C is the safest option for destroying Cyclospora. Cooking is more dependable than washing or routine chemical sanitizing for inactivating the parasite.

During an outbreak or seasonal increase:

• Consider cooking leafy greens, herbs, and vegetables when practical;
• Use cooked herbs in sauces, soups, curries, stews, and other heated dishes;
• Use a food thermometer when the temperature of a food can be practically measured;
• Remember that briefly warming, wilting, or garnishing a hot dish with raw herbs may not provide uniform heating throughout the food.

Cooking is not practical for every fruit or vegetable. Therefore, washing, hygienic handling, proper refrigeration, and following recall notices remain important.

Selecting Produce Safely

When shopping:

• Purchase produce from reputable retailers or growers;
• Avoid produce that is badly bruised, damaged, moldy, or visibly contaminated with soil or fecal material;
• Keep fresh produce separate from raw meat, poultry, seafood, and their juices in the shopping cart and grocery bags;
• Purchase refrigerated cut fruits, vegetables, and salad products only when they are being held cold;
• Check FDA, CDC, and Connecticut DPH recall or outbreak information before purchasing a product identified in an advisory;
• Do not assume that organic, local, imported, domestic, hydroponic, greenhouse-grown, or conventionally produced food is automatically free of Cyclospora. Contamination risk depends on specific growing, water, worker, sanitation, handling, and environmental conditions.

Connecticut DPH has suggested that consumers may consider purchasing whole heads of lettuce, rather than pre-cut or bagged salad products, during the current increase in illnesses. Whole heads allow consumers to remove outer leaves, separate the remaining leaves, and rinse them individually. This precaution reduces some handling concerns but does not guarantee that the product is free of Cyclospora.

Preventing Cross-Contamination at Home

Before Preparation

• Wash hands with soap and running water for at least 20 seconds;
• Clean countertops, sinks, utensils, knives, and cutting boards with hot, soapy water;
• Use a clean produce brush for firm fruits and vegetables;
• Do not place washed produce back into an unwashed package, container, or sink.

During Preparation

• Keep unwashed produce separate from washed produce;
• Use separate cutting boards for produce and raw animal products, when possible;
• Wash knives and cutting boards after cutting unwashed produce and before preparing ready-to-eat foods;
• Do not allow raw meat, poultry, seafood, or egg juices to contact produce;
• Do not prepare food for other people while experiencing diarrhea.

After Preparation

• Refrigerate cut, peeled, or cooked produce within two hours, or within one hour when exposed to temperatures above 90°F;
• Store produce in clean, covered containers;
• Discard food identified in a recall according to the recall instructions;
• Clean and sanitize surfaces that contacted a recalled product.

CDC specifically recommends refrigerating cut, peeled, or cooked fruits and vegetables as soon as possible, and within two hours.

Who May Be More Vulnerable?

Anyone can develop cyclosporiasis. Illness may be particularly concerning for:

• People with weakened immune systems;
• Older adults who may become dehydrated more easily;
• Infants and young children who may be less able to compensate for fluid loss;
• Pregnant individuals who develop substantial dehydration;
• People with chronic health conditions;
• People who cannot promptly replace fluids lost through diarrhea.

These groups and their caregivers should closely follow outbreak advisories, seek medical guidance promptly for persistent diarrhea, and consider cooked produce options when practical.

Cyclospora infection is not usually life-threatening, but severe illness, prolonged symptoms, dehydration, malabsorption, inflammation of the gallbladder, and reactive arthritis have been reported.

Guidance for Food-Service Operations and Community Programs

Restaurants, schools, childcare facilities, senior centers, congregate meal programs, food pantries, farmers’ markets, and community kitchens should:

• Monitor CDC, FDA, Connecticut DPH, supplier, and distributor notices;
• Maintain records identifying suppliers and delivery dates;
• Immediately segregate and stop using products named in a recall;
• Follow employee illness policies and exclude or restrict food workers with diarrhea according to applicable food regulations and health-department instructions;
• Provide accessible handwashing facilities supplied with soap, running water, and disposable towels;
• Prevent bare-hand contact with ready-to-eat foods when required by the applicable food code;
• Wash produce under running potable water before cutting or serving;
• Clean and sanitize food-contact surfaces using approved procedures;
• Avoid placing washed produce into containers that previously held unwashed produce;
• Refrigerate cut leafy greens and other time- and temperature-controlled produce appropriately;
• Retain food, supplier, menu, and event records when illnesses are reported, because investigators may request information about foods served during the preceding two weeks.

Routine sanitizers are important for general food safety and cross-contamination control, but food-service personnel should not assume that routine sanitizer concentrations will destroy Cyclospora on produce.

Information for Produce Growers, Harvesters, and Packers

Cyclospora prevention requires a systems-based approach because there is no single dependable post-harvest intervention that can correct fecal contamination of fresh produce.

Important controls include:

• Evaluating agricultural water sources and distribution systems;
• Protecting water sources from sewage, septic leakage, flooding, and runoff;
• Maintaining toilets and handwashing facilities;
• Training workers to report diarrhea and other symptoms;
• Preventing ill workers from contaminating produce or food-contact surfaces;
• Managing human waste and septic systems appropriately;
• Cleaning and sanitizing harvest tools, bins, equipment, and food-contact surfaces;
• Controlling cross-contamination during washing, cooling, packing, and storage;
• Maintaining traceability and distribution records;
• Investigating unusual employee illness patterns;
• Following applicable requirements of the FDA Food Safety Modernization Act Produce Safety Rule.

In Connecticut, produce growers should work with the Connecticut Department of Agriculture, Connecticut Department of Public Health, FDA, local health departments, and UConn Extension when responding to a suspected contamination event, illness cluster, traceback investigation, or recall.

FDA emphasizes worker hygiene, agricultural water, septic-system management, sanitation, and other preventive controls because chlorine and commonly used antimicrobial treatments are not considered effective control measures for Cyclospora contamination.

What To Do When a Product Is Recalled

1. Check the product name, brand, package size, lot code, use-by date, and place of purchase;
2. Do not eat, serve, sell, or donate the recalled product;
3. Follow the recall notice regarding disposal or return;
4. Do not give recalled food to pets;
5. Wash hands after handling the product;
6. Clean and sanitize refrigerator shelves, drawers, containers, countertops, and utensils that contacted the product;

• • Clean produce-contact surfaces first with hot, soapy water, scrub thoroughly, and rinse to physically remove dirt, food residue, and possible Cyclospora.
  • After cleaning, use an EPA-registered food-contact surface sanitizer according to the label. Do not automatically use 5 tablespoons of bleach per gallon, because that is a stronger household disinfecting solution and may not be appropriate for food-contact surfaces.
  • Routine chlorine sanitizers do not reliably kill Cyclospora, so physical cleaning is especially important. Keep the surface wet for the sanitizer’s labeled contact time.
  • Never apply soap, bleach, or household disinfectant sprays directly to fruits or vegetables, and never mix bleach with other cleaners.

7. Contact a healthcare provider if symptoms develop;
8. Save receipts, labels, packaging, or loyalty-card information when safe to do so, because these records may assist outbreak investigators.

A product should not be identified publicly as the source of an outbreak, unless public health and regulatory agencies determine that sufficient evidence supports that conclusion.

Key Messages for Consumers

• Continue eating fruits and vegetables as part of a healthy diet;
• The current 2026 increase is significant, but no specific Connecticut product or source has been identified;
• Wash hands and rinse produce thoroughly under running water;
• Washing reduces some contamination but may not remove Cyclospora completely;
• Do not use soap, bleach, or household disinfectants on food;
• Cook produce to at least 158°F or 70°C when appropriate and practical;
• Prevent cross-contamination and refrigerate cut produce promptly;
• Follow CDC, FDA, and Connecticut DPH outbreak and recall notices;
• Contact a healthcare provider for persistent or relapsing watery diarrhea;
• Ask whether specific Cyclospora testing is needed;
• Stay well hydrated if diarrhea occurs;
• If experiencing diarrhea, please follow guidance about when it is safe to return to work or school, this is typically 48-72 hours.

Connecticut Reporting and Public Health Follow-Up

Cyclosporiasis is a reportable disease in Connecticut. Healthcare providers and clinical laboratories are required to report diagnosed cases to the Connecticut Department of Public Health. DPH conducts surveillance and interviews reported patients to identify shared foods, events, establishments, travel, or other exposure patterns.

People diagnosed with cyclosporiasis should cooperate with public health interviews and provide as much detail as possible about:

• Foods consumed during the two weeks before illness;
• Restaurants, catered events, cafeterias, and community meals;
• Grocery stores and farmer’s markets visited;
• Brands and package information;
• Travel history;
• Other people who became ill;
• Receipts, menus, loyalty-card records, photographs, or leftover packaging.

Because symptoms may begin one to two weeks after exposure, recalling food history can be difficult but is essential for identifying an outbreak source.

Reliable Sources for Updates

Consult the following agencies for current outbreak notices, recalls, prevention recommendations, and clinical information:

• Centers for Disease Control and Prevention;
• U.S. Food and Drug Administration;
• Connecticut Department of Public Health;
• Connecticut Department of Agriculture;
• Local health departments;
• UConn Extension Food Safety Program;
• foodsafety.gov.

Outbreak case counts and recommendations may change as additional illnesses are reported and investigators identify possible food sources.

Resources

Centers for Disease Control and Prevention. (n.d.). Cleaning and disinfecting. https://www.cdc.gov/hygiene/cleaning/index.html

Centers for Disease Control and Prevention. (n.d.). When and how to clean and disinfect a facility. https://www.cdc.gov/hygiene/about/cleaning-and-disinfecting.html

Centers for Disease Control and Prevention. (2024a, September 4). About cyclosporiasis. https://www.cdc.gov/cyclosporiasis/about/index.html

Centers for Disease Control and Prevention. (2024b, March 8). Clinical care of cyclosporiasis. https://www.cdc.gov/cyclosporiasis/hcp/clinical-care/index.html

Centers for Disease Control and Prevention. (2024c, March 4). Clinical guidance for cyclosporiasis. https://www.cdc.gov/cyclosporiasis/hcp/clinical-guidance/index.html

Centers for Disease Control and Prevention. (2024d, March 4). Clinical overview of cyclosporiasis. https://www.cdc.gov/cyclosporiasis/hcp/clinical-overview/index.html

Centers for Disease Control and Prevention. (2024e, February 29). Preventing cyclosporiasis. https://www.cdc.gov/cyclosporiasis/prevention/index.html

Centers for Disease Control and Prevention. (2024f, February 26). Symptoms of cyclosporiasis. https://www.cdc.gov/cyclosporiasis/signs-symptoms/index.html

Centers for Disease Control and Prevention. (2026, January 8). Surveillance of cyclosporiasis. https://www.cdc.gov/cyclosporiasis/php/surveillance/index.html

Connecticut Department of Agriculture. (2026, July 16). CT DoAg addresses parasite concerns and produce safety on local farms. https://portal.ct.gov/doag/agency-press-release-results-page/2026/july/cyclospora-and-food-safety

Connecticut Department of Public Health. (2026, July 13). Connecticut Department of Public Health reports rise in cyclosporiasis cases statewide with link to national outbreak. https://portal.ct.gov/dph/newsroom/press-releases---2026

Diaz, J. (2026, July 20). Health officials report rise in Cyclospora cases in Connecticut. WTNH News 8. https://www.wtnh.com/news/connecticut/52-cases-of-cyclosporiasis-confirmed-in-connecticut-so-far/

Food and Drug Administration. (n.d.-a). Cyclospora. U.S. Department of Health and Human Services. Retrieved July 18, 2026, from https://www.fda.gov/food/foodborne-pathogens/cyclospora

Food and Drug Administration. (n.d.-b). Cyclospora prevention, response and research action plan. U.S. Department of Health and Human Services. Retrieved July 18, 2026, from https://www.fda.gov/food/foodborne-pathogens/cyclospora-prevention-response-and-research-action-plan

Food and Drug Administration. (n.d.-c). Selecting and serving produce safely. U.S. Department of Health and Human Services. Retrieved July 18, 2026, from https://www.fda.gov/food/buy-store-serve-safe-food/selecting-and-serving-produce-safely

Food and Drug Administration. (2021, July 1). Cyclospora prevention, response and research action plan release. U.S. Department of Health and Human Services. https://www.fda.gov/food/hfp-constituent-updates/cyclospora-prevention-response-and-research-action-plan-release

Food and Drug Administration. (2023, June 30). FDA provides an update on Cyclospora research, prevention and response efforts. U.S. Department of Health and Human Services. https://www.fda.gov/food/hfp-constituent-updates/fda-provides-update-cyclospora-research-prevention-and-response-efforts

Ortega, Y. R., Mann, A., Torres, M. P., & Cama, V. (2008). Efficacy of gaseous chlorine dioxide as a sanitizer against Cryptosporidium parvum, Cyclospora cayetanensis, and Encephalitozoon intestinalis on produce. Journal of Food Protection, 71(12), 2410–2414. https://doi.org/10.4315/0362-028X-71.12.2410

Standards for the growing, harvesting, packing, and holding of produce for human consumption, 21 C.F.R. pt. 112 (2026). https://www.ecfr.gov/current/title-21/chapter-I/subchapter-B/part-112