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An outbreak of diarrhea from a parasite is surging. Here’s what to eat and what to avoid

What's safe to eat during the cyclospora outbreak

(CNN) — Cases of diarrhea caused by the parasite cyclospora continue to climb, and with the threat of weekslong illness and no certainty about the source, it’s easy to wonder: Is there anything in the produce aisle that’s safe to eat?

The outbreak has risen to more than 4,000 cases in Michigan and Ohio, and linked to cases in West Virginia and Kentucky. Michigan health officials said their investigation suggests that lettuce or salad greens may be the culprit, but other foods can’t be ruled out — and no specific type, grower or supplier has been identified as the source.

Nationally, more than 7,000 cases have been confirmed or are under investigation, in 34 states since May 1, the US Centers for Disease Control and Prevention said Tuesday. It’s not clear which states are seeing cases connected to the large outbreak in the Midwest.

While Michigan health officials urge shoppers to be especially careful when purchasing and eating lettuce and greens this summer, federal health officials are emphasizing staying up to date on health alerts and using standard safety practices when washing food.

“Cyclospora is a very interesting organism. It’s a parasite, so it’s historically been linked to outbreaks in the past, usually foodborne outbreaks,” said Dr. Nuwan Gunawardhana, a hospital epidemiologist and physician who specializes in infectious diseases at Columbia University Irving Medical Center.

“It’s not really considered contagious from person to person,” he said. “When we’re talking about foodborne outbreaks with cyclospora, it’s a very hardy organism, and so it has the ability to adhere to the surfaces very, very well with our fresh produce and fruit.”

Who’s most at risk

Cyclosporiasis is the intestinal illness caused by the microscopic parasite cyclospora, and symptoms typically develop about two days to two weeks after exposure, including prolonged watery diarrhea, stomach cramps, nausea, fatigue, loss of appetite and weight loss. Although the infection can be treated with a combination antibiotic, the illness can last weeks if left untreated and may lead to dehydration.

About 1 in every 11 cases has been hospitalized, according to data reported to CDC. No deaths have been reported.

“Those most at risk are young children, elderly individuals and immunosuppressed people,” said Dr. Dan Barouch, director of the Center for Virology and Vaccine Research at Beth Israel Deaconess Medical Center.

“In most other healthy people, disease is often mild,” he said. “While it makes sense to take precautions, particularly for people at higher risk, there’s no reason for panic at this stage.”

But for people wondering what foods are safe to eat, there are some simple steps to take, both at the grocery store and at home.

Foods to avoid

When shopping for lettuce or other greens, experts recommend avoiding precut or packaged items and selecting whole, uncut produce instead, because it typically undergoes less handling.

Bagged salad mixes and kits have been specifically linked to previous cyclospora outbreaks in the United States and Canada, according to Michigan health officials.

On Tuesday, fast food chain Taco Bell also said it’s removing some ingredients from its menu at some locations as a precaution.

“It’s probably a good idea to avoid bagged lettuce products and bagged salad products for now. And if those are desired, then to rewash them at home, even if they come prewashed, because the actual source of the outbreak is not yet known,” Barouch said.

Raspberries, basil, salad mixes — like vegetable trays and coleslaw — cilantro, berry and fruit mixes, lettuce and snap peas have all been linked to outbreaks in the past.

It’s also recommended to avoid fruits and vegetables that may be bruised, damaged or moldy.

While the outbreak is ongoing, people with weakened immune systems “may want to avoid eating fresh produce altogether until a culprit is determined, given that this particular population is at a higher risk for severe disease,” Gunawardhana said.

Foods to buy

But whole fruits and vegetables, including leafy greens, should not be avoided completely because they are still an important part of a healthy diet, said Don Stoeckel, an environmental microbiologist, associate at the Produce Safety Alliance and long-term collaborator with the Cornell National Good Agricultural Practices Program.

“My personal risk threshold allows me to continue eating what I normally eat, with a little more caution about preparation, because I know that — whatever the source of the pathogen is — the vast majority of fresh fruits and vegetables on the market are safe to consume,” Stoeckel said in an email.

Michigan health officials suggest purchasing whole head lettuce. It’s also recommended to discard the outer two to three layers of the leaves and thoroughly wash the remaining inner leaves before using.

“If you are eating produce that you’re able to peel, that’s also a very optimal way to prevent ingesting these organisms, because when you’re peeling the fruits or vegetables, you’re getting rid of the contaminated surfaces as well,” Gunawardhana said.

The wrong way to wash

Proper washing also is an important step to reduce the risk of foodborne illnesses – but it’s not recommended to wash produce with soap, bleach or commercial household cleaners, as they are not intended for food and may leave harmful residues.

“Stay away from soaps and detergents or other additives that are not meant to be eaten. Dilute sanitizers are not effective against protozoan pathogens like Cyclospora and could cause more harm than good,” Stoeckel said.

Gunawardhana also said chlorine is not recommended for washing.

“People think that maybe chlorinated tablets might help, but actually, cyclospora is highly resistant to chlorine, and so that’s just another thing to be aware of,” he said.

The CDC says to “Be aware that chemically disinfecting or sanitizing produce might not fully eliminate Cyclospora. It is important to thoroughly wash produce even if it is labeled as pre-washed.”

The right way to wash

Gunawardhana said there are three steps people can take to thoroughly wash their produce before using it:

  • Wash your hands with soap and water.
  • Place your produce under clean running water.
  • Add friction by physically rubbing or scrubbing firm produce such as cucumbers, melons and potatoes with your hands or a brush.

“This won’t 100% prevent it, but it might help,” Gunawardhana said.

While washing helps reduce contamination, experts caution that it cannot guarantee complete removal of cyclospora, particularly from leafy greens, herbs and delicate berries.

But washing “enhances protection when combined with cooking or peeling,” Michigan health officials said in a news release Monday.

In a briefing on Tuesday, Dr. Gwen Biggerstaff, CDC’s deputy director of CDC’s Division of Foodborne, Waterborne, and Environmental Diseases, said the advice she’d share with the public is what she’d tell her family and friends.

“That’s my best advice: is to follow our standing food safety practices and guidelines, and to stay aware of the food safety alerts and investigation updates, so that they know what foods are safe and they know how to keep their families safe and protected,” Biggerstaff said.

Prioritize cooking

It can be helpful to prioritize cooking foods to reduce your risk as the outbreak continues. Cooking food to an internal temperature of 158 degrees Fahrenheit or higher kills cyclospora, according to the Michigan Department of Health and Human Services.

Heat can destroy the parasite, making cooked vegetables a lower-risk option than raw produce.

“The best way to actually prevent getting sick from this particular organism is really thoroughly cooking it,” Gunawardhana said. “Getting the food to being cooked to at least 70 degrees Celsius or 158 degrees Fahrenheit is the best way to kill off this organism.”

Food safety experts also emphasize preventing cross-contamination in the kitchen. Keep unwashed produce separate from ready-to-eat foods and raw meat, poultry or seafood.

“Universal advice, not just during outbreaks, is to always practice good hygiene in food preparation areas,” Stoeckel wrote.

“Keeping work surfaces clean, including hand washing, to prevent cross-contamination from one food item to another. When appropriate to the food, cooking (to about 160 F) kills pathogens before consumption,” he said. “Washing, and for some produce peeling, will reduce risk, but neither process will remove everything from the surface of fresh produce. Even small amounts of pathogen, if consumed, can cause illness.”

The-CNN-Wire
™ & © 2026 Cable News Network, Inc., a Warner Bros. Discovery Company. All rights reserved.

Putin’s false claim of the capture of one Ukrainian town exposes the slow pace of Russia’s bloody advance

(CNN) — It is the fate of just one town, over a year, but provides a rare insight into Russia’s ill-fated war of choice.The slow and costly infiltration of Kostyantynivka, key to Moscow’s advance in Ukraine’s eastern Donbas and claimed as occupied by the Russian defense ministry on July 3, lays bare the persistence of the Kremlin’s forces and the devastating casualties they will tolerate to obtain even the smallest of goals.On July 3, the Ministry of Defense posted a series of videos of Russian troops at various points inside the town’s center, waving Russian flags, to bolster its assertion they had taken the town. The false claim – contradicted by recent videos, testimony from Ukrainian troops, and independent mapping of the frontlines – was one of several made in past months by Russia’s leaders, seeking to suggest their battlefield progress was greater than it is, to perhaps persuade their domestic audience, or counterparts in the White House, that their military campaign had not stalled.Ukraine’s President Volodymyr Zelensky swiftly seized on the falsehood, and urged Russian President Vladimir Putin to meet with him in the town to talk peace, if indeed it was under Moscow’s control.CNN, which has reported in or near Kostyantynivka twice over the past year, has used geolocated videos and testimony, to show the horrific cost and slow pace of the Russian advances that led up to the false claim of the town’s capture. The town’s fate exposes both the dogged, relentless nature of Moscow’s assault, and the relatively minute nature of the victories it claim, even if falsely.July 29, 2025Mapping by the independent Ukrainian analysts Deep State shows Russian forces outside the town, trying to push in. The road into the town is already lined with fishing nets, to protect traffic from Russian attack drones. Cars safely drive into town and the market, in its center, remains busy, despite the occasional threat of drones.A CNN team that visited in July last year, found streets bustling with civilians, although some were reluctant to be filmed, perhaps fearing future Russian occupation and being sanctioned for “cooperating” with Western media.November 2025By the first winter months, the map shows the so-called gray zone of disputed territory edging closer to the town center. Russia’s assault with airstrikes had escalated. Videos posted by Ukrainian forces show apartment blocks in the town’s southwest in flames.And a Russian drone captures the damage caused by an airstrike, just a few streets away.But the Ukrainians are still confidently inside the town center, with the General Staff posting a video of one officer casually standing in Victory Square in November.Russian footage posted from that time shows what appears to be their infantry’s point of view from inside an apartment complex courtyard, off the town’s Gromov Street, on the southwestern edges again.January 2026It is in the latter days of the year that Russia appears to take its largest steps forward, recorded by Deep State in the first week of 2026. The gray zone has reached the town and two separate Russian prongs edge closer to its main access roads.Two key factors inform the extent of Moscow’s progress. The range of attack drones – either the tiny First-Person View drones that target individuals or vehicles, or the larger-payload machines that hit buildings – grows monthly, slowly putting the safe space around Kostyantynivka at a greater distance and complicating its defense by Ukraine. More significantly, at this time Western officials began to echo Ukrainian claims that Russia was experiencing up to 35,000 dead or wounded on the battlefield every month.This staggering figure – an apparent result of both a Ukrainian mandate to kill as many soldiers as possible with its drones and the continued use of brutal “wave” assault tactics by Moscow – exposes the likely human cost of Russia’s small advances around Kostyantynivka.The videos posted in January show, however, that Kyiv’s forces are very much still in the center, near the embattled railway station, at the end of the month.By February, white phosphorus, a horrific munition whose use in warfare over residential areas is considered illegal in humanitarian law, rains down over the apartment blocks of the southwest, suggesting the outskirts are home to the heaviest combat.All the same, the Ukrainians post videos showing they are still in the central-south area of the town.It is clear by this stage that much of the civilian population has left and the town is slowly being reduced to rubble. A video posted in April shows that where Ukrainian troops stood casually in November has been reduced to the skeletal remains of buildings and ruins, raising the question of the economic value of the areas Russia fights for.May 2026CNN experienced the change in Russian drone reach firsthand in May, in a grueling five-hour return journey on foot along the main entrance road into Kostyantynivka, which a year earlier was safely accessible under the cover of fishing nets. By May, the nets remained but the road was littered with the charred remnants of cars, struck by drones, and automated robots used to deliver supplies to the front line.The five-kilometer (3.1-mile) walk down what had become known as the “Road of Life,” from the next main town of Druzhkivka, to the outskirts of Kostyantynivka, was mostly carried out on foot, a journey during which Ukrainian troops had to constantly duck into the foliage and hope the Russian attack drones overhead would pass them by. Vehicles on the road had become targets and the team passed the burned-out car where an officer from the unit was killed just days earlier.The increased peril on the road, despite Ukrainian troops still being in the town’s center, reflected Russian drones having developed greater range over the past few months and the technological advances on both sides that constantly reconfigure the battlefield. The map shows the gray zone now deep inside the town and Russian forces truly inside its southwest.July 2026Two months later, the Russian military would claim the town was theirs and post videos in apparent evidence to that effect. However, it is clear on the July 3 map that they still have to exert control over significant parts of it.A week after the claimed capture, Ukraine’s 19th Army Corps posted a video on Telegram of its drones targeting Russian forces in the rubble of the city, killing one “occupier.” The post says: “The enemy paints victories on screens, but in practice, they are destroyed by our units. The city stands. Defense continues.”This is the lesson of Kostyantynivka: Russia may slowly be taking it, at huge cost. But it covers a mere 66 square kilometers (25.5 square miles), while Russia’s territory amounts to 17 million square kilometers (6.6 million square miles).It is unclear exactly how many Russian or Ukrainian lives have been lost to the fight. But images of the town show its reduction to rubble.The town has some strategic importance, in that its capture would enable Moscow’s forces to edge closer to the last main population centers of the Donbas region that Putin so covets – Kramatorsk and Sloviansk. But the capture of both these towns is likely to involve a similarly gruesome and lengthy fight, putting an even optimistic assessment of attaining this key Moscow war goal at least a year away.A year of horrific violence in Kostyantynivka eats at the weakness at the heart of Putin’s war-plan: how long can he sustain Russian public confidence in a conflict where the smallest achievements must be falsely claimed and in reality remain out of reach?The-CNN-Wire™ & © 2026 Cable News Network, Inc., a Warner Bros. Discovery Company. All rights reserved.
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