Cyclosporiasis primary prevention

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Ammu Susheela, M.D. [2]

Overview

The main preventive measure against Cyclosporiasis is to avoid unclean water and food that are contaminated with feces. Wash, prepare and store are the recommendations for handling fruits and vegetables to prevent transmission.

Primary Prevention

• Avoiding food or water that may have been contaminated with feces is the best way to prevent cyclosporiasis. Treatment with chlorine or iodine is unlikely to kill Cyclospora oocysts. No vaccine for cyclosporiasis is available.
• The U.S. Food and Drug Administration’s (FDA) Center for Food Safety and Applied Nutrition (CFSAN) publishes detailed food safety recommendations for growers and suppliers. In its Guide to Minimize Microbial Food Safety Hazards for Fresh Fruits and Vegetables, CFSAN describes good agricultural practices (GAPs) and good manufacturing practices (GMPs) for fresh fruits and vegetables. The guidelines address the growing, harvesting, sorting, packaging, and storage processes that, if followed, can reduce the overall risk for microbial contamination during these steps. The exact manner in which Cyclospora oocysts become attached to produce is not fully understood, but if these guidelines are followed, they might reduce the risk for Cyclospora contamination.
• Safety of the imported food should be monitored.
• CDC monitors the occurrence of cyclosporiasis in the United States and helps state health departments identify and investigate cyclosporiasis outbreaks to prevent additional illnesses.

Food and water sanitation measures to prevent transmission of Cyclospora

Treatment processes	Efficiency deciding factors
Slow sand filteration processes	Filter depth
Coagulation filtration processes	Coagulant dose, pH, temperature, installation
Soil passage	Soil composition
Pretreatment of reservoir	Storage time, contents

Fruit and Vegetable Handling Recommendations

Wash

• Wash hands with soap and warm water before and after handling or preparing fruits and vegetables.
• Wash cutting boards, dishes, utensils, and counter tops with soap and hot water between the preparation of raw meat, poultry, and seafood products and the preparation of fruits and vegetables that will not be cooked.

Prepare

• Wash all fruits and vegetables thoroughly under running water before eating, cutting, or cooking.
• Fruits and vegetables that are labeled “prewashed” do not need to be washed again at home.
• Scrub firm fruits and vegetables, such as melons and cucumbers, with a clean produce brush.
• Cut away any damaged or bruised areas on fruits and vegetables before preparing and eating.

Store

• Refrigerate cut, peeled, or cooked fruits and vegetables as soon as possible, or within 2 hours.
• Store fruits and vegetables away from raw meat, poultry, and seafood.