Tracing Cyclospora: NC cases not connected to Taco Bell lettuce, source of bug still TBD

Cyclospora outbreaks across five states are linked to shredded lettuce served at Taco Bell, according to the Centers for Disease Control and Prevention and the Food and Drug Administration. However, that link only officially applies only to: Indiana, Kentucky, Michigan, Ohio and West Virginia. 

Officials have not identified the source of the outbreak in North Carolina, although the state Department of Health and Human Services on Friday said the most commonly reported foods linked to cases in North Carolina include parsley, cilantro, and lettuce.

On Friday, Taylor Farms, a grower that supplies lettuce to Taco Bell said it would removing and replacing its lettuce. 

“If you've eaten at Taco Bell, and you have diarrhea, you should go to the doctor. If you've eaten at Taco Bell, and you don't have diarrhea, I would say you're probably fine,” Don Schaffner told WRAL Investigates.

Schaffner is a food microbiologist at Rutgers University.

“There are multiple outbreaks going on, and we've got to figure out whether they're linked or not,” Schaffner said. “Let's say the North Carolina cases are not linked to what's going on in Michigan, then we may just simply never know [the source], and that's just a fact of life.”

He said Cyclospora, specifically, can be difficult to trace.

“The time from when somebody ate the food until when they got sick is very much longer for cyclospora. With E. coli and Salmonella, it's 24, 48, 72 hours. With Cyclospora, it's two days to maybe as much as 14 days,” Schaffner said. “The genetic fingerprinting technology that we have for this organism is not as good, the long incubation periods and the time to diagnosis, since they're so long, people's memories fade.”

He also said the tracing process is time consuming.

“You have to actually go and talk to every single person, and you have to figure out what their food history is and what they ate,” Schaffner explained. “Realize, too, that epidemiology is not an exact science. We're often looking for statistical correlations. So, yes, people that ate lettuce got sick, but you know what? Lots of people eat lettuce every day. It's easier when it's some sort of weird or unique food. But for common foods, it's really hard to pick out that epidemiological signal.”

WRAL Investigates took a look at the Cyclosporiasis National Hypothesis Generating Questionnaire that Wake County uses to identify people who are suspected of having the infection. The document asks 12 pages worth of questions to help identify where a patient contracted the infection, including where patients traveled and bought produce.

WRAL Investigates met Lianne in a grocery store parking lot. She said she is staying away from bagged lettuce and most produce.

“I’m getting checked for it now,” Lianne said.

She said she got sick before news of cyclospora became more widespread.

“It’s not like food poisoning, where you have it for three or four days. The symptoms stay for a while,” Lianne said.

Schaffner said most produce is considered safe at this point.

“Most of the fresh fruits and vegetables that are on the market right now have not been linked to the outbreak. In fact, none of the ones that are on the market right now have been linked. Otherwise, they would be recalled,” he said.