cyclospora, cyclosporiasis outbreak, parasite, chinese medicine, food, produce, diet

This summer has seen the worst domestic parasite-contaminated food outbreak in our nation’s history. The cyclospora parasite has afflicted 13,895 people thus far (with 2 deaths, 740 hospitalizations, and 10,455 cases still under investigation), but the numbers are likely far higher because most peopledo not report symptoms or get tested. Summer typically has an uptick in these types of parasites. Their eggs stick to the produce and are difficult to wash off. Once ingested, they infect the unassuming human host and cause unpleasant symptomsof illness- mainly explosive diarrhea (sudden onset, frequent, watery bouts ofdiarrhea), and might also cause nausea, reduced appetite, bloating, abdominalcramps or pain, and fatigue. This may lead to dehydration, which can bedangerous, especially during hot summer months. The incubation period may take between2 days to over a week, and symptoms can last for weeks to months if left untreated.Standard treatment is a course of antibiotics.

The parasites come from food sources that have been in contact with infected human fecal matter (fecal-oral route). Either an infected person’s unclean hands touched the produce or, more likely in this case, the produce growing at a farm was irrigated by contaminated water (the wateringsource was polluted by nearby sewage). Because of the widespread nature and large numbers of infections, it is more likely that fields of produce were contaminated this way. Large companies like Taylor Farms which owns many of thefarms that supply markets and restaurants across the country have beenimplicated, as their Mexico growers have been linked to large chains like TacoBell, bagged lettuces at Walmart and Whole Foods, etc. The FDA has declared theoutbreak is over, but the government’s inconsistent statements about the sourceof the problem are disconcerting and frankly hard to believe. There is also presentlya salmonella outbreak being investigated, so there is always something going on.What is safe to eat? Where is our food coming from? How is it being handled?

In the meantime, many patients have reportedly stoppedeating summer produce out of fear of getting sick. Seasonal fruits andvegetables are an important part of our diet, so avoiding these healthy foods isa bad idea. For now, it may be safest to eat local (see your nearby farmer’smarket), to avoid iceberg lettuce, and bagged mixed lettuces (they are made frommultiple sources) and generally avoid the stuff that historically has beenproblematic: raspberries, blackberries, cilantro, parsley, basil, iceberglettuce, green onions, or snap peas. But please do not stop eating your veggiesaltogether! Washing produce thoroughly helps somewhat, while cooking produce killsparasites. I have included a few recipes below that utilize cooked summer vegetablesand are appealing in this seasonal heat. This may be an opportunity to try somethingnew.

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In Chinese medicine, there is extensive literature onparasitic infections and gastrointestinal disease. Of course, no one in ancientChina knew what cyclospora was, but in this field of medicine, the diagnosis iscategorized and labelled very differently. Digestive symptoms are examinedalongside the rest of the person’s state of health as well as their historyleading up to the complaint. The tongue and pulses confirm the state ofimbalance. This presentation informs the diagnosis and treatment of thepatient. Most parasitic infections (and some bacterial infections) that cause explosivewatery diarrhea, as with cyclosporiasis patterns, are classified as a dampheat invasion, possibly coexisting with a spleen-stomach deficiency.In other words, something external invaded the body that brought about symptomsthat mimic moisture and warmth in a toxic or inflammatory way. A weakness inthe digestive process, either a contributing cause or effect of the so-calledinvasion, may coincide. Diet Therapy, a lesser-known branch of Chinese Medicine,looks at food as having healing potential: food is medicine. Patients are advisedbased on their diagnosis of what to avoid and what to consume. Raw foods withcold properties are not recommended for those with damp heat gastrointestinaldiseases, because these are generally harder for the spleen-stomach to breakdown and process. Dairy, alcohol, sugary or greasy foods are best to avoid. Steamedvegetables (rather than, say, a salad) and bland foods that are easily absorbedare best in these cases. Congee (rice porridge that can be flavored with other nutritionalingredients) is often recommended for diarrhea since it is bland and the riceabsorbs excess water. It is easy to digest and “nourishes the spleen.” See therecipe below to make basic congee.

Recipes

1. Sauteed Summer Squash, Zucchini, & White Onions: cut squash and zucchini into half circles and slice white onion thinly. Sautee in a saucepan until onion is limp but the squash is just tender. Season with sea salt and pepper. Sprinkle with fresh French tarragon. (This recipe can be added to things like scrambled eggs for a full meal.)
2. Cannellini Beans with Escarole: rinse a can of white beans and set aside. Sautee chopped fresh escarole and chopped fresh garlic in olive oil until tender and fragrant. Add rinsed beans and stir together, heating throughout. Season with salt and pepper.
3. Sicilian Collard Greens, from “The Kind Diet” by Alicia Silverstone: cut out the stem of the collard greens and rinse in cold water. Tear the leaves into pieces and set aside. Sautee chopped garlic in olive oil for a minute or so, add the damp greens to the skillet. Covered for two minutes. Stir in golden raisins and toasted pine nuts and cover for another two minutes. Add a tablespoon or two of balsamic vinegar, cover and cook another two minutes.
4. Basic Congee: rinse medium or long grain white rice until the water is clear. Add to a pot with appropriate proportion of water or chicken broth and bring to a boil. Add thinly sliced ginger and some salt to the pot. Lower to a simmer for about an     hour, covered. The rice will be soupy and thick. Add toppings of your choice (popular in Asia are tofu, scallions, chopped hard-boiled egg, kimchi or pickled plums, nuts).

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