130730035854_cyclosporaThe U.S. Food and Drug Administration (FDA) along with the Centers for Disease Control and Prevention (CDC) and state and local officials have been investigating outbreaks of cyclosporiasis in the United States.

What is the Problem and What is Being Done About It?

As of August 10, 2015, CDC had been notified of 457 ill people with confirmed cyclosporiasis from 29 states in 2015.

  • Clusters of illness were identified in Texas, Wisconsin, and Georgia. Outbreak investigations of clusters of illness are ongoing in Texas and Georgia.
  • Most (275; 60 percent) ill people experienced onset of illness on or after May 1, 2015 and did not report international travel within two weeks before illness onset.
  • These 275 people were from the following states: Arkansas (2), California (2), Connecticut (3), Florida (11), Georgia (22), Illinois (6), Iowa (1), Kansas (2), Maryland (1), Massachusetts (9), Michigan (2), Missouri (1), Montana (3), Nebraska (1), New Jersey (6), New Mexico (1), New York (29), Texas (157), Utah (1), Virginia (3), Washington (2), Wisconsin (10).

Through preliminary traceback investigations, the FDA, the Texas Rapid Response Team, Texas Department of State Health Services, the Wisconsin Department of Health Services and the Wisconsin Department of Agriculture, Trade and Consumer Protection have found that cilantro from the state of Puebla, Mexico, was supplied to restaurants at which some of those who have become ill ate.  The investigations are ongoing, and a conclusive vehicle for the contaminations has not been identified.

The CDC and state public health officials have identified annually recurring outbreaks (in 2013 and 2014) of cyclosporiasis in the United States which have been associated with fresh cilantro from the state of Puebla, Mexico. Although not confirmed by epidemiological means, the FDA reviewed a cluster of Cyclosporiasis illnesses from 2012 in which the state of Texas had previously identified cilantro as one of multiple possible suspect vehicles. The FDA determined that cilantro from the state of Puebla, Mexico, was supplied to the point of service implicated in that outbreak and was one potential source of the 2012 outbreak.

The FDA and the government of Mexico’s National Agro-Alimentary Health, Safety and Quality Service (SENASICA) and Federal Commission for the Protection from Sanitary Risks (COFEPRIS) are enhancing the safety of fresh cilantro with produce safety controls on both sides of the border.

The controls implemented by COFEPRIS and SENASICA incorporate a system for risk reduction, including export controls, for cilantro from the state of Puebla. On July 27, 2015, the FDA implemented a supportive framework of import controls to detain without physical examination shipments of fresh cilantro from the state of Puebla from April 1, 2015, through August 31, 2015, as well as this time period in ensuing years. This April through August time period aligns with the seasonality of previous cyclosporiasis outbreaks.

Shipments of fresh cilantro from other states in Mexico will be allowed to enter and be released into the United States if sufficient documentation is submitted at entry demonstrating that the cilantro was harvested and packed outside of Puebla. Additionally, the FDA, COFEPRIS, and SENASICA are working collaboratively to prepare a “Green List” of companies in Puebla whose shipments of fresh cilantro will not be detained.