Cases of a stomach parasite that causes abdominal pain and severe diarrhea have been rising in other states. How worried should you be in California?

if you’re in the Bay Area — or are planning to visit any of the affected states in the coming weeks — what should you know about your individual risk of cyclosporiasis? What’s the source of this outbreak? Should you be thinking about your fruits and vegetables differently right now, and how can you reduce your family’s chances of being hit by this truly unpleasant disease this summer?

If I’m visiting an area with a cyclosporiasis outbreak, should I be avoiding certain foods to lower my risk?

Cooking your produce to an internal temperature of at least 158 degrees will kill cyclospora.

But cooking your fruits and vegetables this way might not always be realistic. And while washing produce isn’t guaranteed to remove all traces of cyclospora, when done thoroughly, it could help reduce your risk of infection.

Dr. Erika Noel, an assistant professor at Hawaii’s medical school and a pediatrician on the island of Kauai, shared the following tips for washing produce with the Associated Press:

• When washing items like cilantro and basil, separate the leaves.
• For green onions, cut off the roots, remove the outer layer and run them under water while rubbing the surface.
• Research shows that washing fruits and vegetables in vinegar can be helpful. Vinegar won’t kill the parasite but can help remove it. Noel recommends submerging produce in a bowl filled with three parts water and one part vinegar and swishing it around for a few minutes. Using a salad spinner to rinse with water can help get rid of the vinegary taste.
• Instead of purchasing pre-mixed salad and washing individual leaves, opt for a head of lettuce and remove the outer layer.
• For melons, scrub the outside before cutting through as the knife can carry germs from the rind into the fruit inside.
• Peel fruits and vegetables as much as possible.

Don’t forget to wash cutting boards and countertops. Alcohol-based hand sanitizers don’t kill cyclospora, but soap and water are highly effective at killing or removing the parasite from hands.

Even with low case counts in California, I’m really worried about getting cyclosporiasis. What should I be doing?

First of all, remember that according to CDPH, “there are no known local outbreaks in California, and no California cases are currently known to be linked to multistate outbreaks under investigation by the CDC.” The CDC’s surveillance map, last updated on July 9, shows “1-10” cases currently reported in California.

“We would have seen it if it was some distributor that we had, that the Midwest groceries or restaurants also use,” said Dr. Peter Chin-Hong, an infectious disease expert at UCSF. “Because it should all happen at the same time.”  And because of the foodborne nature of cyclosporiasis, and the lack of human-to-human transmission, “it’s not like somebody from Michigan travels to California and then spreads it around,” he said.

I’ve got diarrhea and now I’m panicking. Could this be cyclosporiasis?

Right now in the Bay Area, getting diarrhea is way more likely to be due to another gastrointestinal disease.

According to Stanford University’s WastewaterSCAN, a team that measures viral levels in human sewage, both Norovirus and Rotavirus — gastrointestinal diseases which, like cyclosporiasis, cause prolonged diarrhea — have been detected in over 99% of samples from their sites across the Bay Area in the last three weeks.

How dangerous is a cyclospora infection?

Cyclosporiasis is not fatal, and no deaths have been reported to the CDC during this current outbreak. 

But Chin-Hong stressed that the dehydration this kind of prolonged diarrhea can cause still poses a danger to the very young and the very old, in how it could impact their organs.