What the Cyclospora Outbreak Means If You Have IBD

Why "just wash your produce" isn't quite enough advice for those of us with IBD, and why I'm reworking what I eat on my next work trip

There’s a parasite outbreak spreading right now, and health officials still haven’t pinned down exactly what’s behind it. If you have Crohn’s or UC, this is worth understanding regardless of what treatment you’re on, and if you’re also on a biologic, there’s an extra layer to it worth knowing about too.

By early July, the CDC had confirmed over 800 domestic cases of cyclosporiasis across more than two dozen states, with thousands more suspected. Michigan and Ohio have been hit hardest, and as of this week the combined case count there has climbed past 3,000. Investigators say lettuce and salad greens keep coming up as a common factor, but they’ve stopped short of naming a specific grower or supplier, and they haven’t ruled out other foods either.

I don’t have any reported cases in my state yet. But I’m not fooling myself into thinking that means much. Outbreaks like this don’t respect state lines, and produce doesn’t either.

What is Cyclospora, actually

Cyclospora cayetanensis is a microscopic, single-celled parasite that gets onto fresh produce when it comes into contact with feces-contaminated water or soil, usually somewhere upstream in the growing or packing process. You can't see it, you can't smell it, and washing doesn't reliably remove it, since Cyclospora clings tightly to produce surfaces and rinsing with water alone often isn't enough to get it off. It’s not a bacteria problem you can rinse away like dirt. It behaves more like a coating that clings to the surface of leaves and skins.

Once it’s in your gut, it causes watery diarrhea that can drag on for weeks if untreated, along with cramping, bloating, fatigue, and weight loss. For most healthy people, that’s miserable but survivable. For those of us managing IBD, it’s a different calculation entirely.

Biologics and parasites

Biologics like anti-TNF drugs work by dialing down specific immune signaling pathways, the same pathways that would normally help the body detect and clear an invading parasite early. That’s the whole point of the medication when it comes to calming Crohn’s or UC. But it also means a small exposure that a healthy immune system would brush off can take hold more easily in someone on immunosuppressive therapy, and take longer to clear once it does.

One of the trickier parts of this outbreak, for anyone on a biologic, is how closely cyclosporiasis can mimic an IBD flare. Persistent diarrhea, cramping, and fatigue are also just the standard symptoms of a flare. Without stool testing, it would be easy for a doctor, or a patient, to assume flare and escalate immunosuppressive treatment, when what’s actually needed is antiparasitic treatment for an infection. Escalating immunosuppression during an active parasitic infection is exactly the wrong direction to move, which is part of why doctors treating IBD patients on biologics are being encouraged to test before assuming during this outbreak.

What produce is most likely affected

Based on this outbreak and the pattern from past ones, the highest-risk categories are:

• Leafy greens and lettuce, especially pre-washed bagged salad mixes

• Fresh herbs, particularly cilantro and basil

• Raspberries and other soft berries with textured, hard-to-clean exteriors

• Snow peas and similar raw, pod-style vegetables

• Green onions

These are the foods people typically eat raw, straight from the package or the produce bin, with no cooking step to knock the parasite out.

Does washing actually help?

Somewhat, but less than you’d hope. Officials still recommend it because it reduces the load of whatever else might be on the produce, but it is not a reliable safeguard against Cyclospora specifically. Current guidance from health departments includes:

• Buy whole heads of lettuce instead of pre-washed bagged greens, and discard the outer two to three leaves before washing the rest under running water

• Separate cilantro and basil leaf by leaf and wash thoroughly, or better yet, cook them

• Trim and peel green onions before washing

• Scrub firm produce like melons and cucumbers with a dedicated produce brush

• Cut away any bruised or damaged areas before eating

Cooking is really the only step that reliably kills the parasite, since heat above roughly 158 degrees Fahrenheit destroys it. Washing lowers risk. Heat eliminates it.

The safest way to eat right now

If you’re immunosuppressed, the honest answer is that cooked produce is the only truly low-risk category at the moment. That doesn’t mean panic and abandon vegetables. It means shifting the ratio: more roasted, sauteed, steamed, and soup-based produce, less raw salad and raw herb garnish, until this outbreak is better understood and contained.

What I’m doing personally

I’ve pulled raw berries and fresh herbs out of my rotation entirely for now. No more tossing basil or cilantro on a dish uncooked, no more grabbing a pint of raspberries as a snack. I’m not cutting out lettuce completely, but I’m being much more careful with it: whole heads only, outer leaves discarded, thoroughly washed, and I’m leaning toward cooked greens more often than raw ones for the time being.

My state hasn’t reported any cases yet. I know that’s not a real shield. It’s probably only a matter of time, and I’d rather adjust now than scramble after the fact.

The part that actually has me nervous: travel

I have a work trip to Tennessee next week. It’s not the exact hotspot driving the case counts right now, but with an outbreak this actively spreading and still unlinked to a single confirmed source, that’s not much reassurance. My travel eating has always leaned on salads and fresh produce, since those are the SCD-friendly options I can reliably find at events, at restaurants, or grabbed as a bagged salad from the grocery store that I bring back to the hotel room and add my own tuna to. Raw greens haven’t been a compromise on the road for me, they’ve been the plan.

Not this time. I’m loading my suitcase with shelf-stable stuff instead: date and nut bars, dry-pack tuna, nuts, dried fruit, plantain chips, and a batch of homemade almond flour cookies. Nothing that needs to stay cold, nothing raw. But I know that won’t carry me through the whole trip. I won’t be ordering the salad, so my meals are probably going to be sparser than usual, and I’m making peace with that trade-off ahead of time rather than figuring it out on the fly. I’ll report back once I’m home and know how it actually went.

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References

1. CNN, “Michigan says diarrhea outbreak may be linked to lettuce and salad greens as cases rise above 3,000,” July 13, 2026 — https://www.cnn.com/2026/07/13/health/cyclospora-parasite-diarrhea-outbreak-increase

2. NPR, “What to know about the cyclosporiasis outbreak hitting more than half of U.S. states,” July 12, 2026 — https://www.npr.org/2026/07/12/nx-s1-5890935/cyclosporiasis-outbreak-diarrhea-nausea-where-states-us

3. Texas State University Newsroom, “Six questions answered about the current cyclospora outbreak,” July 2026 — https://news.txst.edu/faculty-experts/2026/six-questions-answered-about-the-current-cyclospora-outbreak.html

4. Michigan Department of Health and Human Services, “MDHHS makes recommendations on preventing foodborne illness amid growing cyclosporiasis outbreak,” July 4, 2026 — https://www.michigan.gov/mdhhs/inside-mdhhs/newsroom/2026/07/04/mdhhs-makes-recommendations-on-preventing-foodborne-illness-amid-growing-cyclosporiasis-outbreak

5. PBS News, “What you need to know about the cyclosporiasis outbreak,” July 2026 — https://www.pbs.org/newshour/health/what-you-need-to-know-about-the-cyclosporiasis-outbreak

6. USA Today, “It’s not just produce. Where else can ‘explosive diarrhea’ bug hide?” July, 2026 https://www.usatoday.com/story/news/health/2026/07/11/cyclospora-diarrhea-outbreak-has-another-risk-beyond-food-parasite/90881401007/