Lessons Learned Again: Cyclosporiasis and Raspberries

• Coccidiosis
• Fruit
• Raspberries
• Disease outbreaks
• Guatemala

It has been almost 2 years since I was asked to write an editorial to accompany an article by Herwaldt and colleagues entitled “An Outbreak in 1996 of Cyclosporiasis Associated with Imported Raspberries” (1). My editorial detailed important lessons learned in that original investigation and suggested what efforts might be needed to prevent such outbreaks in the future (2). The occurrence of a second and similar outbreak, described by Herwaldt and colleagues (3) in this issue, prompts another look at foodborne illness and what must be done to prevent it.

Herwaldt and colleagues are to be congratulated for this comprehensive and careful outbreak investigation, which confirmed Guatemalan raspberries as the vehicle for Cyclospora cayetanensis(3). Many of their findings are similar to those reported in the 1996 outbreak investigation. One notable finding is that case exposures generally consisted of only a few raspberries, but the median attack rate among persons who ate raspberries was 91.7%. This suggests a very low infectious dose for C. cayetanensis and relatively uniform contamination of the …