Ask Dr. Mike: Do I Really Need to Avoid Lettuce and Raspberries Right Now?

Penn doctor Michael Cirigliano weighs in on the cyclosporiasis parasite causing “explosive diarrhea” in 41 states. (Left: courtesy Michael Cirigliano. Right: a photo-illustration showing the parasite that causes cyclosporiasis set amid lettuce, raspberries and other fruits and vegetables, via Getty Images)

Meet internal medicine physician Michael Cirigliano, affectionately known as “Dr. Mike” to not only his 2,000 patients, who love his unfussy brilliance, tenacity, humor, and warmth (he’s a hugger!), but also to viewers of FOX 29’s Good Day Philadelphia, where he’s been a long-time contributor. For 32 years, he’s been on the faculty at Penn, where he trained. And he’s been named a Philadelphia magazine Top Doc every year since 2008. Now, he’s our in-house doc for the questions you’ve been itching (perhaps literally) to ask a medical expert who’ll answer in words you actually understand. Got a doozy for him? Ask Dr. Mike at victor@phillymag.com.

Dr. Mike, our wellness editor asked me last week if I should talk to you about cyclosporiasis, this horrible stomach thing going around, but I thought maybe it was over. But now that I’m reading the latest news about cyclosporiasis, that does not seem to be the case, even though Robert F. Kennedy Jr. claims that it’s under control.
Well, it’s not really under control because it’s now affecting more than half of the United States. [Ed. Note: It’s currently impacting 41 states, according to the CDC.]

And what is cyclosporiasis, exactly?
It’s a parasite. It comes from some vegetables like lettuce and some fruits like raspberries. They’re trying to figure out exactly where this instance came from — there was a false positive test regarding one distributor. But the bottom line is that no one should panic.

Is this the kind of thing that is going to kill me?
I don’t think there are any reported deaths. There have been a number of people hospitalized because they were severely dehydrated and needed IV fluids. If you have a severe case of rapid onset diarrhea, you might want to check with your healthcare provider and get a stool test. The good thing is we have antibiotics that can treat cyclosporiasis. We can give you Bactrim or Cipro.

So it sounds like this is something that does not scare you very much, but it’s all over the news as this very ominous thing.
Ever since the pandemic, when something [health-related] comes along, everybody’s panicked … that it’s going to be the next pandemic where we’re sequestered at home for a couple of months. I mean, we went through it. The problem with cyclosporiasis is that there’s a fairly long lag-time between getting exposed to the parasite and developing symptoms. It can be up to 10 days. Clearly we don’t really have a handle on it yet. But don’t panic!

Isn’t one of the easiest things to do is just avoid salads?
Well, if you’re going to do a salad, take off the outer couple of layers of your lettuce and wash the rest thoroughly. And try to avoid the prepackaged salads. We even have this thing at our house where it’s like a centrifuge and you wash the salad — it spins around real fast and gets rid of all the water.

Dr. Mike, are you talking about a salad spinner, one of the most common kitchen gadgets around?
A salad spinner! Yes! I said centrifuge because I’m a scientist. A salad centrifuge. I kind of like that better than a salad spinner or whatever you called it.

You could brand your own and sell them. “Dr. Mike believes in the salad centrifuge when the spinner just isn’t enough! $9.99 if you order now!”
You could put all kinds of stuff in there!

While we’re on the subject of parasites, because it’s such a pleasant conversation, what are more common parasites that you see?
Oh, well, there’s a litany of them. I mean, you can have Giardia. I actually had that. I traveled to Ukraine about 25 years ago, and I probably got it from a salad. And there are intestinal worms. I mean, the list goes on and on and on. The key is to listen to your body. If you don’t feel well, if you have [sudden] weight loss, chronic diarrhea, blood in the stool, or [sudden] loss of appetite, get checked out.

We had a big-ass salad last night, and my wife just asked me if I washed the romaine and spinach. I have to admit that I did not, because the bag said “triple washed for your convenience” or something like that. She’s not too happy with me. I guess that was a mistake. But if you don’t hear from me in the next 10 days…
If you get a case of diarrhea, call me!