This meeting is being recorded and summarized.

Good morning.

I'm Legislator Jewel Williams Johnson, Chair of the Board of Legislative's Committee on Health.

Today is August 5th, and I'll note that we are starting calling this meeting to order at 11.04 a.m.

Welcome everyone.

I'll note that we are joined by the vice chair of the committee, Legislator Nancy Barr, as well as legislator Emiliana Uli.

Thank you both for joining us.

And we have very happy to have very happy and appreciative to have Dr.

Gary Zeitlin, who is the chief of infectious disease at White Plains Hospital, along with Soraya Montero.

Soraya, what's your uh title?

Community Director of Community Outreach.

Direct okay.

Thank you both so much for joining us.

Um we're anxious to hear Dr.

Zieten's medical expertise and help us better understand the ongoing and ever evolving national rise of cyclosporarias.

Uh I want to uh start off by noting uh for clarification that uh cyclosporitis is not a virus, right, Dr.

Zeitland.

It's a testin' illness caused by the microscopic parasite cyclospora, most often transmitted through contaminated food or contaminated water.

Um the latest national numbers underscore why this conversation is so timely.

When I wrote this intro, uh it was through July 27th at the Centers of Disease Control and Prevention reported 67 laboratory confirmed domestically acquired cases across 45 states, and that included 423 hospitalizations and no reported deaths.

The CDC is also reviewing more than 11,500 additional cases that have not yet been laboratory confirmed or require further investigation.

Multiple clusters under review, including but not limited to the outbreak linked to iceberg lettuce.

Here in Westchester, again, as of July 27th, the publicly reported local update identified 28 confirmed cases this year.

Um and I will apologize for or convey our Commission of Health, Dr.

Sharita Amler's apologies.

She was originally uh going to join us today, but um she had a uh priority conference, but we know that she's on top of this.

Um these figures are important, but our purpose today is definitely not to create fear, it is to replace uncertainty with reliable information.

We hope to provide residents, uh health professionals, food service establishments, and policymakers with a clear understanding of how this infection spreads, why diagnosis can be difficult, what symptoms should prompt medical attention, and what we can do individually and collectively to reduce risk.

At the same time, the situation continues to evolve, and there remains an urgent need for clear, current and trustworthy information.

Our purpose today again is not to create alarm, but to deepen understanding, answer the questions residents and health professionals are asking, and identify what Westchester can do now to strengthen awareness, diagnosis, prevention, and response.

Again, Dr.

Zeeton, thank you for helping us foster that understanding and for guiding today's important discussion.

And with that, I'll turn it over to you.

Again, many thanks.

Thanks for having me.

So of course, there's a lot of concern about uh cyclosporasis nationally, probably uh most folks haven't had occasion to deal with it or hear about it before, but there is cyclospora uh activity among other gastrointestinal illnesses that has occurred uh over over the years, occasionally with outbreaks uh associated with berries, raspberries, in particular over the last few years.

But recently we've had the biggest outbreak in the United States history.

There was some talk about the Taylor Farm's shredded lettuce, and there was an epidemiologic link made to that product.

There was a subsequent report that the molecular diagnostic link was rescinded, meaning that it was not proved by a lab test that was the source, but all of the investigational epidemiologic data pointed to the Taylor Farm's shredded lettuce, at least as a source of some of the cases.

Subsequently, there was another cluster, and there may be multiple unrelated clusters in the United States currently.

Certainly there is concern among the public how to be safe in the face of this, particularly not knowing for sure what the source is.

So traditionally there have been different foodborne infection outbreaks over the years where a particular item will be recalled and that's the end of it, but uh some of the uncertainty is feeling uh more fear among the public.

I know some folks have decided not to eat any vegetables at all.

Uh one one thing that's not good from a health standpoint, but will certainly kill cyclospora is to deep fry everything.

I'm not advocating that, but it's if your food is above 158 degrees, that will kill all cyclospora.

Uh beyond you there.

So not only deep frying, we can oven roast it too, right?

And get to that temperature.

Absolutely.

Anything above 158 Fahrenheit will kill cyclospora.

Uh beyond the specific recalled items, the formal guidance regarding food safety has been either to heat the food above 158, uh, but not to avoid all fresh fruits and vegetables.

For uh high-risk persons, such as uh neonates, immunocompromised adults.

Uh, there is a recommendation to avoid certain higher risk foods, uh, basal cilantro, blueberry, uh, raspberry, and there are a few other items, and then uh out of an abundance of caution to uh try to avoid uh pre-packaged shredded uh lettuce items, particularly iceberg lettuce.

But there is no current recommendation to avoid uh all vegetables.

Unfortunately, there's not really a washing method that is foolproof at getting rid of cyclospora uh regardless of what you do with soap uh or brushing.

Unfortunately, there is no vaccine for cyclospora.

There is uh an effect very effective treatment called uh back trim.

The uh generic name is trimethoprim sulfamethoxazol, a very old and safe antibiotic uh seven today, seven to ten day uh course.

Uh there for folks who cannot take primethhoprim sulfamethoxazole, cipro is somewhat effective.

There's a third drug called nitazoxinide of more questionable efficacy.