Cyclosporiasis Cases Are Surging. Here’s How to Protect Yourself, Per Doctors

Cases of cyclosporiasis—a parasitic infection known for causing explosive diarrhea—have surged across the U.S. in recent weeks. In Michigan alone, more than 1,200 cases have been reported, with hundreds more reported across New York, Ohio, Illinois, Indiana, North Carolina, and Texas, per CNN.

Cyclosporiasis is caused by a microscopic parasite called Cyclospora, which usually enters the body after an individual consumes contaminated food or water. It doesn’t spread from person to person.

An outbreak like this is typically traced to a common food source, but no such discovery has yet been made. “It’s still unclear whether this is one large multistate outbreak or several smaller outbreaks happening at the same time,” explains Suraj Saggar, D.O., chief of infectious disease at Holy Name Medical Center in Teaneck, New Jersey. “There could be multiple clusters involving different sources.”

Below, Dr. Saggar and a food safety expert share more about cyclosporiasis, how it spreads, and how to stay safe.

Meet the Experts: Suraj Saggar, D.O., chief of infectious disease at Holy Name Medical Center in Teaneck, New Jersey; and Melissa Vaccaro, M.S., C.P.-F.S., P.C.Q.I., a food safety program specialist with the National Environmental Health Association.

How cyclosporiasis spreads

Cyclospora parasites are found worldwide, but are “more common in tropical and subtropical regions where sanitation and water quality may be more challenging,” explains Melissa Vaccaro, M.S., C.P.-F.S., P.C.Q.I., a food safety program specialist with the National Environmental Health Association. “Historically, many U.S. cases were associated with international travel or imported produce. Today, however, we are seeing more domestically acquired illnesses as well.”

In the United States, cyclosporiasis is most commonly spread through fresh produce. Cases have been associated with leafy greens, herbs, berries, and other fresh fruits and vegetables. Dr. Saggar says raspberries, specifically, are vulnerable to the parasite because they have lots of nooks and crannies in which to hide.

There are also some less common ways to contract cyclosporiasis, unrelated to food. For example, water in swimming pools, lakes, and hot tubs that may be contaminated with animal feces can also be a source.

Vaccaro points out that Americans are eating more fresh produce than ever—from a more interconnected food supply—and health surveillance is at an all-time high thanks to modern technology and communications. These factors make a reported outbreak like this more likely.

Cyclosporiasis infections happen every year between late spring and early fall, when people tend to eat more fresh produce. “What’s different this year is the unusually high number of cases and the fact that investigators still haven’t identified a specific source,” says Dr. Saggar.

Cyclosporiasis symptoms and treatment

The parasite infects the small intestine, which leads to digestive trouble. “Symptoms are pretty classic for a gastrointestinal infection: explosive, watery diarrhea; nausea; vomiting; fatigue; fever; and stomach cramps,” Dr. Saggar says.

Unlike most other gastrointestinal infections, though, cyclosporiasis-related diarrhea can be prolonged or even come and go over several weeks, Vaccaro says. Also, because cyclospora is a parasite, it’s not included in routine lab tests. “If a healthcare provider suspects cyclosporiasis, they may need to specifically request testing for it,” she adds.

For people with healthy immune systems, the infection usually runs its course without medical intervention. In some cases, however, treatment with the antibiotic Bactrim, along with supportive care like IV fluids, can be helpful, Dr. Saggar says.

How to prevent infection

It takes a multi-faceted approach, Vaccaro says. Sanitation is required during the growing, harvesting, and processing of fresh produce. Consumers are then responsible for cleaning foods before consuming them.

“Wash your hands before preparing food, rinse fresh fruits and vegetables under running water, scrub firm produce when appropriate, and refrigerate cut produce promptly,” Vaccaro adds. “These are all good food safety practices that can help reduce the risk of illness.” Even then, pathogens can be difficult to remove from food, which is why food safety is important at every level, she notes.

The bottom line

This news doesn’t mean you should stop eating fresh fruits and vegetables. “Produce is an important part of a healthy diet,” says Vaccaro. “The goal is to identify where contamination occurred, remove affected products from commerce if necessary, and prevent additional illnesses.”

However, such an investigation can take time. “Public health officials are interviewing patients, looking for common food exposures, conducting traceback investigations, and working with state, local, and federal partners to determine whether illnesses are connected,” Vaccaro adds.

In the meantime, do what you can by engaging in food safety best practices and, if possible, knowing where your produce comes from. And if you experience an unexplained, extreme bout of diarrhea that comes and goes for weeks and is accompanied by fatigue, loss of appetite, or weight loss, contact your doctor as soon as possible.