The Recent Cyclosporiasis Outbreak

The Recent Cyclosporiasis Outbreak

By Anthony Robniak, MD

The CDC and FDA are actively investigating reported cases of Cyclosporiasis in several states across the US, including North Carolina. Initial reports are linking the cases to store-bought lettuce.

What is Cyclosporiasis?

Cyclosporiasis describes the infection caused by the Cyclospora parasite. A Cyclospora parasite begins as a microscopic organism that develops in conditions with elevated temperature and humidity. Initially, the early forms of Cyclospora parasites cannot infect humans. However, as the parasite develops, it can catch a ride on some of the foods we eat and enter cells lining our intestines to wreak a bit of havoc.

How will I know if I'm suffering from Cyclosporiasis?

Oftentimes, people who have Cyclospora parasites in their intestines will experience no symptoms, and their immune system will naturally rid their body of the parasite. Some folks will experience a sudden, single episode of diarrhea before their immune system kicks in gear; then they will experience no further symptoms. Some folks may suffer from persistent watery or bloody diarrhea, loss of appetite, nausea, abdominal cramping, mild fever, and weight loss.

Young children, older adults, folks taking medications that suppress their immune systems, and folks with disorders that suppress their immune systems are more likely to experience symptoms of Cyclosporiasis.

What should I do if I start to have these symptoms?

Start a daily journal of your symptoms if they aren't debilitating or intolerable. Weigh yourself each morning before eating or drinking anything and include that weight in your daily journal. The symptoms may be subtle, and they might go away on their own in a matter of days.

However, if you start to notice blood mixed in with the diarrhea, a mild fever, an unintended loss of weight, or otherwise intolerable symptoms, you should call your primary care doctor or other healthcare professional and report your concerns. They may ask you to provide stool for testing as Cyclosporiasis is diagnosed definitively through examination of the stool.

Is there a treatment for Cyclosporiasis?

There are a couple of different antibiotics and antiparasitic medications available. Taken by mouth, these medications have been shown to reliably eradicate all Cyclospora parasites present in the intestine. These medications are usually given for seven to ten days to be taken once in the morning and once in the evening. Those who are more likely to experience symptoms of Cyclosporiasis may be given recommendations to take the medication a bit longer.

How can I avoid getting Cyclosporiasis?

Wash your hands, then rinse and scrub your produce under a cold faucet. Scrubbing the produce with your washed hand can help agitate the surface of the produce and allow the flowing water to wash away parasites and other unwelcome microorganisms.

Avoid pre-packaged processed produce like chopped lettuce for now--these products seem to be most implicated and they are difficult to rinse. Instead, buying a head of lettuce, washing and scrubbing the leaves, and then chopping them yourself is probably the better bet while this outbreak is ongoing. If you really don't want to risk it, then heat your produce up to 200 degrees Fahrenheit before cooling and eating. This will destroy the Cyclospora parasite.

Anthony J. Robniak, M.D., is a second-year internal medicine resident at UNC Health Southeastern. In addition to offering services you'd expect from a community healthcare system, UNC Health Southeastern provides a number of specialized services that are unique to our system and not available anywhere else in the region. To schedule an appointment, call our referral line at 984-974-CARE. To learn more, visit UNCHealthSE.org.