Meta Description: CDC is probing hundreds of cases of Cyclospora in 18 states. Understand the symptoms, causes, treatment, prevention and how to avoid getting cyclosporiasis.
CDC is investigating a deadly outbreak of cyclospora in 18 states
The Centers for Disease Control and Prevention (CDC) is conducting an investigation of a multi-state outbreak of cyclosporiasis, an intestinal illness caused by a tiny parasite, Cyclospora caetanensis, that is spread through food or water. The U.S. Centers for Disease Control and Prevention (CDC) has reported hundreds of cases in 18 states, so a multi-agency investigation is underway to determine the source.
The disease is not typically fatal but the unprecedented rate of infections and absence of clear evidence on where the infection is coming from has led to public health concerns. Authorities are collaborating closely with the U.S. Food and Drug Administration (FDA) and state health departments to find out where the infection is coming from.
What Is Cyclospora?
Cyclospora cayetanensis is a tiny organism that lives in the small intestine and causes cyclosporiasis. Transmission occurs from eating or drinking food or water contaminated by human excrement (poop) with the parasite.
Cyclospora infections are not spread person to person as the parasite needs to be in the environment for a certain time to become infectious, unlike many common foodborne illnesses.
Current Outbreak Overview
The CDC reports that:
- To date, there are over 400 confirmed cases in 18 different states in the United States.
- From May 1 through June 16, a total of 145 laboratory confirmed cases were identified in 17 states.Â
- 20 patients required hospitalization.Â
- As of now, there have been no fatalities associated with the outbreakÂ
- No single source has been identified and it’s believed there could be clusters around the country.
States with the highest number of infections are:
- New York
- Texas
- Illinois
- Michigan
Other states involved are:
- Alaska
- Colorado
- Connecticut
- Florida
- Georgia
- Louisiana
- Massachusetts
- New Jersey
- North Carolina
- Ohio
- Pennsylvania
- Tennessee
- Virginia
- Wisconsin
The Michigan health officials, in a separate announcement, have reported a record number of cases – more than 300 — since the end of June, well above the state’s average number of cases for an entire year.
Symptoms of Cyclosporiasis
The symptoms typically appear 2 days to 2 weeks after eating or drinking something that has been contaminated.
Common symptoms include:
- Severe watery diarrhea
- Frequent bowel movements
- Explosive diarrhea
- Stomach cramps
- Nausea
- Vomiting
- Fatigue
- Loss of appetite
- Low-grade fever
- Weight loss
Some infected individuals experience only mild symptoms, while others may have prolonged illness lasting several weeks.
How is Cyclospora transmitted?
The main mode of transmission of the parasite is:
- Contaminated fresh fruits
- Leafy vegetables
- Fresh herbs
- Contaminated drinking water
Previous epidemics have been associated with:
- Basil
- Cilantro
- Spinach
- Raspberries
- Other fresh produce consumed raw
Fresh produce is often used raw, so contamination will remain if proper precautions are not taken during the growing, picking, processing and handling of the crop.
Why Cases Increase During Summer
Cyclospora infections are seasonal, with the majority of cases in the United States occurring. From May to August.
There are a number of reasons behind this:
- More eating of fresh salads and fruits Â
- More imported produce
- Warm environmental conditions which enable the parasite to mature and become infectious Â
This phenomenon has been observed for many years and summer season is a critical time for surveillance.
How is Cyclosporiasis Diagnosed?
A healthcare provider can diagnose the disease with special laboratory tests of stool samples.
Many stool tests do not detect Cyclospora, so doctors might specifically ask to have the stool tested if a patient has diarrhea that does not go away and has a history of exposure.
Treatment
People who are healthy generally get better without problems.
Treatment may include:
- Hydration (drinking lots of fluids to make sure they don’t become dehydrated)Â
- If necessary, replace electrolytes.Â
- Rest
- Appropriate prescription antibiotics (usually trimethoprim-sulfamethoxazole) if the infection is moderate or severeÂ
For those who are not tolerant to the recommended antibiotic, patients should discuss with their healthcare provider what the options are for managing the patient.
Protection: How to Protect Yourself
While it is not possible to wash away all potential contaminants, there are some tips food safety experts recommend:
✔ Wash fresh fruits and vegetables well under running water.
✔ Wash hands before preparing food.
✔ Washing cutting boards, knives and other work surfaces frequently.
✔ Quickly refrigerate perishable produce.
✔ Consume safe uncontaminated water.
✔ If diarrhea doesn’t improve after a few days or if it is very severe, seek medical help.
People with Cyclospora should also report to local public health officials if they are asked to assist in the investigation to identify potential sources.
Why Investigators haven’t found a single source
One of the problems associated with Cyclospora outbreaks is that:
- Symptoms may not be noticeable for several days after exposure.
- Patients can have difficulty recalling what food they have consumed.
- There are complicated supply chains for fresh produce. ·
- Several contaminated products can be floating around.Â
Consequently, investigators are investigating several possible clusters instead of a nationwide outbreak.
Public Health Response
CDC, FDA and state health departments continue to:
- Interview infected individuals
- Trace food purchases
- Analyze laboratory samples
- Compare case patterns to other states ·
- Wait to see if more people get sickÂ
The investigation is ongoing and recommendations could be updated if a contaminated product is found.
Internal Links
Use these as internal links on your website:
External Resources
For authoritative information, refer to:
- CDC – Cyclosporiasis: https://www.cdc.gov/cyclosporiasis/Â
- CDC – Food Safety: https://www.cdc.gov/foodsafety/Â
- U.S. FDA – Foodborne Illness Information: https://www.fda.gov/foodÂ
- World Health Organization – Food Safety: https://www.who.int/health-topics/food-safetyÂ
Conclusion
The ongoing Cyclospora investigation reminds us of the need for all of us to practice food safety and be on the lookout for disease outbreaks, especially during summer when fresh produce consumption rises. Most people get over cyclosporiasis without any complications, but the recent outbreak of cyclosporiasis in several states highlights the importance of paying attention to good hygiene practices, proper food preparation, and seeking medical attention promptly for diarrhea that doesn’t go away.
