Cyclosporiasis Cases Are Rising: How to Avoid the Severe Stomach Illness

How does cyclosporiasis spread? 

Cyclosporiasis generally spreads via food or water that’s been contaminated with human feces, often through irrigation systems used to water fresh fruit and produce.  

It does not spread directly from person to person. Even when someone passes the parasite in their stool, it takes weeks for the parasite to mature to a state where it is infectious.

How is it prevented?

The best way to prevent cyclosporiasis is to practice good hygiene, specifically washing your hands with soap and water before handling food and after using the restroom or changing diapers. Alcohol based hand sanitizers are not as effective as soap and water for killing Cyclosporiasis. And avoid drinking water directly from streams, lakes, springs, or swimming pools, which may be contaminated.

Peeling fruits and cooking vegetables can kill Cyclospora. For uncooked fruits and vegetables, we would recommend washing them thoroughly with running water. We do not yet know the exact source (or more likely sources) of this year's increase in cases, but historically foods such as bagged lettuce or salad mixes, herbs such as basil and cilantro, and fruits like raspberries have been implicated.

Understandably, people may also be concerned about eating raw fruits and vegetables in a restaurant. While there may be an increased risk of transmission, it depends on the level of risk with which an individual is comfortable.

What are the symptoms? Do they differ from other diarrheal illnesses? 

The main symptom is watery diarrhea that can be frequent or "explosive." Other symptoms can include loss of appetite, weight loss, bloating, nausea, and low-grade fever. Most people develop symptoms about one week after becoming infected, but it can range from two days to two weeks. 

Ultimately a diagnosis requires specialized stool testing since the symptoms are similar to many other diarrheal illnesses, like giardia, cryptosporidium, or norovirus. So if you experience symptoms like persistent diarrhea, dehydration, or weight loss, talk to your doctor to see if you should be tested.

How is it treated? Is it fatal? 

Cyclospora is generally not life-threatening and most people with healthy immune systems will recover without treatment, though some may have symptoms that recur, signifying a relapse. People with weakened immune systems, older adults, and young children may be at increased risk for severe or prolonged illness.

If a diagnosis is confirmed, the recommended treatment is a one-week course of the antibiotic trimethoprim-sulfamethoxazole, also known as Bactrim or Septra. Treatment can shorten the duration of symptoms and help prevent a relapse. Regardless, if you are experiencing persistent diarrhea, it’s important to hydrate by drinking lots of fluids, including those with electrolytes, like sports drinks or pediatric electrolyte solutions for children.

Is there anything else people should know about cyclosporiasis? 

Look out for updated guidance from public health authorities as more information becomes available. In the meantime, be diligent about cleaning raw fruits and vegetables and before you eat them, and make sure you and your loved ones are practicing good hand hygiene.