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By Jordan King
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More than 10,000 confirmed cases of cyclosporiasis have been reported across the United States this year, with the intestinal illness reaching nearly every state, according to the latest figures from the Centers for Disease Control and Prevention (CDC).
New data released by CDC show 10,468 laboratory-confirmed, domestically acquired cases were reported across 47 states between May 1 and August 3. At least 517 patients were hospitalized and two died.
The agency is also reviewing more than 12,255 additional cases that have not been laboratory-confirmed or require further investigation, including checks for possible exposure outside the country. Many of these reports come from Michigan.
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Cyclosporiasis is an intestinal illness caused by the microscopic parasite Cyclospora cayetanensis, a single-celled organism that infects the small intestine. People become infected by consuming food or water contaminated with the parasite, which must mature outside the human body before it becomes infectious, according to the CDC. The illness typically causes prolonged, watery diarrhea, along with fatigue, loss of appetite and stomach cramps.
The CDC said it is investigating several clusters, including a multistate outbreak linked to iceberg lettuce that has contributed significantly to this year’s increase.
What the Latest CDC Data Shows
Patients with confirmed domestically acquired infections ranged in age from 1 to 98, with a median age of 45, and 56 percent were female. The median date on which symptoms began was July 4. Reported onset dates ranged from May 1 to July 28.
The CDC estimates that approximately six weeks can pass between the onset of illness and a case being reported to the agency. As a result, officials expect the total to continue rising as state and local health departments submit further data. The actual number of infections is also likely higher because some people recover without seeking medical care or being tested.
Cases are generally investigated by health officials where patients live, even when exposure may have occurred elsewhere so it is important to note that the map identifies patients’ states of residence, not necessarily the places where they encountered the parasite.
Separately, the CDC recorded 1,341 confirmed cases linked to food or water consumed during international travel. Those cases involved residents of 44 states and resulted in 46 hospitalizations, but no deaths.
Cyclosporiasis Diagnosis and Treatment
Symptoms generally develop about a week after exposure. They can appear between two days and two weeks or longer afterward.
Without treatment, the illness may persist for more than a month, and symptoms can disappear before returning, according to the CDC.
Cyclosporiasis is diagnosed through stool testing, but detecting the parasite may require several samples and specialized tests that are not routinely performed.
The standard treatment is trimethoprim-sulfamethoxazole, an antibiotic combination commonly sold as Bactrim or Septra. Rest and fluids are also important, particularly for patients experiencing diarrhea. People with weakened immune systems or poor health may be more likely to develop severe or prolonged illness.
How Cyclospora Spreads and How to Reduce the Risk
Cyclospora can reach fresh produce when food, agricultural water or food-contact surfaces are contaminated with feces from an infected person. Outbreaks have been associated with both domestically grown and imported fruits and vegetables.
There is no definitive list of fruits and vegetables guaranteed to be free of the parasite and people should monitor federal food-safety alerts and avoid any recalled products, the CDC says.
The CDC also recommends washing hands before and after preparing produce, rinsing fruits and vegetables thoroughly under running water, even when labeled prewashed, and scrubbing firm produce, such as melons and cucumbers, with a clean brush. Damaged or bruised sections should be removed, while cut, peeled or cooked produce should be refrigerated within two hours.
This can reduce the risk but may not completely remove Cyclospora—cooking produce to at least 158 degrees Fahrenheit can kill the parasite. Routine chemical disinfectants and sanitizers may also be ineffective, particularly when treating food or water during travel in areas where cyclosporiasis commonly occurs.
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