Credit CDC
# 7462
Although fairly common in developing tropical, or sub-tropical countries, Cyclosporiasis – an infection generally acquired through consuming food or water contaminated with Cyclospora cayetanensis - is relatively rare in the United States.
According to the CDC’s Epidemiology & Risk Factors:
In the United States, foodborne outbreaks of cyclosporiasis since the mid-1990s have been linked to various types of imported fresh produce, including raspberries, basil, snow peas, and mesclun lettuce; no commercially frozen or canned produce has been implicated.
U.S. cases of infection also have occurred in persons who traveled to Cyclospora-endemic areas. To reduce the risk for infection, travelers should take precautions, such as those recommended in CDC's Health Information for International Travel (Yellow Book). Travelers also should be aware that treatment of water or food with chlorine or iodine is unlikely to kill Cyclospora oocysts.
Unlike cryptosporidium, which can be easily be passed from human-to-human, Cyclospora is rarely transmitted directly from an infected host. Hosts infected with Cyclospora shed unsporulated (non-infective) cysts in their stool which require days or even weeks to mature into infectious agents.
So far, the source of this outbreak remains a mystery, but at least 3 dozen people in Iowa and Nebraska have been identified as infected – all apparently since mid-June. Public Health departments in Iowa and Nebraska are urging lab testing for patients with prolonged diarrhea accompanied by anorexia and fatigue.
This from the Iowa Department of Public Health.
IDPH Investigates Intestinal Illness
The Iowa Department of Public Health, CDC and local public health agencies are investigating an outbreak of an intestinal illness caused by Cyclospora (a rare parasite). As of today, July 8, 22 cases of Cyclospora infections have been reported to IDPH; almost all have been identified through testing at the State Hygienic Lab (SHL), including:
- Linn County - 10 cases
- Fayette County - 3 cases
- O’Brien County - 2 cases
- Webster County - 2 cases
- Benton County - 1 case
- Des Moines County - 1 case
- Mills County - 1 case
- Polk County - 1 case
- Van Buren County - 1 case
Most people’s illness began in mid to late June, and at least one person has been hospitalized. Many people report still being ill with diarrhea and some have had relapses.
Specific treatment is available (but it is not typically used for more common diarrheal illnesses). Also, very specific laboratory testing (not commonly ordered) must be done to detect Cyclospora.
Additional cases have been identified in Nebraska and other Midwestern states. IDPH is coordinating the investigation with public health officials in those states. The investigation is ongoing; no specific source of exposure has been identified. Fresh produce (fresh fruits and vegetables) have been implicated in previous outbreaks. Washing fresh produce is recommended; however, it can be very difficult to wash Cyclospora off all types of produce.
People become infected with cyclospora by consuming food or water contaminated with the parasite, which causes a watery diarrhea that lasts an average of 57 days if untreated.
Symptoms of cyclosporiasis include:
- Watery diarrhea
- Fatigue (severe tiredness)
- Loss of appetite
- Weight loss
- Bloating
- Increased gas
- Stomach cramps
- Nausea
- Vomiting
- Muscle aches
- Low-grade fever
