If you've been following the news, you've probably heard about cyclospora outbreaks linked to fresh produce. Cyclospora is a parasite that causes an intestinal infection called cyclosporiasis. It's not as well-known as E. coli or salmonella, but it's increasingly common. Here's what you need to know to protect yourself.
What is cyclospora?
Cyclospora cayetanensis is a single-celled parasite that infects the small intestine. It's transmitted through food or water contaminated with feces containing the parasite. Unlike bacteria, cyclospora needs days to weeks after being passed in stool to become infectious, which means direct person-to-person transmission is unlikely.
The parasite is more common in tropical and subtropical regions, but outbreaks in the United States have increased over the past decade. Most U.S. cases are linked to imported fresh produce, particularly leafy greens, berries, and herbs.
Symptoms
The hallmark symptom is watery, explosive diarrhea that can be persistent and relapsing. Symptoms typically start about a week after exposure and can last for weeks if untreated. Other symptoms include loss of appetite, weight loss, stomach cramps, bloating, nausea, fatigue, and low-grade fever.
Some people infected with cyclospora never develop symptoms. They can still shed the parasite and potentially infect others, though this is less common than symptomatic transmission.
Recent outbreaks
In recent years, cyclospora outbreaks have been linked to bagged salad mixes, fresh basil, raspberries, and other produce. The CDC investigates outbreaks and issues recalls when contaminated products are identified. Texas has seen cases in multiple outbreak investigations due to our large population and diverse food supply chain.
Outbreaks tend to peak in spring and summer when fresh produce consumption increases and import volumes are higher. The parasite doesn't survive cooking or freezing well, so most cases are linked to raw produce.
How to reduce your risk
Washing produce reduces but doesn't eliminate risk. Cyclospora oocysts are resistant to chlorine and can survive standard washing procedures. However, thorough washing under running water is still recommended. Scrub firm produce like cucumbers with a clean brush.
The most effective way to kill cyclospora is heat. Cooking produce to an internal temperature of 165°F destroys the parasite. If you're concerned about an outbreak, cooking high-risk produce is the safest option.
Pay attention to recall notices from the CDC and FDA. If a product you purchased is part of a recall, discard it or return it. Don't eat produce that's been recalled due to parasitic contamination.
Diagnosis and treatment
Cyclosporiasis is diagnosed through stool testing. Special tests are needed to detect cyclospora, so if you have persistent diarrhea and suspect parasitic infection, ask your doctor specifically about cyclospora testing. Standard stool cultures may not detect it.
The treatment is trimethoprim-sulfamethoxazole (Bactrim, Septra), typically taken for 7 to 10 days. Most people respond quickly to treatment, with symptoms improving within a few days. Without treatment, symptoms can persist for weeks or even months.
For people allergic to sulfa drugs, there are limited alternatives. Nitazoxanide has been used in some cases, but it's less effective. Your doctor will work with you to find the best option if you have allergies.
When to see a doctor
If you have diarrhea lasting more than a few days, especially if it's watery and persistent, see your doctor. This is especially important if you've recently eaten fresh produce that might be part of an outbreak, traveled to a tropical country, or have symptoms like significant weight loss or fever.
Dehydration is the main concern with prolonged diarrhea. If you can't keep fluids down, feel dizzy or confused, or have significantly decreased urination, seek medical attention immediately.
The bigger picture
Cyclospora outbreaks highlight the challenges of our global food supply. Produce grown in one country can be distributed across the United States within days. While this gives us access to fresh food year-round, it also means outbreaks can affect multiple states simultaneously.
Food safety regulations continue to evolve in response to these outbreaks. Importers and growers are implementing better practices, but the risk can't be eliminated entirely. Consumer awareness and proper food handling remain important defenses.
How we can help
At FloMD Primary Care in Cypress, TX, serving Northwest Houston and surrounding communities, we diagnose and treat parasitic infections including cyclosporiasis. If you have persistent gastrointestinal symptoms, we can order the appropriate tests and get you on the right treatment.
If you're experiencing prolonged diarrhea or other digestive symptoms, schedule an appointment with us. We'll figure out what's going on and get you feeling better.
