Epidemics are big news! Pandemics are even bigger news! The media loves a good outbreak of an infectious, contagious disease because of the drama accompanying the unknowns, and the public anxiety they are able to generate because of it. The COVID-19 pandemic was the perfect example of what I mean.
Currently, Americans are spending a lot of mental energy worrying about an infectious disease I have not previously heard of. Cyclosporiasis is the current disease du jour that has captured public attention. It is a parasitic intestinal disease acquired by eating food contaminated with Cyclospora cayetanensis. This parasite is highly contagious and lives in the intestinal tract of symptomatic patients, and spreads via the “fecal-oral route.” Somehow, people ill with the disease get the parasite on their hands. They then unknowingly spread it. They acquire it originally by ingesting food or water contaminated with the parasite. Direct person-to-person spread is thought to be unlikely.
Anyone can get it, but travel to states and countries where Cyclospora is endemic puts patients at greatest risk of infection. Typically, tropical or subtropical climates or areas of higher humidity are more likely to have cases of cyclosporiasis. Cases were first reported in the U.S. around May 1 and since, it has appeared in 31 states and affected nearly 1000 patients. As of July 9th, 83 people have been hospitalized, but fortunately no deaths have occurred. The incubation period is 2 days to 2 weeks from exposure to clinical illness. Symptoms are watery diarrhea, explosive and uncontrollable bowel movements, nausea, abdominal pain, weight loss, gas, loss of appetite, fatigue, vomiting, fever, and flu-like symptoms.
To diagnose it, several specialized methods of testing a patient’s fecal material are used to identify evidence of the parasite and/or the oocytes they shed. Identifying these things is diagnostic of cyclosporiasis. Once confirmed, appropriate antibiotic treatment can be started.
The drug of choice is sulfamethoxazole-trimethoprim double strength (SMZ-TMP DS) taken twice daily for 7-10 days. Hydration is very important for symptom relief and prevention of dehydration. The. disease will get better without treatment but can last up to a month if not.
The best way to prevent Cyclosporiasis is to avoid eating food contaminated with the parasite. How you do that is not mentioned because you can’t tell food is contaminated just by looking at it. However, the minute you get sick, you know you’ve eaten contaminated food. The CDC states it’s not exactly known how fruits and vegetable become contaminated. So, if you’re in an area endemic for cyclosporiasis, you must be very careful what you eat and how the food is prepared. Frequent hand washing, especially when handling raw fruits and vegetables, and after using the bathroom, is very important. Washing fruits and vegetables thoroughly before cooking or eating is advised. Food labeled “pre-washed” is felt to be safe. Other foods must be heated to a temperature adequate to kill the parasite.
The media hype about this disease far surpasses the seriousness of it clinically. It can resolve on its own, is rarely, if ever, fatal, and only 83 patients were hospitalized because of it. But it’s still wise to be aware it exists.
References: https://www.cdc.gov/about-cyclosporiasis
www.cdc.gov/preventing-cyclosporiasis
www.cdc.gov/clinical-overview-cyclosporiasis
