What you need to know
- The U.S. is experiencing an outbreak of cyclosporiasis, a stomach infection that spreads through eating contaminated foods.
- There are more than 18,000 confirmed or suspected cases as of August 3 across several states, but most cases are in Michigan and Ohio.
- To protect yourself, wash all fruits and vegetables before eating or cooking (though washing alone may not fully remove the cyclospora parasite); refrigerate fresh produce promptly; and if you’re consuming lettuce, stick with heads of lettuce (instead of bagged lettuce), remove the outer two to three layers, and wash it.
Several U.S. states are experiencing an outbreak of cyclosporiasis, a stomach infection that causes frequent, watery, “explosive” diarrhea. The CDC says there are more than 18,000 confirmed or suspected cases across the country as of August 3, with most cases in Michigan and Ohio. On August 3, the Michigan Department of Health and Human Services reported that two people have died as a result of the outbreak.
The infection doesn’t transmit from person to person: It’s spread through eating food or drinking water that has been contaminated with feces. While public health officials are still investigating the exact source of the current outbreak, previous outbreaks have been caused by contaminated lettuce, raspberries, cilantro, and basil.
Cyclosporiasis usually spreads more easily in the summer because of the heat, given that “the parasite in the stool, in the environment, and in vegetables within high temperatures can become infectious,” Dr. Peter Chin-Hong, an infectious disease specialist and associate dean at the University of California, San Francisco, tells Public Good News.
Read on to learn more about the current cyclosporiasis outbreak.
What are the symptoms?
According to the Centers for Disease Control and Prevention, the most common symptoms of cyclosporiasis include:
- Frequent, watery diarrhea
- Weight loss
- Fatigue
- Nausea
- Cramping
- Loss of appetite
- Bloating
- Increased gas
Less common symptoms include vomiting, headaches, and low-grade fever.
What should I do if I have symptoms?
If you have symptoms, stay hydrated, and contact your health care provider. The only way to diagnose cyclosporiasis is to get your stool tested. If your sample is positive, Dr. Chin-Hong explains that your doctor may prescribe an antibiotic to treat it.
What is causing this outbreak?
Michigan has reported over 4,000 cases as of July 16. Dr. Natasha Bagdasarian, chief medical executive for the state, tells PGN that “based on our early signals, that there is some implication that lettuce, bagged lettuce or bagged salad kits could be involved in this outbreak.”
However, other foods have not been completely ruled out, and the exact source of the outbreak in other states is unclear.
How can I protect myself from cyclosporiasis?
Chin-Hong explains that you don’t have to avoid eating all fruits and vegetables, especially if you live in a state where cases are low.
However, if you live in a state where cases are high, including Michigan, Ohio, New York, Illinois, Indiana, and North Carolina, there are some precautions you can take.
In Michigan, Bagdasarian says, “if you are going to eat a salad or lettuce right now, the safest way to do that is to buy a whole head of lettuce to remove the outer layers and remove any damaged parts, and then of course washing.” Bagged lettuce is harder to wash again at home, while whole heads let you remove the outer leaves where contamination is more likely.
Additionally, she says that “if it’s something that can be peeled, you should peel it, [and] if it’s something that can be cooked, cooking is actually the best way to reduce your risk.”
Overall, the CDC says that to prevent cyclosporiasis, you should take the following precautions when it comes to fresh produce:
- Wash your hands with soap and water before touching raw fruits and vegetables.
- Wash all fruits and vegetables before eating or cooking (However, keep in mind that washing fruits and vegetables can reduce dirt and some contaminants, but it may not completely remove cyclospora.)
- Cut damaged areas of fruits and vegetables.
- Refrigerate cooked, cut, or peeled fruits and vegetables within two hours.
What are the differences between cyclosporiasis and other types of food poisoning (caused by bacteria like E. coli or salmonella)?
The main difference, according to Chin-Hong, is that cyclosporiasis can last longer and a person can get better and then get symptoms again. However, similarly to other types of food poisoning, the frequent diarrhea can cause dehydration, which, he adds, can lead to people being hospitalized.
Another difference is that unlike other similar illnesses, cyclosporiasis symptoms don’t begin right away. Most people become sick about one week after eating contaminated food or drinking contaminated water, though it can take anywhere from two days to about two weeks.
Who’s most at risk?
Bagdasarian says that people who face a higher risk with cyclosporiasis include those who are immunocompromised and people who are at higher risk for dehydration, including very young children and older adults.
She adds that “if you have people in your family, in your household who fall into any of those categories, it would be wise to be extra cautious about the food you’re eating, including when you go out to eat at a restaurant or a fast food chain.”
For more information, talk to your health care provider or local health department.
(Disclosure: The Michigan Department of Health and Human Services is a partner of The Public Good Projects, the organization that owns Public Good News.)