Doctors share tips for staying safe during cyclosporiasis outbreak

In four days, the reported cyclosporiasis cases across the United States have nearly doubled. While Michigan is the biggest hotspot in the U.S. as of now, Delmarva residents may also wonder about their risk. 

The U.S. Centers for Disease Control and Prevention had logged 843 reported U.S. cases as of July 9, with the number rising to 1,645 as of July 13. As of both dates, Maryland was listed as having one to 10 cases, with Delaware reporting zero. 

Cyclosporiasis, also known as Cyclospora infection, is an intestinal infectious disease caused by a parasite called Cyclospora cayetanesis, generally causing a lot of watery diarrhea. 

Areej Khan, MD, who cares for patients at TidalHealth Infectious Disease in Delmar, says the outbreak is concerning, as case counts are rising over the years, it’s hard to identify the source and because the parasite resists standard disinfection methods. There’s also no vaccine for this.

Both she and Makondo Shimukowa, MD, who also cares for patients at TidalHealth Infectious Disease, recommend that people be cautious about what they’re eating, as it’s unknown what specific food or foods may be causing this. 

Dr. Shimukowa said even washing contaminated food doesn’t kill the parasite, so she would recommend not to eat salads and berries until the cause is determined. Baking soda or vinegar won’t help with washing the vegetables and fruits, either. Chlorine disinfectants also won’t help, Dr. Khan said. 

For those who already grow their own food, that should be safe, Dr. Shimukowa said. 

Foods to avoid

Although washing the food won’t kill the parasite, it’s still worth doing. Dr. Khan recommends to wash your hands before eating and wash all produce under running water. 

Both also mentioned that if vegetables or herbs are cooked, that would kill the parasite. 

“Avoid raspberries, as they have crevices in which parasites can hide,” Dr. Khan said. This includes frozen raspberries.

For those who want to eat lettuce, Dr. Khan said it’s safer to buy a head of lettuce and remove the first two layers, then wash the lettuce under running water, instead of buying a bagged mix. 

Symptoms

This outbreak has not caused any deaths, according to the CDC, though 141 people have been hospitalized. 

“Cyclospora is treatable, and early diagnosis can help shorten symptoms and prevent complications,” Dr. Khan said. 

Dr. Shimukowa said this illness leads to diarrhea that makes the person lose a lot of fluid and can lead to dehydration. People will also likely experience bloating.

If someone has serious symptoms, they may need to go to the Emergency Department, she said. If symptoms are less severe, they can go to their primary care practitioner. Cyclosporiasis can be treated with antibiotics.

While neither doctor has treated cyclosporiasis this summer, Dr. Shimukowa says she has seen this impact immunocompromised people in the past. 

Those who are immunocompromised, along with the elderly, should be extra cautious, she said. Dr. Khan also added that young children may also experience more serious symptoms. 

“A unique feature of Cyclospora infection is without antibiotic treatment, symptoms may come and go, sometimes lasting for weeks or even months,” Dr. Khan said. 

Both also mentioned that the symptoms don’t appear immediately after someone eats food with the parasite on it. It’s also not contagious from person-to-person.