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Publisher’s Platform: What Is Cyclospora cayetanensis?

The parasite cyclospora has gained notoriety this week as it’s been revealed to be responsible for over 170 illnesses in the Midwest in June. What is this organism that is a relatively rare cause of foodborne illness outbreaks in the U.S.? Here’s a little primer:

What is cyclospora?

Cyclospora is a parasite composed of one cell, too small to be seen without a microscope. The organism was previously thought to be a blue-green alga or a large form of cryptosporidium. Cyclospora cayetanensis is the only species of this organism found in humans. The first known human cases of illness caused by cyclospora infection (that is, cyclosporiasis) were first discovered in 1977. An increase in the number of cases being reported began in the mid-1980s, in part due to the availability of better diagnostic techniques. Over 15,000 cases are estimated to occur in the United States each year. The first recorded cyclospora outbreak in North America occurred in 1990 and was linked to contaminated water. Since then, several cyclosporiasis outbreaks have been reported in the U.S. and Canada, many associated with eating fresh fruits or vegetables. In some developing countries, cyclosporiasis is common among the population and travelers to those areas have become infected as well.

Where does cyclospora come from?

Cyclospora is spread when people ingest water or food contaminated with infected stool. For example, exposure to contaminated water among farm workers may have been the original source of the parasite in raspberry-associated outbreaks in North America.

Cyclospora needs time (one to several weeks) after being passed in a bowel movement to become infectious. Therefore, it is unlikely that cyclospora is passed directly from one person to another. It is not known whether or not animals can be infected and pass infection to people.

What are the typical symptoms of Cyclospora infection?

Cyclospora infects the small intestine (bowel) and usually causes watery diarrhea, bloating, increased gas, stomach cramps, loss of appetite, nausea, low-grade fever, and fatigue. In some cases, vomiting, explosive diarrhea, muscle aches, and substantial weight loss can occur. Some people who are infected with cyclospora do not have any symptoms. Symptoms generally appear about a week after infection. If not treated, the illness may last from a few days up to six weeks. Symptoms may also recur one or more times. In addition, people who have previously been infected with cyclospora can become infected again.

What are the serious and long-term risks of cyclospora infection?

Cyclospora has been associated with a variety of chronic complications such as Guillain-Barre syndrome, reactive arthritis or Reiter’s syndrome, biliary disease, and acalculous cholecystitis. Since cyclospora infections tend to respond to the appropriate treatment, complications are more likely to occur in individuals who are not treated or not treated promptly. Extraintestinal infection also appears to occur more commonly in individuals with a compromised immune system.

How is cyclospora infection detected?

Your health care provider may ask you to submit stool specimen for analysis. Because testing for cyclospora infection can be difficult, you may be asked to submit several stool specimens over several days. Identification of this parasite in stool requires special laboratory tests that are not routinely done. Therefore, your health care provider should specifically request testing for cyclospora if it is suspected. Your health care provider might have your stool checked for other organisms that can cause similar symptoms.

How is cyclospora infection treated?

The recommended treatment for infection with cyclospora is a combination of two antibiotics, trimethoprim-sulfamethoxazole, also known as Bactrim, Septra, or Cotrim. People who have diarrhea should rest and drink plenty of fluids. No alternative drugs have been identified yet for people with cyclospora infection who are unable to take sulfa drugs. Some experimental studies, however, have suggested that ciprofloxacin or nitazoxanide may be effective, although to a lesser degree than trimethoprim-sulfamethoxazole. See your health care provider to discuss alternative treatment options.

How can Cyclospora infection be prevented?

Avoiding water or food that may be contaminated is advisable when traveling. Drinking bottled or boiled water and avoiding fresh ready-to-eat produce should help to reduce the risk of infection in regions with high rates of infection. Improving sanitary conditions in developing regions with poor environmental and economic conditions is likely to help to reduce exposure.

Washing fresh fruits and vegetables at home may help to remove some of the organisms, but cyclospora may remain on produce even after washing.

© Food Safety News
  • Oginikwe

    Thank you for this information, Mr. Marler.
    This sounds a lot like giardiasis, too, which is also miserable to have.

  • chris

    ive had these symptons for 2 months and have lost several pounds. Damn no insureance. help Obama care!!!!!

  • KC

    Why isn’t our government telling us who the producer of greens causing the outbreak is? They can’t control our food any more than our borders. To hell with all this touchy freely globalization crap (literally, sorry for that but it is!) a lot of us are under financial constraints. This is BS!

  • Anonymous50538

    Some of your stated ‘facts’ are inaccurate. I just came off of the FDA and CDC websites where it’s stated that the discovery of the first known human cyclosporiasis infection case was 1979- not 1977. Also, it’s incorrect to state that it’s not known if it can be passed from one person to another. This infection sickens people when they ingest the microbe; this is not an airbourne illness that will pass to another individual sitting next to the patient. This is a type of food-poisening so to speak, and most of us should recognize that you don’t ‘catch’ food poisening from another person.

    The danger, however, could lie in sharing a bathroom with a sickened person which has not been properly disinfected. You also must wash your hands with soap for at least 15 seconds. Imagine this scenario- You share a bathroom with an infected individual whom has been ill for over a week. The bathroom goes without being thoroughly disinfected and the bugs lie on the surfaces of the counter, sink, etc…you touch those surfaces, don’t wash your hands, and then within an hour touch your food. This is when it will be passed from one person to another.

    Aside from a few minor corrections, I have a few more important points to make. One is regarding treatment and the other is regarding our Government failing to name the source. I’ll start with the latter.

    Americans are witnessing and experiencing an unprecedented level of secrecy within their Government: the evidence is abundent. Congress is losing control of their oversight capabilities because things are hidden from them or they are lied to. I’ve seen the evidence of many recent instances. The only conclusion someone like myself can logically draw from all of this secrecy is that it is intentional and that they have great reason to fear backlash for the activites in which they are engaging. Why do I think this? It’s simple: Our Government is vast and there are still checks and balances in place where some of our officials still have a conscience. Thus secrecy is a lot of extra effort. I’m making that point in order to make this one: I strongly believe the source of the illness would have come from a large corporate food producer- not a smaller Mom-n-Pop organic farm. Who are the politicians in bed with? I actually believe there is greater oversight and safety to be found at the smaller organic farms. I realize it’s expensive to buy at your local health food store, but I personally am willing to forgo other luxuries for quality organic food, spring water, and supplements. I believe that I can’t afford not to. Think about the fact that ‘organic’ only exists because of the levels of danger that been imposed on our food sources- a sad commentary. I’m not hyping up this account; I’ve researched it well to find ample evidence.

    The second point I wanted to make is with regard to treatment. The Mayo clinic mentions utilizing antibiotics as an option. WHY would you use an antibiotic (kills only bacteria) on a patient that is sickened by a protozoa? This make NO sense. Furthermore, antibiotics weaken your immune system which a person desperately needs to fight ANY infection. How? For those unfamiliar, all antibiotics kill the good bacteria as well as the bad. Good bacteria (think probiotics) are absolutely essential for proper immune function. Ever heard of systemic candidiasis? That’s a brutal fungal infection that can proliferate throughout your entire body weakening your immunity even more, as a result of being overmedicated by antibiotics. This brings me to my last point- a potentially better method of treatment.
    A protozoa is a single-celled parasite, just like a yeast. There are many enzymatic-based supplements available on the market to work against any type of systemic yeast infection, which generally work by breaking down its cell wall to where it can no longer survive. It should not be hard for an enzyme, given in supplement form, to break down and destroy a simple protozoan microbe. The question is which enzymes would be effective? I’m curious enough to investigate further.

  • ab

    my question is, who the heck actually named it and how did it get its name!? Also who found it in the first case in 1979; the information that its 1977 is incorrect.

  • Willow

    I have been sick with these symptoms for 7 months. My family was all infected. My daughter got rid of it after 4 months and my son still has occasional mild attacks. This all started during the spring/summer outbreak in the US. The doctors I have seen refuse to treat me for parasites and refuse to test for this bug. They tested for other parasites. I am sick on a cyclical pattern twice a week Wed and Sat with worse attacks on the monthly anniversary of my first attack. I have lost 30 pounds since getting sick from malabsorbtion. Why won’t any medical doctor take me seriously and help me? Right now I am taking anti-parasitic herbs from a naturopath but I am beginning to think they are not going to kill this….and it might just kill me.

  • Anonymous

    It just sounds bad