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Cyclospora Can Cause Weeks of Illness Before Being Identified

Nell Townsend was perplexed when she woke up the morning before her family vacation and didn’t have any energy. The retired 65 year-old from Jacksonville, FL, leads an active life, travels often and never gets sick. But on this particular June morning, she just felt lethargic, apathetic and not herself.

As it turned out, Townsend was infected with Cyclospora, a single-celled foodborne parasite of which she had never heard. At the same time, the bug was infecting hundreds of other unsuspecting people around the country.

For Townsend and many other victims, it would take anywhere from weeks to more than a month to learn what was really making them sick. Cyclospora’s long incubation period of several days to several weeks – coupled with a level of rarity that keeps it off many doctors’ radar – resulted in many people experiencing diarrhea, cramping, fatigue and other symptoms for weeks without knowing why.

By the time Townsend’s family left for their vacation the next day, she was suffering all the classic symptoms. Throughout the five-day trip, she tried to tough out diarrhea, fatigue and severe chills.

“I took Pepto Bismol, Immodium, anything I could think of to feel better,” she said. “I was tired the entire time, and I had no appetite, which wasn’t like me. I just felt crappy.”

Townsend said she even came down with shingles, which she had once before, attributing it to her weakened immune system.

She visited her doctor as soon as she got home. She was told that she probably had a stomach bug and was sent home with a prescription to treat the shingles.

But 10 days later, Townsend was still suffering from diarrhea and chills. It had now been more than two weeks since she first came down with symptoms, and, in that time, she had lost 11 pounds.

She went back to the doctor, who took some samples for testing. She first felt ill on June 19, but it wasn’t until July 16 that she learned she was infected with a parasite called Cyclospora and given an antibiotic to treat it.

Townsend was sickened for a total of five weeks and spent that entire time with diarrhea, fatigue and constant chills.

One of at least 29 confirmed Cyclospora cases in Florida, Townsend’s case has not been officially linked to any contamination source. Only victims from Iowa and Nebraska have had their infections connected to lettuce grown by Taylor Farms de Mexico and served in salads at Olive Garden and Red Lobster outlets in those states.

It is not clear if Darden Restaurants, which owns Olive Garden and Red Lobster, sourced its lettuce from Taylor Farms in any states other than Nebraska and Iowa. A company representative has previously been quoted as saying that its Texas restaurants did not use Taylor lettuce.

Townsend said she did eat at an Olive Garden on June 12, one week before first feeling ill. She shared a salad with a friend, who did not come down with any symptoms.

Christine Mann, spokeswoman for the Texas Department of State Health Services, said that the illnesses in Texas and many other states developed one to two weeks after the Iowa and Nebraska ones and don’t seem to have a clear epidemiological connection to the Darden restaurants. She reiterated that Cyclospora’s relatively long incubation period means it’s more difficult for victims to remember back to the meals they ate one or two weeks prior.

“By the time all the cases are reported to the CDC, several weeks have gone by,” Mann said. “When an epidemiologist interviews cases, people might not remember to make a connection back to what really might have gotten them sick.”

Mann said the entire state of Texas typically sees 10 to 12 reported cases of Cyclospora infections each year. Since June, the state has recorded 258 such cases, making it the hardest hit in the ongoing round of infections.

While Townsend said her illness ruined her family vacation and generally made life difficult for the five weeks she had to deal with it, the experience wasn’t all bad.

“It made it hard to travel and work out and clean the house, and it has really made me cautious of eating salad,” she said, “but it also really jump-started my diet.”

© Food Safety News
  • J’Marinde Shephard

    How about some information on how to avoid this; ex. cooking, for how long, to what temp, etc???
    I fry my lettuce and radishes. (YUM!) Would that help?

  • flameforjustice

    Not knowing the source of all these outbreaks is dangerous for all who consume food unless they grow their own safely,parasite free, toxic free, and free of all illness making pathogens.