When foodborne illnesses make the news, names like Salmonella and E. coli often come to mind. Another infection that deserves attention is cyclosporiasis, an intestinal illness caused by the parasite Cyclospora cayetanensis. While it is less common than some other foodborne illnesses, it can cause prolonged digestive symptoms and may be linked to contaminated fresh produce.
What Is Cyclosporiasis?
Cyclosporiasis is an infection of the small intestine caused by the microscopic parasite Cyclospora cayetanensis. The illness primarily affects the digestive system and can last for days or even weeks if left untreated. Some people experience recurring symptoms that seem to improve before returning again.
What Are the Symptoms?
Symptoms usually begin about one week after swallowing the parasite, although they can appear anywhere from 2 to 14 days later. Common symptoms include:
- Frequent, watery diarrhea
- Loss of appetite
- Weight loss
- Stomach cramps and bloating
- Nausea and vomiting
- Fatigue
- Low-grade fever
Some people, especially healthy adults, may have mild symptoms or none at all. However, young children, older adults, and people with weakened immune systems may become more seriously ill.
How Do You Get Cyclosporiasis?
People become infected by consuming food or water contaminated with Cyclospora parasites. Fresh produce is the most common source because fruits and vegetables are often eaten raw.
Foods that have been linked to outbreaks include:
- Leafy greens
- Cilantro
- Basil
- Snow peas
- Raspberries
- Other fresh fruits and vegetables
Unlike many stomach bugs, Cyclospora is not usually spread directly from person to person. The parasite needs time in the environment, usually several days to weeks, before it becomes infectious. This makes direct transmission much less likely.
How Is It Diagnosed?
Because the symptoms are similar to many other gastrointestinal illnesses, your healthcare provider may order a stool test specifically designed to detect Cyclospora. Routine stool tests may not always identify the parasite, so it's important to mention recent travel or consumption of fresh produce if you've been sick.
Treatment
Cyclosporiasis is typically treated with the antibiotic trimethoprim-sulfamethoxazole (TMP-SMX), which is highly effective for most people.
If you are allergic to sulfa medications, your healthcare provider will discuss alternative treatment options, although they may be less effective.
During recovery, it's also important to:
- Drink plenty of fluids to prevent dehydration.
- Rest as needed.
- Follow your healthcare provider's recommendations if symptoms persist.
Prevention Tips
Although no method can eliminate all risk, these steps can help reduce your chances of infection:
- Wash fresh fruits and vegetables thoroughly under running water before eating.
- Refrigerate perishable produce promptly.
- Practice good hand hygiene before preparing or eating food.
- Drink safe, treated water, especially when traveling.
- Follow food safety alerts and recalls involving fresh produce.
Keep in mind that washing produce may reduce contamination but may not completely remove Cyclospora. Buying produce from reputable sources and staying informed about food recalls can also help lower your risk.
When Should You See a Healthcare Provider?
Contact your healthcare provider if you experience:
- Diarrhea lasting more than a few days
- Severe dehydration
- Bloody stools
- High fever
- Significant weight loss
- Persistent vomiting
Early diagnosis and treatment can shorten the illness and help prevent complications.
The Bottom Line
Cyclosporiasis is a preventable foodborne illness caused by the parasite Cyclospora cayetanensis. It is most often linked to contaminated fresh produce and causes prolonged diarrhea and digestive discomfort. Fortunately, it is treatable with the appropriate antibiotic, and following good food safety practices can help reduce your risk of infection.
If you develop ongoing diarrhea after eating fresh produce or traveling, don't ignore your symptoms. Talk with your healthcare provider to determine whether testing for Cyclospora is appropriate.
References
1. CDC, About Cyclosporiasis
2. CDC, Clinical Guidance for Cyclosporiasis
3. FDA, Cyclospora Prevention, Response and Research Action Plan
