Cyclospora – Common Microscopic Parasite

Cyclospora cayetanensis is a microscopic (cannot see it without a microscope) parasite, that when ingested causes an intestinal illness – aptly named – Cyclosporiasis.  People can develop this illness by consuming food or water that is contaminated with the parasite.  It is most common in tropical and subtropical regions.

In the US this parasite is spread primarily through foodborne outbreaks linked to various imported fresh produce, such as lettuce, basil, raspberries and cilantro. Infection also occurs when those from the US travel to Cyclospora-endemic areas.  Beware… the treatment of water or food by routine chemical disinfection or sanitizing methods is unlikely to kill this nasty bug!

Cyclospora is a particularly tricky parasite.  It produces some common intestinal parasitic symptoms that include: diarrhea and explosive bowel movements, stomach cramps or pain, gas, nausea and fatigue.  Vomiting, headache, fever and body aches (flu-like symptoms) can also occur.  The not so common symptom is that the ‘illness’ phase may last a few days to a few months… then the person may start to feel much better, only to have their symptoms return!  To further complicate this bugger – It’s incubation period can be anywhere from 2 to 14 days!  Add to this, that diagnosis (done by examining stool samples) can be difficult at best.  The Centers for Disease Control and Prevention (CDC) warns that even patients with severe symptoms might not shed enough ‘evidence’ in their stool to detect this parasite.  Therefore, it often requires several stool specimens collected on different days.  Let’s make this even tougher…. Identification of this particular parasite requires special lab tests that are not routinely done when stool is tested for parasites.  Healthcare professionals must specifically request testing for Cyclospora!

If a diagnosis is made, antibiotics usually do the trick… but the ones that work are sulfa based. For those who have a sulfa allergy or who do not respond to this antibiotic treatment, there is no known alternative antibiotic treatment that works. Many seek alternative over-the-counter remedies.

Your best prevention is to follow safe fruit and vegetable handling recommendations and pay attention to all food recalls.  The following are prevention tips recommended by the CDC.

Wash: Wash hands with soap and warm water before and after handling or preparing fruits and vegetables. Wash cutting boards, dishes, utensils, and counter tops with soap and hot water between the preparation of raw meat, poultry, and seafood products and the preparation of fruits and vegetables that will not be cooked.

Prepare: Wash all fruits and vegetables thoroughly under running water before eating, cutting, or cooking. Fruits and vegetables that are labeled “prewashed” do not need to be washed again at home. Scrub firm fruits and vegetables, such as melons and cucumbers, with a clean produce brush. Cut away any damaged or bruised areas on fruits and vegetables before preparing and eating.

Store: Refrigerate cut, peeled, or cooked fruits and vegetables as soon as possible, or within 2 hours. Store fruits and vegetables away from raw meat, poultry, and seafood.