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Food Poisoning Information
What Is Cyclospora?
Cyclospora cayetanensis is a protozoan parasite that causes the diarrheal illness known as cyclosporiasis. People acquire this infection by consuming food or water contaminated with feces containing Cyclospora. Cyclosporiasis was not previously a reportable disease in the U.S., so its rise in prevalence is due in large part to the increased availability of tests that can detect Cyclospora. It is now a nationally notifiable disease, so physicians are required to report cases of this infection.
The first three cases of cyclosporiasis were reported in 1977 and 1978, but the parasite that was causing the illnesses could not at that time be identified as Cyclospora cayetanensis; it was not until 1979 that the correct identification was made.
What are the symptoms of Cyclospora?
The symptoms of cyclosporiasis vary from none to severe. In the majority of cases, people who have been infected with Cyclospora do not have any symptoms and do not remember ever having a diarrheal illness. Those who do get sick often experience a range of symptoms within two to 11 days of eating the contaminated food or water. The symptoms include:
- Diarrhea that occurs frequently and is watery
- Diarrhea interspersed with constipation
- Loss of appetite and weight loss
- Fatigue — this symptom can last for months after the acute infection has healed.
- Flatulence, bloating, and burping
- Stomach cramps
- Nausea and vomiting
- Muscle aches
- A general sense of malaise
The symptoms of cyclosporiasis can feel like acute gastroenteritis, which is an infection that causes inflammation in the stomach and intestines.
How long can the symptoms last?
The most common initial symptoms are a high fever, headache, and vomiting. If the illness is not treated, it may last from a few days to a month or more. The symptoms may appear to go away only to return at a later time (relapse). It’s typical to feel rather drained.
How common is this disease?
Cyclosporiasis is not very common, but it has become more prevalent in the U.S. since 1995. This is because testing for Cyclospora has become more widely available, so physicians are more likely to test for this disease if they have patients with diarrhea who live in or have traveled to countries where Cyclospora is endemic.
Cyclosporiasis affects approximately 15,000 people in the United States each year.
How is Cyclospora transmitted?
Cyclospora spreads through the fecal-oral route. When people are infected with this parasite, their feces may contain millions of Cyclospora parasites that are passed into the environment in their feces. If food or water becomes contaminated by feces containing Cyclospora, it can lead to further spread of the parasite.
This contamination can occur at the producer level, for example through contact with contaminated irrigation water or exposure to fecal contamination during harvesting. It can also occur at the processing stage if food that is contaminated with Cyclospora is not cooked or otherwise prepared before it is eaten.
Who is at risk?
Anyone who eats food or drinks water contaminated with feces containing Cyclospora parasites may become infected. Young children, the elderly and those whose immune systems are compromised are more likely than others to develop severe symptoms of cyclosporiasis.
How is it diagnosed?
If someone is sick with Cyclospora, the doctor will first do a physical examination to look for signs of infection. The doctor may also ask about recent travel and other risk factors.
Examination of stool samples, which can reveal Cyclospora parasites even if there are no symptoms present. Stool testing is the preferred method for diagnosing cyclosporiasis.
What is the treatment for Cyclospora?
Most people who have been diagnosed with cyclosporiasis recover fully. Symptoms usually stop within a few days to a month after they start, and a person’s immune system typically clears the infection.
Trimethoprim-sulfamethoxazole, also known as Bactrim*, Septra*, or Cotrim*, is a combination of two antibiotics that doctors use to treat Cyclosporiasis. People who have a fever should rest and drink plenty of fluids. They should also eat as normally as possible, although diarrhea may make this difficult.
How can cyclosporiasis be prevented?
To prevent the spread of Cyclospora: Wash your hands thoroughly with soap and water after using the bathroom or changing diapers; after handling food; before eating, and anytime you come in contact with another person’s feces. If water is not available, use an alcohol-based hand sanitizer that is at leas 60% alcohol.
Cook all food thoroughly; Avoid raw vegetables and fruits unless you are certain they have been washed in clean, running water or peeled by you or someone else.
Never eat raw cookie dough, cake batter, fresh salsa, salad dressing, or unpasteurized dairy products.
Seek medical attention
If you have a fever over 102 degrees, bloody stool, or other severe symptoms you should seek medical attention immediately.