September 3, 2021 | Susan Napier-Sewell

Parasite Spikes Illnesses: Cyclospora


Likely as not, there is someone out there who practiced every pandemic precaution only to become infected with Cyclospora in the past month.

The small intestine infection associated with Cyclospora usually announces itself with frequent watery and sometimes explosive diarrhea and bowel movements.

In the past month, an additional 402 cases of “domestically acquired cases of Cyclosporiasis” have been reported, according to the federal Centers of Disease Control and Prevention. The CDC continues taking these reports, which since May have totaled 864 illnesses in 34 states.

Cyclospora cayetanensis is a parasite so small it can be seen only under a microscope.

It causes cyclosporiasis, causing loss of appetite, weight loss, stomach cramps, bloating and increased gas, nausea, and fatigue. It’s common to feel very tired, and other common symptoms include vomiting, body aches, headaches, low-grade fever, and other flu-like symptoms.

The parasite has yet to kill anyone this year, but it has required the hospitalization of 59 people. The median illness onset date is June 24, 2021, with the range for onset dates running from May 1, 2021, to Aug. 7, 2021.

According to reports by 34 states and New York City, none of the 864 people suffering from cyclosporiasis reported any international travel during the 14 days before they became ill from the parasite.

People living or traveling in countries where cyclosporiasis is expected, including certain tropical and subtropical regions, are at increased risk for infection. Food or water contaminated with the parasite can also transmit the illness.

“Domestically-acquired” outbreaks of Cyclosporiasis in the United States have, in recent years, been linked to various types of fresh produce, including basil, cilantro, mesclun lettuce, raspberries and snow peas.  

According to the CDC, “domestically-acquired” illnesses are reported year-round, but a spike comes in the spring and summer months. The exact timing and duration of these outbreaks can vary but usually run from May through September.

The most recent Cyclospora-rated recall was in June. That’s when Dole Diversified North America Inc. recalled a limited number of cases of Dole fresh blueberries packaged in various clamshell sizes for potential Cyclospora contamination.  At the time, the company said the recall was because of possible Cyclospora.

Dole Diversified North America Inc. said no illnesses were associated with the recall.

Before that, there were four recalls of organic basil. Those came on Feb. 8, 2021; Feb. 5, 2021; Nov. 27, 2020; and Nov. 24, 2020, for various brand names by Shenandoah Growers and Vallarta Organics. While the parasite likes to live on basil, the CDC has not said any of these recalls are associated with the near 900 illnesses.

Cyclospora usuallyis transmitted when microscopic amounts of infected feces contaminate food or water, according to the U.S. Food and Drug Administration.

It’s unlikely to be transmitted directly from person to person because the parasite needs time (days to weeks) to become infectious for another person after being passed in a bowel movement.

Anyone can become infected with Cyclospora by consuming food or water that is contaminated with the parasite.

Rinsing or washing foods that transmit the parasite are not likely to remove it.  Nevertheless, according to CDC guidance, consumers should follow these steps:

  • Wash the inside walls and shelves of the refrigerator, cutting boards, and countertops.
  • Sanitize them with a solution of one tablespoon of chlorine bleach one gallon of hot water.
  • Dry with a clean cloth or paper towel not previously used.
  • Wash hands with warm water and soap for at least 20 seconds before and after handling food.
  • Wipe up spills in the refrigerator immediately and clean them on a regular schedule.
  • Wash hands with hot, soapy water after doing any cleaning and sanitizing tasks.
  • See a health care provider anytime illnesses may be due to contaminated foods.

CDC also advises consumers to make sure the retailers and restaurants they do business with always practice safe food handling.

Source: Food Safety News, “Parasite causes illnesses to spike, but they’ve not been connected to recalls,” Dan Flynn, September 3, 2021.

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