Friday, August 9, 2013

Cyclospora — What Is It?

By Gilbert Handal, MD
Infectious Disease/Clinical Care Physician
Professor, Department of Pediatrics, Texas Tech University Health Sciences Center, El Paso

The Centers for Disease Control and Prevention has reported that as of Aug. 9, 514 cases of cyclosporiasis have been reported in 17 states. 206 cases have been reported from Texas, but this outbreak has subsided as most of the cases appeared in late June and July.

Cyclospora Cayetanensis is a parasite that infects humans usually through the consumption of fresh produce, especially lettuce and berries. The source of the infection in this outbreak has not been identified with certainty, but in Iowa and Nebraska ― two other states with a high incidence of cases ― premixed salad from Taylor Farms in Mexico was found to be contaminated with cyclospora. The investigation is not complete yet as many more samples from the same premixed salad have tested negative for the parasite.

An infected person can have a variable incubation (the amount of time it takes for an infected individual to show symptoms); the symptoms can appear between two days to two weeks after the infection but can be as long as one month.

There is no direct transmission from person to person.

Some people are infected and show no symptoms, but many patients will experience severe, frequent, watery diarrhea; bloating; cramping; excessive gases; and vomiting. They may also have a low-grade fever.

If the infection is not treated, the illness may last anywhere from a few days to a month or longer. If you think you may be infected with Cyclospora, contact your physician. Diagnosing this parasite requires a special test, which is not done routinely. And this parasite is fairly uncommon among patients, so it takes time to identify. So when it comes to identifying an infection, patients and physicians must be diligent. Patients must talk over their symptoms with their physicians.

The same is true when it comes to uncovering the source of a community-wide or multistate outbreak. Patients, physicians, laboratories, and public health investigators, all work together to share information.

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