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Cyclosporiasis (Cyclospora Infection): Symptoms - Prevention - Treatments

Author: Thomas C. Weiss : Contact: Disabled World

Published: 2013-09-20 : (Rev. 2019-11-29)

Synopsis and Key Points:

Information regarding cyclospora a newly recognized infectious organism that infects the small intestine.

A genus of apicomplexan parasites. It includes the species Cyclospora cayetanensis, the causative agent of cyclosporiasis.

The fact that cyclospora is still a newly recognized infectious organism finds a number of questions in regards to its biology, the way it is spread, and the illness it causes remaining unanswered.

Main Digest

Cyclospora is a single-celled parasite that is too small for a person to see with their naked eye; it is only 8-10 microns in diameter. Its full name is, 'Cyclospora cayetanensis,' although it used to be referred to as, 'cyanobacterium-like, 'coccidian-like,' and, 'Cyclospora-like,' bodies. The first known cases of Cyclospora infection were diagnosed in the year 1977 and reported in medical literature in 1979.

What is Cyclosporiasis?

Cyclosporiasis is an infection of the intestine caused by a parasite called Cyclospora (SIGH-clo-SPORE-uh). A genus of apicomplexan parasites, it includes the species Cyclospora cayetanensis, the causative agent of cyclosporiasis.

Anyone can get cyclosporiasis. The infection can occur in many countries, including the United States, but it is more common in tropical areas. The majority of cases and outbreaks are reported during the spring and summer months, although infections can occur year-round. People who have been infected with Cyclospora can become infected again.

Cyclospora infection causes watery, and sometimes explosive, diarrhea. The one-celled parasite that causes cyclospora infection can enter your body when you ingest contaminated food or water. Fresh produce is the culprit in many cases of cyclospora infection. Cyclospora is acquired by people ingesting something - such as food or water - that was contaminated with the parasite. Cyclospora needs days to weeks after being passed in a bowel movement to become infectious for another person. Therefore, it is unlikely that Cyclospora is passed directly from one person to another.

Since that time, people have been diagnosed with cyclospora infections with increased frequency, in part because of the availability of better techniques for detecting the parasite in stool samples. In the spring of 1996 there was a multi-state outbreak of cyclospora, including cases and suspected cases in northeastern Illinois. In other states in America, investigations have linked infections to the consumption of raspberries or strawberries. Very few cases are reported each year in the state of Illinois. The fact that cyclospora is still a newly recognized infectious organism finds a number of questions in regards to its biology, the way it is spread, and the illness it causes remaining unanswered.

Infected people shed unsporulated (non-infective; immature) Cyclospora cayetanensis oocysts in their stool; immature oocysts usually require at least 1 to 2 weeks under favorable laboratory conditions to sporulate and become infective. An unsporulated oocyst, with undifferentiated cytoplasm, is shown (far left), next to a sporulating oocyst that contains two immature sporocysts (A). An oocyst that was mechanically ruptured has released one of its two sporocysts (B). One free sporocyst is shown as well as two free sporozoites, the infective stage of the parasite (C). Oocysts (D) are auto-fluorescent when viewed under ultraviolet microscopy (E). (Image Credit: CDC/DPDx)
Infected people shed unsporulated (non-infective; immature) Cyclospora cayetanensis oocysts in their stool; immature oocysts usually require at least 1 to 2 weeks under favorable laboratory conditions to sporulate and become infective. An unsporulated oocyst, with undifferentiated cytoplasm, is shown (far left), next to a sporulating oocyst that contains two immature sporocysts (A). An oocyst that was mechanically ruptured has released one of its two sporocysts (B). One free sporocyst is shown as well as two free sporozoites, the infective stage of the parasite (C). Oocysts (D) are auto-fluorescent when viewed under ultraviolet microscopy (E). (Image Credit: CDC/DPDx)

Cyclospora is spread by a person placing something in their mouth that was contaminated with infected stool. For example, the parasite may be transmitted by swallowing contaminated food or water. It is not known how common the various modes of transmission are. It is also not known whether animals may become infected and serve as sources of infection in human beings.

Cyclospora is not infectious at the time it is passed in the stool of a person who is infected. The parasite does not become infectious until days or even weeks after it is passed in the stool. The amount of time depends upon factors such as humidity and temperature. What this means is the spread of cyclospora directly from a person who is infected to another person is unlikely. The potential for indirect spread of infection does exist however. For example, cyclospora may be spread if the stool of a person who is infected contaminates something in the environment such as water, to which another person is then exposed after the parasite has had enough time to become infectious.

Cyclospora and Infection

Chart showing the symptoms of a cyclospora infection
Chart showing the symptoms of a cyclospora infection

Unfortunately, people of all ages are at risk of cyclospora infection. While people who travel to tropical countries might be at an increased risk, infection may be acquired in nations to include Canada and the United States of America. The risk might vary with the seasons. Some evidence suggests that infection is more common in spring or summer seasons.

Cyclospora infects a person's small intestine and usually causes an illness characterized by watery diarrhea, with an average of around 6-7 stools each day. Additional symptoms may include:

Some people experience flu-like symptoms before noticing gastrointestinal ones. Others who experience a cyclospora infection do not experience any symptoms at all. The amount of time between becoming infected and the time a person begins experiencing symptoms averages several days and is often around a week, although longer and shorter times have been reported. If the infection remains untreated, the illness associated with it might last for a period lasting from a few days up to a month or even longer and may come back one or more times. Medical science does not know whether or not people with compromised immune systems, such as people with AIDS, more commonly develop severe illness associated with a cyclospora infection.

If you believe you might be infected with cyclospora you should contact your doctor. Identification of the parasite in stool requires specific kinds of laboratory techniques that are not used routinely and your doctor should request testing for the cyclospora parasite. More than one stool sample might need to be checked to find the organism. Your doctor may also want to have your stool checked for other infectious organisms that can cause symptoms that are similar.

A cyclospora infection is treatable with antibiotics. People who are infected and have diarrhea need to rest and drink plenty of fluids. They need to pursue their doctor's advice before taking any medications to slow their diarrhea.

Preventing Cyclospora Infection

Avoiding food or water that might have been contaminated with stool may help prevent Cyclospora infection. Consumers and retailers should always follow safe fruit and vegetable handling recommendations:

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.

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