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Cyclospora Infection: Prevention, Symptoms and Treatment

  • Date: 2013/09/20 (Rev. 2016/06/13)
  • Disabled World
  • Synopsis : Information regarding cyclospora a newly recognized infectious organism that infects the small intestine.

Main Document

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.

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

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

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:

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

  • Nausea
  • Bloating
  • Vomiting
  • Tiredness
  • Weight loss
  • Muscle aches
  • Increased gas
  • Loss of appetite
  • Low-grade fever
  • Stomach cramps

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 a Cyclospora Infection

Based upon information that is currently available concerning how cyclospora infection is spread, avoiding food and water that might be contaminated with stool is most likely the best way to prevent infection. It is also important to wash produce thoroughly before you eat it. People who are infected should wash their hands often in order to prevent the spread of cyclospora infection. People who have previously been infected may become infected again.

A new cyclospora outbreak was noted in the state of Iowa when two people were diagnosed and reported to the CDC on June 28th, 2013. The disease was reported to the CDC because it has been infrequently documented in America and is believed to be endemic in some semitropical nations. As of July 24th, 2013 285 people in 11 states in America have been diagnosed with cyclospora infections with other awaiting a diagnosis. Eighteen people have been hospitalized with the infection. The largest numbers of people who have become infected have been in the states of Nebraska, Iowa, and Texas.

Between August 11-19, 2013, the FDA in cooperation with Mexican government authorities and Taylor Farms de Mexico, S. de R.L. de C.V., conducted an environmental assessment of Taylor Farms de Mexico's processing facility and five farms identified through the cyclospora outbreak's traceback investigation. The team discovered that conditions and practices observed at the facilities at the time of the assessment were in accordance with known food safety protocols.

Epidemiologic and traceback investigations by the states of Nebraska and Iowa, the FDA and CDC had linked salad mix supplied by the firm to Red Lobster and Olive Garden restaurants. The last date someone who had eaten in one of these restaurants reported becoming ill with a cyclospora infection was on July 2nd, 2013 - more than 5 weeks before the start of the environmental assessment. As a result of the environmental assessment and the FDA's product sampling plan for cyclospora, the FDA agreed to Taylor Farms de Mexico resuming operations. The firm has committed to comprehensive cyclospora sampling for leafy green and other products from their farms and processing facility in Mexico. The sampling includes both products and water.


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