Explosive Diarrhea Parasite: Cyclospora Outbreak in Multiple US States

Cyclospora Outbreaks Cause Explosive Diarrhea Parasite Infections in Multiple States

Federal health officials report a higher-than-expected number of cyclosporiasis cases caused by the explosive diarrhea parasite Cyclospora across several states, including Illinois, New York City, New York State, Pennsylvania, and Texas. The outbreaks may not all stem from a single source, and investigators are probing multiple clusters linked to Mexican-style restaurants, a grocery chain, and a catered event. The US Food and Drug Administration’s Coordinated Outbreak Response and Evaluation network is conducting traceback investigations on white and green onions, cucumbers, and cilantro.

Michigan typically logs about 50 cases of cyclosporiasis annually; it has now seen 681 since June 22.

Dr. Natasha Bagdasarian, chief medical executive for the state of Michigan, described the surge for this explosive diarrhea parasite as “highly unusual,” noting 708 cases over about 10 days. Cases could easily reach 1,000, according to Dr. Anurag Malani of Trinity Health Ann Arbor. At least eight additional clusters have been identified in Alabama, Kentucky, Michigan, Ohio, Pennsylvania, Tennessee, Virginia, and West Virginia.

The CDC says there’s no evidence at this point suggesting these clusters are part of a single multi-state outbreak. Investigations are ongoing.

The Debilitating Symptoms of Cyclosporiasis Can Persist for Weeks

The explosive diarrhea parasite cyclospora causes explosive diarrhea, severe cramping, and bloating that can last for weeks without treatment. Symptoms often mimic other stomach bugs but are unusually prolonged. Nausea, fatigue, and low-grade fever may also occur.

• Explosive diarrhea
• Severe abdominal cramps
• Bloating and gas
• Nausea and fatigue
• Low-grade fever

Untreated infections can lead to dehydration and weight loss, especially in vulnerable populations such as young children, the elderly, and immunocompromised individuals. Anyone experiencing persistent gastrointestinal symptoms should seek medical attention and mention possible cyclospora exposure.

How Cyclospora Spreads and How to Protect Yourself

Cyclospora is transmitted through ingestion of contaminated food or water. Fresh produce—especially berries, herbs, and Mexican-style vegetables—is a common vehicle. The FDA is currently investigating onions, cucumbers, and cilantro as potential sources.

1. Thoroughly wash all fruits and vegetables, especially those eaten raw. Note that the parasite may be resistant to standard sanitization.
2. Cook food to proper temperatures, as heat kills the parasite.
3. Avoid potentially contaminated water and ice in endemic areas.
4. Practice good hand hygiene after handling raw produce.

Because the parasite can survive on produce even after washing, cooking remains the most reliable prevention method. Health officials are scrambling to identify the specific food items driving the outbreak, with investigators pulling grocery shopping lists from affected individuals.

Key Takeaways

• Cyclospora outbreaks are occurring at higher-than-normal levels in several U.S. states, primarily linked to Mexican-style produce and restaurant clusters.
• Symptoms include prolonged diarrhea, cramping, and bloating, often lasting weeks without treatment.
• Transmission occurs through contaminated food or water; thorough washing and cooking can help reduce risk.
• Michigan has seen over 700 cases in recent weeks, far exceeding its typical annual count of 40-50.
• Federal and state health agencies are investigating multiple clusters but have not identified a single source.
• Anyone with persistent gastrointestinal illness should see a doctor and mention possible cyclospora exposure.