‘Explosive Diarrhea’ Parasite Cases Near 1,000 in Michigan as Outbreak Spreads to 28 States

The number of confirmed cyclospora cases continues to jump, putting Americans on edge about what they can and cannot eat safely. Read on for the latest information about this parasite.

Cyclospora Cases Increasing Across Dozens of States

Cyclospora cases are soaring across much of the U.S. as public health officials race to determine the source of the parasitic infection that can lead to weeks of diarrhea. While at least 28 states have confirmed cases, Michigan seems to be the hot zone this time around. Confirmed cases in Michigan are approaching the 1,000-mark, making it the largest outbreak in the state's history and one of the most significant of its kind in U.S. history.

Although there have been no fatalities attributed to the infection, it is leading to an uptick in hospitalizations. Most of the patients are receiving treatment for severe dehydration.

Public health officials in Michigan first announced the cyclospora outbreak last week. At the time, all of the cases were confined to the southeastern corner of the state. To put the numbers into context, Michigan typically reports about 50 cases of cyclospora each year.

Adjacent Ohio is also reporting an unusually high number of cases. Northwest Ohio is experiencing the most activity, with more than 500 confirmed cases of the parasite.

According to the U.S. Centers for Disease Control and Prevention (CDC), cyclospora is a small parasite known to cause explosive bowel movements. While the illness is not usually life-threatening, it can result in severe dehydration that requires hospitalization. Outbreaks are the most common during the late spring and summer months.

Getting a formal diagnosis is key for treatment, as the infection responds well to antibiotics. The parasite thrives in the human bowels, spreading through fecal matter. Most people are infected with the parasite after eating contaminated fruits and vegetables that have come into contact with irrigation water containing feces.

Cyclospora is less common than food-borne illnesses such as E. coli and Salmonella. The volume of cyclospora cases has increased in recent years; however, some experts believe that the higher numbers may simply be a result of improved detection.

Comparing the Current Volume of Cases to Past Outbreaks

Health experts caution that it is difficult to understand the true scope of the outbreak. These types of outbreaks are generally significantly underreported because few people seek treatment. Most tests designed to detect food poisoning do not test for cyclospora.

In addition, comprehensive data on cyclospora outbreaks is lacking. What the data does show is that most outbreaks do not exceed 1,000 cases, making this particular outbreak more concerning. A 1997 outbreak blamed on raspberries imported from Guatemala sickened over 1,000 people in the U.S. and Canada. More recently, a 2019 outbreak tied to basil from Mexico made over 2,400 people ill.

It is also difficult to pinpoint the source of the parasite because one single ingredient may be used in several recipes. For example, basil could be used in salads, pastas, pizza, and more, making it challenging to discern where the parasite originated.

Lastly, food distributors often provide products to both restaurants and grocery stores. The wide reach of these products makes it harder to determine where the infected food first came from.

Dianna Blau, the CDC’s acting parasitic diseases branch chief, said that the latest cyclospora outbreak is not yet a national health emergency. No evidence points to the parasite becoming more infectious, despite numbers being about four times higher than what was recorded during this same time period last year.

It is also possible that while Michigan seems to be bearing the brunt of the infections, it could just be that the state is being more aggressive about testing and reporting.

How to Mitigate Your Risk of Cyclospora

Cyclospora is an invasive parasite, but that does not mean that you are helpless in lowering your risk. The best strategy is to avoid food or water that could have been contaminated. Although public health officials have not yet determined the culprit, foods that are susceptible to these types of parasites include bagged lettuce and salad mixes, fresh herbs, cucumbers, snap peas, and all types of berries.

This does not mean that you have to avoid fruits and vegetables entirely. Instead of bagged salad mixes, consider buying whole heads of lettuce and removing the first few leaves before washing the rest thoroughly under running water. Scrubbing firm produce with a brush will add another layer of protection. Cooking your vegetables will also work to reduce the risk. This is also a good excuse to visit your local farmers market to source locally grown produce.

Should you experience diarrhea, nausea, or stomach cramping that does not clear in a few days, it is a good idea to seek medical treatment and ask for antibiotics.

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