Cyclosporiasis
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About... Cyclosporiasis
What is cyclosporiasis?
Cyclosporiasis (sigh-clo-spore-EYE-uh-sis) is an infection caused by a one-celled parasite, Cyclospora cayetanensis. In the past, cyclosporiasis was usually found in developing countries, however, in the last several years, more infections have been reported in the United States. Cyclosporiasis remains a common cause of “traveler’s diarrhea”. Because the parasite is protected by an outer shell (cyst), it can survive outside the body and in the environment for long periods of time. Concentrations of chlorine used in routine water treatment do not kill Cyclospora cysts. On average, one case of cyclosporiasis is reported in Indiana each year.
How is cyclosporiasis spread?
Cyclospora is passed in the stool, and people become infected by ingesting feces from an infected animal or person (fecal-oral route). Cyclosporiasis is likely not transmitted directly from person to person. Cyclospora needs time (days or weeks) after being passed in a bowel movement to become infectious. It is not known if animals can be infected and pass the infection to humans.
There are three main ways to become infected with Cyclospora:
- Eating contaminated food, such as fresh produce, or drinking water, usually while traveling to countries where the parasite is common.
- Swallowing contaminated water from lakes, rivers, or streams.
- Swallowing treated but unfiltered drinking or recreational water.
The most common sources of Cyclospora outbreaks have been linked to various types of imported fresh produce and recreational water.
What are the symptoms of cyclosporiasis?
- Watery diarrhea (sometimes explosive)
- Loss of appetite
- Increased gas
- Stomach cramps
- Nausea
- Vomiting
- Fatigue
- Weight loss
Symptoms usually begin one week after exposure and last from a few days to a month or longer. If not treated with antibiotics, symptoms can be prolonged and can fade and then return (relapse). Some people infected with Cyclospora may not have any symptoms. Being infected with Cyclospora and recovering from the infection does not provide any immunity against reinfection.
How do I know if I have cyclosporiasis?
A person with diarrhea that lasts more than 24 hours should consult a health care provider. The health care provider may collect a stool sample to test for Cyclospora.
How is cyclosporiasis treated?
A health care provider can prescribe antibiotics to treat cyclosporiasis. Since diarrhea can cause dehydration, an infected person should also drink plenty of fluids.
Is cyclosporiasis a reportable disease?
Yes. Health care providers or laboratories must report cases of cyclosporiasis to the local health department (LHD) or the Indiana State Department of Health (ISDH) within 72 hours of diagnosis. The LHD will contact all cases diagnosed with Cyclospora to determine a possible exposure and help prevent others from becoming ill.
How can cyclosporiasis be prevented?
In general, cyclosporiasis can be prevented by strictly adhering to the following guidelines:
- Practice good hygiene:
- Thoroughly wash hands with soap and water after using the restroom; after assisting someone with diarrhea and/or vomiting; after swimming; before, during, and after food preparation (please refer to Quick Facts about Hand Washing).
- Clean food preparation work surfaces, equipment, and utensils with soap and water before, during, and after food preparation.
- Separate raw and cooked foods:
- Avoid cross-contamination by separating produce, ready-to-eat foods, and cooked foods.
- Use separate equipment and utensils to handle raw foods.
- Eat safe foods and drink safe water (Remember: Contaminated foods may look and smell normal):
- Do not consume unpasteurized dairy products or juices.
- Wash all produce before cooking or eating raw.
- Use treated water for washing, cooking, and drinking.
- Avoid swallowing untreated water.
- Test your well if:
- Members of your family or others who use the same water are becoming ill,
- The well is located at the bottom of a hill or it is considered shallow, or
- The well is in a rural area where animals graze.
- Protect others:
- Persons with diarrhea and/or vomiting should not prepare food or provide health care for others and should limit direct contact with others as much as possible.
- Persons with diarrhea and/or vomiting should not attend a day care facility or school.
- Persons with diarrhea and/or vomiting shall be excluded from employment involving food handling (Indiana Retail Food Establishment Sanitation Requirements, 410 IAC 7-24-122).
- Do not change diapers near recreational water.
- Do not go swimming or use hot tubs if you have diarrhea and for at least 2 weeks after diarrhea stops.
- Safe travel outside of the United States:
- Drink bottled beverages and water, even when brushing teeth.
- Do not eat uncooked fruits or vegetables unless you peel them yourself.
- Do not eat foods or beverages from street vendors.
- Do not consume local water or ice.
Where can I find more information on cyclosporiasis?
To search Indiana data and statistics:
www.in.gov/isdh/dataandstats/disease/diseases_index.htm
To search disease information:
http://www.cdc.gov/ncidod/dpd/parasites/cyclospora/default.htm
http://www.cfsan.fda.gov/~mow/cyclosp.html
To search for national data, statistics, and outbreaks:
www.cdc.gov/mmwr/
Updated on January 6, 2009
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