Cyclospora confusion? Four questions about the parasite in Minnesota, answered
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By the time summer rolls around, Minnesotans are eager to dive into their beloved lakes and ride bikes on trails. However, extreme heat, wildfire smoke and an army of mosquitoes and ticks can make summer less appealing.
This year, there is another curveball: a microscopic party crasher known as the cyclospora parasite, which is suspected of making over 18,000 people in the United States sick.
Cyclospora is typically found in contaminated produce or water and can lead to symptoms such as watery, frequent and explosive diarrhea.
While cases of gastrointestinal distress and diarrhea rise every summer in Minnesota, the likelihood that these incidents are due to the cyclospora parasite remains relatively low.
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Has the national cyclospora outbreak reached Minnesota?
Minnesotans can be reassured that the large multistate outbreak of cyclosporiasis infections, a gastrointestinal illness caused by cyclospora, has not yet reached the state.
The Minnesota Department of Health has identified 98 cases of cyclosporiasis since May1, marking the beginning of what the CDC considers cyclospora season in the U.S.
“We see cyclospora every single summer in Minnesota, and what we are seeing is right on par with what we would expect to see,” said Trisha Robinson, supervisor of the waterborne diseases unit at the Minnesota Department of Health.
Robinson mentioned that cases of cyclosporiasis are expected to increase for the remainder of the summer.
The health department has not identified any cases in Minnesota linked to the outbreak and is not observing any concerning trends. Currently, there is no evidence to suggest that the contaminated food items were distributed in Minnesota.
Why is it so hard to trace the source of an outbreak?
The CDC and U.S. Food and Drug Administration have linked a subcluster of the current cyclosporiasis outbreak to iceberg lettuce. Taylor Farms, the supplier, has recalled all iceberg lettuce sourced from central Mexico that is available in the U.S. market.
A separate investigation is ongoing to identify other cyclosporiasis clusters across the country, but no specific product has yet been pinpointed as the source.
Tracking the source of a cyclosporiasis outbreak can be more challenging than other foodborne illnesses due to its long incubation period and the difficulty in obtaining samples.
Robinson emphasized that there is typically about a one-week period between when a person is exposed to when they start showing symptoms, although it can sometimes take up to a couple of weeks.
Parasites have a much longer incubation period, requiring time outside the human host to become infectious. According to Robinson, this can result in a significant delay in symptoms, making it different from viruses like the common cold or influenza.
This delay in becoming infectious can lead to contamination events occurring long before the subsequent illnesses are recognized as part of an outbreak. This situation, Robinson said, is a key reason why identifying the exact source of an outbreak can take time.
How do people get infected with cyclospora?
Unlike other foodborne pathogens, such as salmonella and E. coli, cyclospora is primarily transmitted through food or water that has come into contact with human feces. This can occur when produce is irrigated or washed with contaminated water during agricultural production.
Robinson said cyclospora is most commonly associated with environmental contamination. If the irrigation water supply on a farm comes into contact with wastewater and is not adequately filtered, it can contaminate crops intended for human consumption, and people become ill after eating food, usually fresh produce that is contaminated with the parasite.
There is no evidence that cyclospora spreads from person to person. "This is a human-only pathogen," Robinson said.
What can Minnesotans do to stay healthy?
Cyclospora can remain on certain types of produce that are hard to wash thoroughly, such as leafy greens, cilantro, and berries. Robinson mentioned that cooking fresh produce at high temperatures effectively eliminates this parasite.
The health department advises following safe food-handling practices, which include washing hands and fresh produce, to minimize the risk of illness.
If diarrhea persists for an extended period, Robinson said it's important to contact a healthcare provider for appropriate treatment.
“Even though cyclospora seems to be the hot topic of the summer, there are lots of other pathogens that are causing diarrhea that also are important,” she said. “We want to make sure that they're not being overlooked.”
Healthcare providers can test for cyclospora. Robinson noted that they previously had to order a specific test for cyclospora. However, advances in testing methods have led to an increase in the number of identified cases over the past decade. Under Minnesota’s reportable disease regulations, all laboratory-confirmed cases must be reported to the Minnesota Department of Health.
Cyclosporiasis can be treated with a seven- to ten-day course of antibiotics, and most individuals start to feel better within a few days. Additionally, public health officials recommend replenishing lost fluids by drinking water or electrolyte solutions as an essential part of successful treatment and recovery.
