Each summer, reports of foodborned illnesses tend to increase, and one parasite that often makes headlines is Cysclospora. While it’s less common than viral or bacterial stomach infections, Cyclospora can cause prolonged diarrhea and other uncomfortable digestive symptoms that may require medical treatment.
As cases emerge across the country, many people are wondering how to recognize the symptoms, whether they should be concerned, and what they can do to protect themselves.
Dr. Eyad Gharaibeh, GI hospitalist at Austin Gastroenterology, explains what you need to know about this intestinal parasite and when it’s time to seek medical care.
What is Cyclospora?
Cyclospora is a microscopic parasite that infects the small intestine. People become infected after consuming food or water contaminated with the parasite, often through fresh produce.
Unlike many foodborne illnesses that resolve within a few days, Cyclospora infections can linger for weeks if left untreated.
“Cyclospora spreads through food or water contaminated with feces,” says Dr. Gharaibeh. “While investigators continue working to identify the source during an outbreak, we’ve seen fresh produce repeatedly linked to Cyclospora infections over the years.”
What are the symptoms of Cyclospora?
The most common symptom is watery diarrhea, which typically begins about one week after exposure. However, many patients experience several other gastrointestinal symptoms, including:
- Watery diarrhea
- Loss of appetite
- Nausea
- Abdominal cramping
- Bloating
- Fatigue
One characteristic that makes Cyclospora different from many other stomach infections is its tendency to relapse.
“One of the distinctive features of Cyclospora is that symptoms often come and go,” explains Dr. Gharaibeh. “Patients may feel better for a day or two before another cycle of diarrhea returns.”
Because many illnesses can cause diarrhea, these symptoms alone do not necessarily mean someone has Cyclospora.
How do doctors diagnose Cyclospora?
Since diarrhea can have many different causes, proper testing is important before beginning treatment.
“When I suspect a parasitic infection, I order a Stool PCR test,” says Dr. Gharaibeh. “This test detects the DNA of parasites in a stool sample. It can also identify many bacteria and viruses that commonly cause infectious diarrhea.”
He notes that outside of known outbreaks, viruses and bacteria remain much more common causes of infectious diarrhea than parasites.
Additionally, not every case of diarrhea is caused by an infection.
“There are also many non-infectious causes of diarrhea that gastroenterologists are trained to diagnose and treat,” he says.
How can you reduce your risk of Cyclospora?
Because Cyclospora is spread through contaminated food and water, practicing good food safety is always important.
During previous outbreaks, the CDC has linked Cyclospora to certain fresh produce items, including:
- Basil
- Cilantro
- Raspberries
- Snow peas
- Mesclun lettuce
“When there’s an active outbreak, I personally recommend avoiding foods that have been associated with Cyclospora until more information becomes available,” says Dr. Gharaibeh.
Does washing produce prevent Cyclospora?
Unfortunately, washing fruits and vegetables is not always enough.
Cyclospora exists in a form called an oocyst, which strongly adheres to produce and is difficult to remove through routine washing.
“Washing your produce is still a good habit, but it doesn’t guarantee protection against Cyclospora,” says Dr. Gharaibeh. “The parasite’s eggs are very sticky and aren’t easily removed with water or standard produce washes.”
Some people soak produce in baking soda solutions to remove pesticide residue, but this has not been proven to eliminate Cyclospora.
Cooking food thoroughly remains the only reliable way to kill the parasite.
How long does Cyclospora last?
Without treatment, symptoms may last anyway from several days to a month or longer.
The illness often follows a frustrating pattern of improvement followed by recurrence.
“Patients frequently tell me they thought they were getting better, only to have the diarrhea return a few days later,” says Dr. Gharaibeh.
How is Cyclospora treated?
Unlike many viral stomach illnesses, Cyclospora typically requires prescription medication.
The recommended treatment is trimethoprim-sulfamethoxazole (TMP-SMX), an antibiotic that is effective against this parasite.
“TMP-SMX works by preventing the parasite from reproducing,” explains Dr. Gharaibeh. “Most patients improve once appropriate treatment is started.”
When should you see a doctor?
Most cases of diarrhea improve on their own within a few days. However, you should seek medical evaluation if you experience:
- Diarrhea lasting more than several days
- Symptoms that improve but repeatedly return
- Signs of dehydration
- Severe abdominal pain
- Bloody diarrhea
- Fever
- Persistent nausea or vomiting
Don’t Ignore Persistent Diarrhea
Although Cyclospora infections are relatively uncommon, recognizing the symptoms early can help you receive the right diagnosis and treatment more quickly. If you’ve developed prolonged or recurring diarrhea, it’s important to speak with your healthcare provider or a gastroenterologist.
At Austin Gastroenterology, our physicians are experienced in diagnosing and treating both infectious and non-infectious causes of diarrhea, helping patients find answers ad relief as quickly as possible.
