Cyclosporiasis, a gastrointestinal disease that causes symptoms like explosive diarrhea from ingesting contaminated water or produce, is on the rise in the U.S.
The Centers for Disease Control and Prevention has officially confirmed over 800 cases in more than 30 states, including Florida.
NPR reports the actual number of infections is likely much higher, because that total is only cases reported by states directly to the CDC.
For example, as of Monday, the state of Michigan had reported more than 2,600 cases alone.
The source of the foodborne outbreak hasn’t been confirmed. On Monday, Michigan health officials identified "lettuce or salad greens" as a possible source for the outbreak, "no specific type of produce, grower or supplier has been identified."
As the investigation continues, some experts in foodborne illness say the outbreak was preventable.
Jill Roberts, a professor of environmental health biology in the University of South Florida College of Public Health, has been teaching about this disease for years.
Unfortunately, she said, this outbreak was predictable because of funding cuts that scaled back the CDC’s FoodNet surveillance network, which tracks foodborne illnesses. As of last year, such reporting is optional.
ALSO READ: CDC dramatically scales back program that tracks food poisoning infections
“An incredibly important prevention method is to get those surveillance systems back up and running,” Roberts said. “When we were able to detect these things fast, we can keep them out of the food systems.”
What is cyclosporiasis?
The “not so classy” disease, as Roberts categorizes it, is caused by cyclospora, a parasite, which contaminates water or produce.
It’s a seasonal disease, she said, and it usually trends up in the summer, in line with the parasite’s life cycle.
Cyclospora isn't found in the U.S., Roberts said, and past outbreaks have been traced to produce imported from other countries.
It’s not considered a dangerous disease, she added, saying “it’s more annoying.”
Cyclosporiasis causes diarrhea and gas, Roberts said, making it “literally explosive.” The diarrhea can last for weeks, removing any doubt that it’s another type of food illness, she said. A person can have it for weeks or months, and it might stop, and then return.
Other symptoms include abdominal pain and bloating, she said, but they don’t usually get worse than that. In addition, it doesn’t usually cause serious injuries in otherwise healthy people, Roberts said.
There’s treatment for it, Roberts said, which is especially important for people with weak immune systems.
Anita Cihlar, nutrition director at Neighborly Senior Care Network Meals on Wheels in Pinellas County, said senior populations need to be extra careful during the outbreak.
“Seniors are more vulnerable for foodborne illness in general, just because of advanced age can make their immune systems weaker,” Cihlar said.
Seniors might have other conditions they’re managing, she added, which can make that age group more vulnerable. It’s important for them, as well as caretakers, to pay attention to advisories on foods causing foodborne illness, she said.
The impact of the lack of surveillance
Early detection is an important prevention method, Roberts said. But now that FoodNet is scaled back, “we have to be reactive instead of proactive.”
It’s up to epidemiologists to track down the source of the outbreak through interviewing people with cyclosporiasis, Roberts said.
ALSO READ: A diarrhea-causing parasite is in dozens of states, including Florida. What is cyclospora?
But that's not an easy process. The incubation period for cyclosporiasis can range from two days to over two weeks, according to the CDC.
People simply might not remember what they’ve eaten in that time period, she said, making it harder to pinpoint the source of the outbreak.
This year’s outbreak is something Roberts said she expected when she learned about FoodNet’s funding cuts.
“Watching the surveillance systems kind of get gutted, my No. 1 prediction was ‘screwworms (are) going to end up in the U.S.,’ ” Roberts said. “And they did. My No. 2 prediction is … we’re going to see all those things that FoodNet was tracing that we’ve just decided to cut all that funding (for) because the people doing the cuts don’t understand the importance of the systems.”
Another concern Roberts has is the possibility of cyclospora beginning to infest U.S. crops as more pathogens move into the country due to climate change.
“As it gets hotter here, cyclospora may become established in the U.S.,” she said. “It’s something we should really keep doing surveillance for.”
How to avoid the unpleasant disease
Washing produce might help a person avoid getting cyclosporiasis, Roberts said, but it’s not a guarantee.
You might be able to wash off some of the parasites, but “sometimes they’re a little bit sticky,” she said, and it’s easy for them to hide in crevices on fruit and vegetables.
Cyclospora is also resistant to bleach and vinegar, Roberts said — a precaution she's been asked about.
The only way to ensure you remove any potential parasite is through cooking produce, she said, adding that high temperatures will kill it.
Because the parasite isn’t found in U.S. crops, Roberts recommends buying produce grown domestically.
The illness has been linked in the past to such products as cilantro, basil, raspberries and snow peas, Roberts said. She suggests avoiding those until the source of the outbreak is determined.
If you want to eat produce raw, she said, it’s important to weigh personal risks.
“Are you a healthy college kid who has no comorbidities and could get diarrhea and be fine?” Roberts said. “That’s a different conversation than, ‘Are you an at-risk person who is in cancer treatment?’
"In (that) case, absolutely not.”
