Cyclosporiasis: Symptoms, Treatment and How It Spreads

Not every case of diar­rhea is caused by a typ­i­cal stom­ach bug. When symp­toms linger, return after you thought you were feel­ing bet­ter, or leave you feel­ing unusu­al­ly tired and run down, it may be time to look for anoth­er cause.

One pos­si­ble cause is Cyclospo­ra, a micro­scop­ic par­a­site that can lead to an intesti­nal infec­tion called cyclospo­ri­a­sis. Recent cas­es have been iden­ti­fied, and health offi­cials con­tin­ue to inves­ti­gate the source. Know­ing the symp­toms and when to seek care can help you take the next step toward feel­ing better.

Cyclospo­ra spreads when some­one con­sumes food or water con­t­a­m­i­nat­ed with the par­a­site. Because Cyclospo­ra is too small to see with­out a micro­scope, con­t­a­m­i­nat­ed food or water may look, smell and taste normal.

Most peo­ple recov­er com­plete­ly with appro­pri­ate treat­ment, but with­out care, symp­toms can con­tin­ue for weeks and may lead to dehy­dra­tion, fatigue and unin­tend­ed weight loss.

What are the symp­toms of Cyclospora?

The most com­mon symp­tom of Cyclospo­ra infec­tion is fre­quent, watery diar­rhea. Symp­toms typ­i­cal­ly begin about one week after expo­sure, but they can appear any­where from a few days to more than two weeks later.

Oth­er symp­toms may include:

• Stom­ach cramps or bloating
• Nau­sea
• Loss of appetite
• Fatigue
• Unin­ten­tion­al weight loss
• Low-grade fever
• Headache or body aches

Cyclospo­ra can some­times be dif­fi­cult to rec­og­nize because symp­toms may improve and then return. Some peo­ple may expe­ri­ence mild symp­toms, while oth­ers may not have symp­toms at all.

How does Cyclospo­ra spread?

Peo­ple usu­al­ly become infect­ed by eat­ing food or drink­ing water con­t­a­m­i­nat­ed with Cyclospo­ra. Pre­vi­ous out­breaks in the Unit­ed States have been asso­ci­at­ed with con­t­a­m­i­nat­ed pro­duce, includ­ing fresh herbs, leafy greens, and berries.

How­ev­er, the source of indi­vid­ual cas­es is not always imme­di­ate­ly known. Health offi­cials con­tin­ue to inves­ti­gate pos­si­ble sources and share addi­tion­al infor­ma­tion as it becomes available.

Unlike many oth­er ill­ness­es that cause diar­rhea, Cyclospo­ra does not typ­i­cal­ly spread direct­ly from per­son to per­son. The par­a­site needs time out­side the body before it becomes infectious.

Even though direct spread is uncom­mon, good hygiene is still impor­tant. Wash your hands thor­ough­ly and avoid prepar­ing food for oth­ers while you are sick.

When should you see a health­care provider?

Many com­mon stom­ach ill­ness­es improve with­in a few days. If diar­rhea lasts longer than expect­ed or keeps return­ing, it may be a sign that you need addi­tion­al evaluation.

Con­tact your health­care provider if you:

• Have diar­rhea last­ing more than a few days
• Notice symp­toms improve and then return
• Are los­ing weight with­out trying
• Have ongo­ing fatigue or weakness
• Are hav­ing trou­ble stay­ing hydrated

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It is also impor­tant to watch for signs of dehy­dra­tion, including:

• Dry mouth
• Dark urine
• Dizzi­ness or lightheadedness
• Dif­fi­cul­ty keep­ing flu­ids down

Con­fu­sion, faint­ing or rapid­ly wors­en­ing symp­toms require urgent med­ical attention.

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How is Cyclospo­ra diagnosed?

Diag­nos­ing Cyclospo­ra requires a stool test. How­ev­er, rou­tine stool test­ing does not always include test­ing for this par­a­site, so your health­care provider may need to specif­i­cal­ly request it.

Your provider can eval­u­ate your symp­toms, check for dehy­dra­tion and deter­mine whether Cyclospo­ra or anoth­er con­di­tion may be caus­ing your illness.

How is Cyclospo­ra treated?

If Cyclospo­ra is con­firmed, the stan­dard treat­ment is a com­bi­na­tion antibi­ot­ic called trimetho­prim-sul­famethox­a­zole (TMP-SMX).

Always tell your health­care provider about any med­ica­tion aller­gies before begin­ning treat­ment. Your provider will con­sid­er your med­ical his­to­ry and symp­toms when rec­om­mend­ing the best approach for your care.

What can help while you recover?

Replac­ing flu­ids is one of the most impor­tant parts of recov­ery. Diar­rhea can cause your body to lose flu­ids and elec­trolytes, so take small, fre­quent sips of water, broth or elec­trolyte drinks through­out the day.

As your appetite returns, grad­u­al­ly add foods that are eas­i­er to tol­er­ate, such as:

• Toast
• Rice
• Bananas
• Pota­toes
• Soup
• Lean pro­teins

You may want to tem­porar­i­ly avoid alco­hol, caf­feine, greasy foods, spicy foods, and heavy dairy prod­ucts if they make symp­toms worse.

How can you reduce your risk?

Safe food han­dling habits can help low­er your risk of many food­borne illnesses.

When prepar­ing fruits and vegetables:

• Wash your hands before and after han­dling food
• Rinse pro­duce thor­ough­ly under run­ning water
• Scrub firm pro­duce with a clean pro­duce brush
• Refrig­er­ate cut pro­duce promptly
• Avoid wash­ing pro­duce with soap or bleach

Wash­ing pro­duce can reduce con­t­a­m­i­na­tion, but it may not remove every Cyclospo­ra parasite.

When trav­el­ing in areas where food or water safe­ty may be uncer­tain, choose sealed or treat­ed water, avoid ques­tion­able ice, and select foods that are ful­ly cooked and served hot.

Get Care for Per­sis­tent Diarrhea

Diar­rhea can have many pos­si­ble caus­es, and symp­toms alone are not always enough to deter­mine what is mak­ing you sick. A health­care provider can help iden­ti­fy the cause, order the appro­pri­ate test­ing and rec­om­mend treatment.

If diar­rhea is last­ing longer than expect­ed, return­ing after improv­ing or mak­ing it dif­fi­cult to stay hydrat­ed, sched­ule an appoint­ment with your South Bend Clin­ic pri­ma­ry care provider. Get­ting eval­u­at­ed ear­ly can help you receive the right care and get back to feel­ing your best.

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