Cases of a parasite that causes explosive diarrhea have surged by more than 400% in Michigan over the past week, with 681 confirmed infections as of Monday. This marks a significant increase from the 170 cases reported less than a week prior, making Michigan the hardest-hit state.
While New York, Illinois, and Texas have also reported cases ranging from 11 to 80, according to the Centers for Disease Control and Prevention (CDC), their data only extends to mid-June. Michigan's more current state reporting indicates the national figures may be considerably higher.
Cyclosporiasis, the illness caused by the parasite Cyclospora, can lead to watery, "explosive" diarrhea, severe cramping, nausea, vomiting, and fatigue. In some cases, individuals may experience no symptoms at all. The CDC notes that dehydration can be a serious complication of severe diarrhea and vomiting, particularly for young children, the elderly, and those with compromised immune systems.
Investigating the Source
Experts have yet to identify a specific source for the current outbreak, although cyclosporiasis is typically contracted through contaminated food, such as raw produce like basil, cilantro, and lettuce, or contaminated drinking water. The CDC stated that cases have not been definitively linked to a common food source, and investigations are ongoing.
The parasite is microscopic and transmitted through feces. It takes one to two weeks after passing into feces to become infectious outside the body, making person-to-person transmission unlikely. Identifying the infection can be challenging, requiring specialized lab tests that are not part of standard stool examinations, which may lead to underdiagnosis.
Patient Experience
One individual, Cristy Cooper, 51, described her experience with the infection as "miserable" and worse than any flu she had experienced. Her symptoms began on June 25 with severe diarrhea, followed by excessive gas, fatigue, vomiting, nausea, and cramping, accompanied by a fever of 100.2 degrees Fahrenheit. At its worst, she reported using the toilet up to 30 times a day.
Cooper, who has a compromised immune system due to being a dialysis patient, required careful management of her fluid intake to prevent complications like high blood pressure and heart strain. Treatment typically involves a sulfa-based antibiotic. She is currently recovering after receiving a course of antibiotics.
Cyclosporiasis can sometimes improve with antibiotics only to return if the parasite is not fully eradicated, a phenomenon known as relapse.
Risk Reduction
To reduce the risk of infection, officials recommend thorough washing of all fresh produce under running water, paying attention to crevices where microbes might hide. Buying whole heads of lettuce instead of pre-washed bagged mixes and discarding the outer leaves before washing inner leaves is also advised. For herbs like cilantro and basil, washing them under running water while separating the leaves can help. Opting for frozen raspberries over fresh ones can also reduce, though not eliminate, the risk.
In June, the CDC reported 145 cases across 17 states, with 20 hospitalizations and no reported deaths at that time. The CDC's mid-June data did not account for the high number of cases later reported in Michigan, suggesting the national total is likely higher.