What Is Cyclosporiasis & How Can You Tell When You Have It?

photographed by Ashley Armitage.
It seemed like we were finally in the clear of the great romaine scare of 2018, but earlier this week, the Food Safety and Inspection Service (FSIS) published a public health alert about another lettuce-related concern. Instead of E. coli, though, the lettuce supplier Fresh Express is warning customers that their chopped romaine may be contaminated with a parasite called Cyclospora.
If you recently bought salad or wraps containing beef, pork, or poultry from Trader Joe's, Walgreens, or Kroger, then there is a chance that those products are affected by this recall. (For full details of which products are involved, see here.) Just last month, the Food and Drug Administration found that Fresh Express salad mix used in McDonald's salads also contained Cyclospora.
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So, what is Cyclospora and why should we be concerned? Cyclospora is a tiny, one-cell parasite that causes an intestinal infection, called cyclosporiasis, according to the Centers for Disease Control (CDC). When someone consumes food contaminated with Cyclospora, it infects the small intestine, according to the CDC. Then, days or weeks later, when a person passes a bowel movement, Cyclospora becomes infectious, according to the Mayo Clinic. It's usually spread when people ingest food or water that was tainted with feces, and most foodborne outbreaks are linked to fresh produce, like lettuce.
It usually takes at least a week for symptoms to hit, and when they strike, they are intense. Most people experience watery diarrhea, and "explosive bowel movements," according to the CDC. Some less-common symptoms include loss of appetite, weight loss, cramps, bloating, gas, nausea, and fatigue. Occasionally, people may also experience flu-like symptoms as well, including fever, vomiting, and aches. And some people don't have any symptoms at all.
If you think you have cyclosporiasis, or if you ate a food involved in the recall and are shook, you should see your doctor or healthcare provider. Usually, your doctor will test your stool for infection, and if it comes back positive, they'll prescribe antibiotics (a combination of trimethoprim-sulfamethoxazole is usually recommended) to treat it. It's important to actually see someone about cyclosporiasis, because the infection can last a month or longer, and it's common for it to come back after you've been infected. Fortunately, cyclosporiasis is rarely fatal.
One reason why everyone is freaking out about this is because the "incubation period," aka the time between exposure and infection, for Cyclospora lasts two to 14 days, meaning contaminated products that you ate weeks ago could still wreak havoc on your intestines. For the time being, the FSIS is urging people to throw away these products or return them to the place of purchase, and contact a healthcare provider if you're at all concerned about illness. And definitely keep an eye out for when these agencies say that lettuce products are officially in the clear — which, if the E. coli outbreak was any indication, could be a while.
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