Cases of parasite that causes ‘explosive’ bathroom emergencies surge to nearly 600 as officials issue new warnings

Suspected cases of a parasitic infection that causes severe digestive issues have surged to nearly 600, as officials issue new warnings.

The CDC has reported that 145 Americans in 17 states have contracted the cyclospora parasite from an unknown source in the US and 20 have been hospitalized. 

However, health officials in Michigan reported that as of July 4, 572 cases have been reported in the state alone. The CDC’s latest update from July 1 listed no cases in Michigan.

Michigan state health officials first reported the state’s cases last week, but the outbreak appears to quickly be growing. On June 30, there were 170 reported cases, which surged to more than 300 by July 3. 

The Michigan Department of Health and Human Services (MDHHS) is racing to find the cause of the outbreak and believes it may be linked to food. 

MDHHS noted no specific grower, supplier or produce type has been identified as the source.

However, the agency has warned restaurants, particularly in Southeast Michigan, where the majority of cases are concentrated, to take specific steps to reduce risks of exposure. 

For lettuce and greens, the department urged restaurants to buy whole heads of lettuce rather than prewashed, bagged lettuce or salad mixes, throwing away the outer two to three layers of leaves and washing inner leaves under running water.  

MDHHS also recommended in a press release washing cilantro and basil thoroughly under running water and separating the leaves. Green onions should be trimmed at the root end and have the outer layer removed before washing under running water.

And for raspberries, the department warns their bumpy surface makes them hard to clean, allowing the cyclospora parasite to hide in the crevices. Snow peas must also be washed under running water. 

The agency also noted heating foods to 158F (70C) can kill the cyclospora parasite, and all fresh produce should be washed under running water, even if you plan to peel it.  

Cyclospora causes cyclosporiasis, an infection that leads to sudden and severe gastrointestinal symptoms, including diarrhea, cramping, nausea, vomiting and fatigue. 

The Cleveland Clinic warned: ‘Cyclosporiasis is an illness you get from the parasite Cyclospora cayetanensis. It causes watery, and sometimes explosive, diarrhea and other stomach problems.’

The CDC said: ‘Local, state and federal (CDC, FDA) public health authorities are investigating several clusters of cases in more than one state. Investigations to identify potential sources are ongoing.’

It is possible there are more undiagnosed cases in other states as well, as not everyone who contracts the parasite gets tested or treated for it. 

Cyclosporiasis is acquired through eating or drinking food or beverages contaminated with the parasite, often from feces. Symptoms usually occur about a week after exposure. 

Human-to-human transmission is rare. 

MDHHS emphasized its food-related recommendations are especially vital for people at a higher risk of dehydration or with weakened immune systems, such as those on chemotherapy, organ transplant recipients, young children and older adults. 

‘Cases remain the highest in Monroe, Lenawee, Washtenaw, Wayne, Shiawassee, Jackson, Oakland and Livingston counties,’ the agency said in its press release.

‘MDHHS is working with local health departments and the Michigan Department of Agriculture and Rural Development (MDARD) and will update information as it becomes available.’

As of July 1, patients in Michigan range from eight to 84 years old, with an average age of 44. 

If not treated, cyclosporiasis could last for more than a month, with symptoms subsiding and reappearing multiple times. 

To prevent the disease, the CDC recommends avoiding consuming food or water at risk of contamination with feces and following general food safety preparation guidelines. 

Treatment consists of a course of the antibiotic trimethoprim-sulfamethoxazole, which is sold as Bactrim, Septra or Cotrim. 

Most people with a healthy immune system will recover without any treatment. 

‘People experiencing gastrointestinal illness, such as sudden and ongoing diarrhea, are encouraged to contact their health care provider and reach out to their local health department,’ MDHHS said.  

Cases of cyclosporiasis tend to rise between May and August and it is more common in people returning to the US from foreign travel. 

In the current outbreak, according to the CDC’s report, New York is experiencing the most cases, between 31 and 80. 

Texas and Illinois are experiencing the second-most cases, between 11 and 30. 

The remaining 14 states with cases are experiencing between one and ten cases in each. 

Previous outbreaks have been linked to bagged salad kits, cilantro, basil and other leafy green produce – though no source or suspected source has been identified in this outbreak.  

An additional 45 cases of cyclosporiasis have been reported in people who ate or drank food or water that made them sick while traveling outside of the US. These patients range in age from 17 to 89 years old. 

Of the 45 patients, three have been hospitalized and no deaths have been reported. 

The CDC did not reveal where the patients had reported recent travel.