Eighty-six hospitalizations with zero deaths, and thirty-one states involved: these are the numbers of the cyclosporiasis epidemic that has hit the United States, a problem that is growing week after week without anyone, for now, being able to indicate with certainty where it comes from.
The numbers updated by the CDC
The Centers for Disease Control and Prevention has been monitoring the disease since May 1st, the date that conventionally opens the cyclosporiasis season in the United States (it closes on August 31st). As of July 9, the agency had received reports of 843 cases acquired on American territory, distributed across 31 states: 86 people hospitalized, no deaths, but the estimated cases are around 3000. The figure, however, almost certainly underestimates the reality, as many patients recover without consulting a doctor and are never subjected to specific tests to identify the parasite. The age of those infected ranges from 15 to 89 years (41% of men and 59% of women) and the onset of symptoms is mainly concentrated between May and June.
The Michigan outbreak, off the charts
If there is one state where the epidemic has taken on proportions that epidemiologists say are unprecedented, it is Michigan. The Michigan Department of Health and Human Services reported 2,640 cases as of July 9, with 44 hospitalizations, a number that exceeds approximately fifty times the annual average that the state usually records (40-50 cases per year). Local health authorities are working with county public health departments, but admit they have not yet isolated the food or supplier responsible.
What is cyclosporiasis and how is it treated?
Cyclosporiasis is an intestinal infection caused by Cyclospora cayetanensisa microscopic parasite that is transmitted through water and/or food contaminated with human feces, never from person to person. Typical symptoms are diarrhea, sometimes described by patients as “explosive”, abdominal cramps, nausea, tiredness and, less frequently, mild fever. Incubation generally takes one to two weeks, which complicates the work of investigators quite a bit, because sick people struggle to remember precisely what they ate fourteen days before.
The diagnosis is not trivial, given that standard stool tests often do not identify the parasite, and it is necessary to specifically request a modified acid-fast stain or a PCR test. The reference treatment remains the trimethoprim-sulfamethoxazole combination.
The source remains a mystery
The CDC, along with the Food and Drug Administration, is investigating multiple distinct clusters in several states, although so far it has not linked the cases to a single common food source. In the United States, the other cases of cyclosporiasis epidemics have been associated with raspberries, basil, coriander, snow peas and lettuce, all products which remain under observation this time too, but no official recall has been triggered.
How to protect yourself
The recommendations of the American health authorities are those valid for any food contamination by parasites:
In the presence of compatible symptoms, especially persistent diarrhea without apparent cause, it is better to explicitly ask your doctor to carry out a test for Cyclospora, especially in the case of a recent stay in one of the affected areas. For now, the only certain thing is that the investigation is still open.
