There’s been a run on diarrhea. Pun intended. For weeks people have complained of diarrhea lasting days or weeks. Of course, everyone thought they had Covid-19 which can cause gastrointestinal symptoms in 8-12 % of patients. But, they had no other symptoms to suggest that. They had no common contacts. No history of foreign travel. They had not been around other sick people and had not been to restaurants. Some of them seemed to respond to antibiotics which were used when their symptoms persisted, others did not. The epidemiologists at the San Antonio Health Department were otherwise engaged and not able to offer any guidance. Stool studies done in those with persistent symptoms were negative. Finally, a discussion with a gastroenterologist yielded a possible answer. He said that there had been an outbreak of Cylospora in Alamo Heights. It is a type of protozoa which can cause diarrhea in humans. The following is some information about it from the Mayo Clinic’s website.
Symptoms
Some people infected with the microscopic parasite that causes cyclospora infection develop no signs or symptoms. For others, signs and symptoms — which usually begin within two to 11 days of eating contaminated food or drinking contaminated water — may include:
- Frequent, watery diarrhea
- Bouts of diarrhea alternating with bouts of constipation
- Loss of appetite and weight loss
- Bloating, flatulence and burping
- Stomach cramps
- Nausea and vomiting
- Muscle aches
- Fever
- Fatigue — this symptom may last long after the active infection has gotten better
- General feeling of unwellness (malaise)
The diarrhea may end by itself within a few days, or it may last for weeks. If you have HIV or another condition that compromises your immune system, the infection can last for months if not treated.
When to see a doctor
Many conditions can cause diarrhea and other gastrointestinal signs and symptoms. If you develop persistent diarrhea that lasts several days or recurs, contact your doctor so that he or she can identify the cause and recommend treatment. If you’ve eaten a food that’s been recalled because of a cyclospora outbreak or traveled in an area where parasites such as cyclospora are common, be sure to tell your doctor.
If you experience dehydration due to diarrhea, see your doctor. Warning signs of dehydration include:
- Sunken eyes
- Dry mouth and tongue
- Reduced production of tears
- Decreased urine output
Causes
A one-celled parasite, Cyclospora cayetanensis, causes cyclospora infection. You get it by drinking water or eating food that’s been contaminated by a person infected with the parasite.
A person infected with cyclospora passes the parasite in stool. However, unlike some other foodborne parasites, cyclospora doesn’t become infectious until days or weeks after it’s passed in a bowel movement. So it’s unlikely that you can get the infection directly from a person infected with cyclospora, such as a restaurant worker who doesn’t wash his or her hands adequately after using the toilet.
Before the 1990s, sporadic cases of cyclospora infection turned up only in people who traveled in developing countries and in those with HIV or another condition that caused a weakened immune system. However, since the 1990s, lettuce, fresh basil and imported raspberries have been implicated in cyclospora outbreaks in the United States and Canada.
Risk factors
In the past, people who traveled in developing countries were more likely to get cyclospora infection. These days, the infection is found worldwide, and anyone who ingests contaminated food or water can get it.
Complications
The prolonged diarrhea of untreated cyclospora infection can cause dehydration. If you’re an otherwise healthy adult, you can treat dehydration by drinking more fluids. Some people may need to be hospitalized to receive intravenous fluids because they’re at higher risk of severe dehydration. Examples include:
- People with other serious illnesses
- Infants and young children
- Older adults
Prevention
When traveling to developing nations, it’s essential to be careful about what you eat and drink. However, recent cyclospora infection outbreaks have been linked to foods imported to or grown in the United States and Canada. Unfortunately, even careful washing of foods isn’t enough to eliminate the parasite that causes the infection.
To keep track of what foods have been linked to recent outbreaks of cyclospora infection, you may want to periodically check the food safety alert section of the Food and Drug Administration’s website.
