Pennsylvania joins more than 30 states that have reported cases of a parasitic infection that causes diarrhea.
Pennsylvania’s Department of Health has recorded 28 cases of cyclosporiasis so far this year, with two in Northeast Pennsylvania. Officials said the department could not clarify which counties the cases were recorded in due to patient confidentiality. The largest cluster of cases has been in Southeast Pennsylvania, with 14 cases.
“I just talked with the hospitalists here, and we really haven't seen any increase in cases at UPMC Williamsport Medical Center at this point,” said Dr. Roman Tuma, the medical director of infectious diseases at UPMC Williamsport.
Pennsylvania recorded a relatively low number of infections compared to other states involved in the national outbreak. For example, Michigan reported more than 3,500 cases as of early July.
Nationally, the Centers for Disease Control (CDC) reported 1,645 cases of cyclosporiasis and is aware of more than 5,000 cases that require further analysis in at least 34 states as of July 14 since May 1. The CDC reported 141 hospitalizations and no deaths.
The true number of infections is likely much higher, as NPR reports, "that figure only represents cases reported by states directly to the CDC" and there's a lag between symptom onset and reporting.
Only 249 cases had been reported at this time last year.
What is cyclosporiasis?
The infection's most common symptoms include watery diarrhea, loss of appetite, weight loss, bloating, nausea and fatigue, according to the CDC. Less common symptoms can include low-grade fever and vomiting.
“Cyclosporiasis is an intestinal illness caused by a parasite,” said Neil Ruhland, press secretary for the state’s Department of Health. “Cyclosporiasis usually causes diarrhea with frequent and sometimes irregular bowel movements. If not treated, the illness may last from a few days to more than a month. Typically, cyclosporiasis is not life-threatening.”
The illness does not come immediately after exposure.
“Probably at least a week, week to 10 days, maybe 14 days [after exposure]. That's the estimated incubation period,” Tuma said.
Nationally, health officials do not know the cause of the outbreak, but previous outbreaks have been linked to imported fresh produce, including bagged salads, leafy greens, fresh basil, fresh cilantro and raspberries, according to Johns Hopkins Medicine.
The state’s Department of Health said the illness is most likely connected to produce.
“Pennsylvanians are most likely to be infected after eating fresh produce imported from tropical and subtropical regions where cyclosporiasis regularly occurs, or while traveling to those regions,” Ruhland said.
How can you protect yourself from cyclosporiasis?
The Department recommends washing fresh produce before consumption.
“[Pennsylvanians] should also rinse fruits and vegetables, including herbs, under running water, scrub firm produce, such as melons or cucumbers, with a clean produce brush, cut away damaged areas on fruits and vegetables before eating, and refrigerate cut, peeled, or cooked produce as soon as possible,” Ruhland said. “These steps will greatly reduce the possibility of people ingesting the parasite that causes cyclosporiasis.”
Tuma said exposure comes from contaminated water, produce and even contaminated surfaces.
“Keep washing your hands. If you eat food that you can wash properly or peel, or if you can eat food that you can heat, I would think to at least 153 degrees Fahrenheit. Public pools are a concern as well. Be careful when going to those places,” Tuma said.
What do you do if you become infected with cyclosporiasis?
If infected, the CDC recommends antibiotics for treatment.
And for those with gastrointestinal disorders such as irritable bowel syndrome (IBS), there could be signs that differentiate a cyclosporiasis infection with normal IBS symptoms.
“If you have extensive watery diarrhea, multiple bowel movements per day, then that would be a concern that you might be infected,” Tuma said.
Tuma said most cases are outpatient, but that it’s important to take care of yourself at home if you do become infected.
“The most important thing is keeping hydrated. Hand hygiene, washing hands and trying not to transmit it is as important as well. But if you have severe diarrhea and you can't keep hydrated by oral fluid intake, then it's time to seek out medical attention at the hospital,” he said.
