Cyclospora can cause prolonged diarrhea and other gastrointestinal symptoms.
With recent reports of cyclospora infections making headlines, it’s understandable that parents have questions about what this parasite is, how it spreads and whether they should be concerned. While cyclospora can cause prolonged diarrhea and other gastrointestinal symptoms, it remains an uncommon cause of illness in children.
To help separate fact from fear, Evelyn Pangonis, MD, pediatric infectious diseases specialist at Akron Children’s, answers common questions about cyclospora, including how people become infected, what symptoms to watch for, when to seek medical care and how families can reduce their risk.
What is cyclospora?
Cyclospora is a parasite that causes an infection of our intestines called cyclosporiasis. People become infected by eating food or drinking water contaminated with the parasite.
Dr. Evelyn Pangonis
What foods are most often linked to cyclospora?
Fresh fruits and vegetables are the foods most commonly associated with cyclospora outbreaks. In previous outbreaks, leafy greens, cilantro, basil, raspberries and other fresh produce have been implicated. During many outbreaks, however, the exact food source is never identified.
Can washing fruits and vegetables prevent infection?
Washing fresh fruits and vegetables under running water is recommended by the Centers for Disease Control and Prevention (CDC) and the Ohio Department of Health as part of good food safety. However, washing may not completely remove cyclospora, so it can’t guarantee prevention.
Unlike many stomach viruses, cyclospora is most often acquired from contaminated food rather than close contact with someone who is sick. Leafy greens and fresh fruits and vegetables have been linked to cyclospora outbreaks.
What symptoms should parents watch for?
The most common symptom is watery diarrhea that may last for days or even weeks. Other symptoms can include:
- Stomach cramps
- Loss of appetite
- Nausea
- Bloating or increased gas
- Fatigue
- Weight loss
- Less commonly, vomiting or a low-grade fever
Some people experience symptoms that improve and then return.
Washing hands with soap and water before preparing or eating food can help decrease the risk of many illnesses.
How soon do symptoms appear?
Symptoms usually begin about one week after eating contaminated food but can develop anywhere from two to 14 days after exposure.
How is cyclospora different from a typical stomach bug or food poisoning?
Most intestinal illnesses improve within a few days. Cyclospora often causes prolonged (lasting longer than seven days) or relapsing (comes and goes) watery diarrhea, meaning symptoms may last for weeks or improve and then return if untreated. Unlike many stomach viruses, cyclospora is most often acquired from contaminated food rather than close contact with someone who is sick.
Many mild diarrheal illnesses can be managed at home by encouraging plenty of fluids to drink and looking out for signs of dehydration.
When can diarrhea be managed at home, and when should a child be seen by a healthcare provider?
Many mild diarrheal illnesses can be managed at home by encouraging plenty of fluids to drink and looking out for signs of dehydration.
Parents should contact their child’s healthcare provider if their child has:
- Diarrhea lasting longer than seven days
- Diarrhea continues to come and go, rather than resolve
- Signs of dehydration, such as decreased urination, dry mouth, no tears when crying, dizziness or unusual sleepiness
- Bloody diarrhea
- Severe abdominal pain
- Persistent vomiting that prevents drinking fluids
- A high fever
- Significant diarrhea in an infant or a child with a weakened immune system
How is cyclospora diagnosed?
Cyclospora is diagnosed with a stool test. Not all stool tests detect cyclospora, so healthcare providers must order a test that specifically looks for this parasite.
The recommended treatment for cyclospora is an antibiotic called trimethoprim-sulfamethoxazole (TMP-SMX), although some people may recover with no treatment.
How is it treated?
The recommended treatment is an antibiotic called trimethoprim-sulfamethoxazole (TMP-SMX).
Some people may eventually recover with no treatment. However, typically symptoms will last for weeks and may come and go. Treatment shortens how long you have the illness.
Who is most at risk?
Anyone can become infected after eating contaminated food. People who may develop more severe or prolonged illness include:
- Individuals with weakened immune systems including those who take medicines that suppress the immune system
- The elderly
Can it spread from person to person?
No. Unlike many causes of diarrhea, cyclospora is not typically spread directly from one person to another. The parasite must live in the environment before it becomes infectious.
If your child has diarrhea that lasts longer than seven days, is bloody or stops and then returns, consult your child’s pediatrician.
Families can help reduce their risk by:
- Washing hands with soap and water before preparing or eating food
- Rinsing fresh fruits and vegetables under running water before eating or preparing them
- Refrigerating cut fruits and vegetables promptly
- Following Food and Drug Administration and Ohio Department of Health food safety alerts and avoiding recalled products
Should my child be tested for cyclospora if they have diarrhea?
Usually no. Most children with diarrhea have a viral illness, and symptoms last between a day to a week. Your child’s healthcare provider may consider testing if diarrhea lasts longer than seven days or follows a pattern of returning after improving.
Reassurance for parents
Although cyclospora has received attention because of the current outbreak investigation, it remains an uncommon cause of diarrhea. Most diarrheal illnesses in children are caused by viruses and resolve without specific treatment. If your child’s diarrhea is prolonged, severe or accompanied by dehydration, bloody stools or significant weight loss, contact your healthcare provider.
Find an Akron Children’s pediatrician close to you.
