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Cyclospora Outbreak Spans Nine States in the US

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Cyclospora Outbreak Spans Nine States in the US


A parasite called Cyclospora cayetanensis was determined to be the cause of a recent outbreak (June through July 2013) of debilitating intestinal infections that cause watery, and sometimes explosive, diarrhea along with other symptoms including weight loss, cramping, nausea, fatigue, loss of appetite, bloating, and flatulence. Almost 300 people have be diagnosed with the infection which can last for up to two months if untreated, longer for immune compromised individuals.

The first case was found in New Jersey, but infections have also been reported in Iowa, Nebraska, Texas, Wisconsin, Georgia, Connecticut, Illinois and Kansas. The majority of cases have been found in Iowa Nebraska and Texas. Based on previous epidemiological investigations, the suspected source is fresh vegetables, though no single type of produce has been identified – likely for commercial reasons. In the past outbreaks were traced to imported produce, but in this instance the source appears to be domestic fruits or vegetables.

Though the rate of new infections seems to be subsiding, prudence would suggest avoiding fresh produce from the Midwest until the specific source is identified. Washing fresh vegetables thoroughly won’t hurt either, even though the parasite may not be easily washed from the produce. If diagnosed (a stool sample must be laboratory tested for Cyclospora cayetanensis), treatment consists of antibiotics including trimethoprim-sulfamethoxazole, ciprofloxacin or the anti-protozoal drug nitazoxanide.


The biggest risk from infection is dehydration from persistent diarrhea. Drinking lots of fluids can help. In some cases, immune compromised individuals, infants and elderly victims have been hospitalized and placed on intravenous fluids. In most cases, this won’t be necessary.

The primary treatment for dehydration is oral rehydration salts, such as Pedialyte, to replace the water and electrolytes lost due to the diarrhea. According to the World Health Organization (WHO), each of the electrolytes in oral rehydration salts has a specific purpose:

  • Glucose facilitates the absorption of sodium (and hence water) in the small intestine
  • Sodium and potassium are needed to replace these essential ions which are lost during diarrhea (and vomiting)
  • Citrate corrects the acidosis that occurs as a result of diarrhea and dehydration.

The best response is to start rehydration therapy as soon as the diarrhea occurs. The Mayo Clinic Web site

[i] provides the following improvised home formula for emergency use. They advise measuring carefully or having a second person check the measurements.

Home Oral Rehydration Salts: ½ teaspoon table salt, 6 level teaspoons of sugar and 1 liter (about 1 quart) of safe drinking water.


By |2016-11-05T04:27:07+00:00July 25th, 2013|Diet and Digestive Health|0 Comments

About the Author:

Norm Robillard received his Ph.D. in microbiology from the University of Massachusetts, Amherst studying Bacillus anthracis and other Bacillus species. His post-doctoral training at Tufts University focused on antibiotic resistance and gene transfer between the gut microbes Bacteroides fragilis and E. coli. During his career in pharma / biotech, Dr. Robillard studied the genetics of antibiotic resistance, septic shock, viral illnesses and antimicrobial and antibody-based therapies prior to founding the Digestive Health Institute. Dr. Robillard is the creator of the Fast Tract Diet, author of the Fast Tract Digestion book series and publisher of the Fast Tract Diet mobile app. He was the first to propose excess intestinal fermentation as the underlying cause of acid reflux and explained the connection between intragastric pressure from gas-producing bacteria in our intestines, nutritional malabsorption and the symptoms of acid reflux. His latest book series, Fast Tract Digestion provides a safe and effective dietary tool and behavioral strategy as an alternative to proton pump inhibitors (PPIs), H2 blockers, IBS drugs or antibiotics for heartburn, acid reflux, GERD, laryngopharyngeal reflux disease (LPR), IBS and other SIBO related conditions.

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