Cyclospora: The Waterborne and Salad Parasite Behind Diarrhea

     Recently, there have been reports of an outbreak of a parasitic infection in the United States, with a record high of over 3,300 cases in a single state and a tendency to spread to many areas. A major source of this infection often hides in "salad greens" and "fresh vegetables" that we choose to eat for health. Ramkhamhaeng Hospital wants everyone to be aware of Cyclosporiasis to properly care for yourself and your loved ones anywhere in the world.

Cyclosporiasis

     Cyclosporiasis (Cyclosporiasis) is caused by an infection of a parasite named Cyclospora cayetanensis, which is a microscopic single-celled organism that cannot be seen with the naked eye. This parasite enters the body by consuming food or drinking water contaminated with feces containing the parasite, especially fresh fruits and vegetables grown or washed with unclean water. Furthermore, this infection is most commonly found in tropical and subtropical regions, such as Central America, South America, Europe, Asia, and Africa.

Beyond this, we also run the risk of exposure through activities such as swimming in contaminated water sources (including pools, ponds, and lakes). Using contaminated water or organic fertilizers containing human waste in agricultural processes also leads to 'harvests that carry the parasite.'

Watch for Warning Signs: What Symptoms Indicate a Risk of Infection?

Typically, about 1 week after the parasite enters the body, patients will start to show abnormal gastrointestinal symptoms. Important symptoms you should watch for include:

• Severe watery diarrhea: Abnormally frequent bowel movements that are usually watery.
• Explosive diarrhea: Some individuals may experience severe, sudden diarrhea that is difficult to control.
• Abdominal cramps and pain: Experiencing stomach pain, bloating, or increased gas in the digestive tract.
• Nausea and vomiting: Feeling queasy and experiencing stomach discomfort.
• Loss of appetite: Which can lead to rapid weight loss.
• Chronic fatigue: Feeling exhausted and weak. Some individuals may also have a low-grade fever and body aches similar to the flu.

If left untreated, symptoms can worsen and persist for months, or they may seem to resolve only to recur again (Relapse), leading to dehydration and electrolyte imbalance, which can be dangerous to the body.

Who is in the Risk Group?

     Although anyone can contract the infection, those who need to be especially cautious are individuals with compromised immune systems, children, and the elderly, as they are at a higher risk of developing severe symptoms. Additionally, anyone who enjoys eating raw vegetables or berries—such as salad blends, lettuce, basil, cilantro, and raspberries—should take extra care when washing and cleaning them.

Care and Guidelines for Prevention

Because this parasite is relatively resistant to common chemical disinfectants like chlorine, normal vegetable washing methods may not be sufficient. The hospital recommends the following guidelines for good hygiene:

• Follow the "Cooked, Hot, Clean" rule: Cook food at a heat of at least 70 degrees Celsius to help destroy the parasite.
• Wash hands thoroughly and frequently: Especially before and after preparing food, or after using the restroom.
• Pay attention to water sources: Do not drink water that has not passed standard cleanliness quality control processes.
• Maintain kitchen hygiene: Regularly clean food preparation areas and the refrigerator.

If you or someone close to you experiences chronic diarrhea lasting longer than 3 days or severe symptoms as mentioned above, you should see a doctor for a thorough examination. This ensures that the physician can select the most appropriate treatment and care, even during critical periods.