Michigan's cyclosporiasis outbreak is growing at an alarming rate, with over 1,500 cases reported since June 22. The illness, caused by the cyclospora cayetanensis parasite, leads to severe gastrointestinal symptoms such as explosive diarrhea, abdominal pain, and nausea. The incubation period can range from two days to two weeks, and the source of the outbreak remains unknown. This raises concerns about the potential for further spread, especially since the parasite can survive in contaminated food and water for days to weeks.
Dr. Anurag Malani, an infectious disease specialist, warns that the actual number of cases is likely much higher due to asymptomatic infections and limited access to diagnostic testing. The outbreak has led to hospitalizations and visits to urgent care centers and primary care doctors' offices. The most affected counties in Michigan include Monroe, Wayne, Washtenaw, Lenawee, Oakland, Shiawassee, Jackson, Ingham, Livingston, and Genesee.
Previous outbreaks in the United States and Canada have been linked to contaminated bagged salad mixes and kits, fresh cilantro, basil, raspberries, snow peas, and green onions. The Michigan Department of Health and Human Services has issued updated recommendations to reduce the risk of infection, including cooking leafy greens and thoroughly washing fresh produce. However, washing fruits and vegetables may not completely eliminate the parasite, and heat is the only definitive way to kill it.
The FDA warns that cyclospora is highly persistent in the environment and is not killed by commonly used disinfectants. Symptoms of cyclosporiasis typically begin two to 14 days after exposure and may include diarrhea, abdominal cramps, loss of appetite, weight loss, fatigue, nausea, low-grade fever, and vomiting. Treatment with antibiotics is recommended, with trimethoprim sulfamethoxazol (Bactrim or Septra) being the most effective.
While the decision to eat fresh produce is a personal choice, eating locally sourced foods will definitely decrease the risk of infection. However, without knowing the source of the current outbreak, it's challenging to determine the safest options. Cooking fruits and vegetables to a temperature of at least 158 degrees is the safest bet, and thoroughly washing all produce is always a good practice. If you develop gastrointestinal symptoms, contact a healthcare provider to seek testing and treatment.
