LEXINGTON, Ky. – The number of reported cases of cyclosporiasis, a foodborne parasitic illness that often leads to extreme gastrointestinal distress and “explosive” diarrhea continues to spread around the region and throughout the country.

The CDC does not yet know the exact origin of the outbreak, but Dr. Fares Khater said the cyclospora pathogen – a fecal-to-oral illness – is most commonly caused by unwashed fresh produce and contaminated water.

Khater, who serves as the ARH System Director of Infectious Disease, said awareness of symptoms, treatment and prevention are essential.

“It’s important always, but especially during an outbreak like this, to wash your produce thoroughly,” he said, adding women who are pregnant and those who are immunocompromised should take the extra precaution of cooking all fresh produce as that is the only definitive way to kill the parasite.

“Also, hand hygiene is very important, so keep your hands clean and, especially if you’re traveling overseas or are uncertain of the quality of water, drink bottled water instead of tap water.”

The most common symptom of cyclospora is watery diarrhea, but other symptoms include loss of appetite, weight loss, cramping, bloating and increased gas.

“Severe, unrelenting diarrhea is the biggest one,” Khater said, explaining those with the illness often report upwards of 10 bowel movements per day.

As those are also symptoms of the common stomach flu, Khater said it is important to note that cyclosporiasis continues far beyond the 48-to-72 hours typical of norovirus.

“Without treatment, symptoms can come and go for weeks or months,” he said. “It can be especially dangerous for children and the elderly, who are more prone to dehydration, but also for anyone with a compromised immune system.”

Khater said hydration – the continuous consumption of water and even Gatorade or Powerade to replenish electrolytes and other minerals, is essential for anyone in GI distress. And for those whose symptoms last longer than the common stomach bug, Khater said it is important to seek medical attention.

“Cyclospora needs to be properly diagnosed and the most important way to do that is through a stool test or a GI panel which will reveal if cyclosporiasis is present,” he said.

The illness is typically treated with a 10-to-14-day course of an antibiotic like Bactrim or trimethoprim sulfa, though he said other options are available for those allergic to sulfa drugs.

Cyclosporiasis is not a new disease, but Khater said it is not common either, particularly in the United States, where the CDC said at least 843 cases in 31 states were reported between May 1 and July 9. That number, however, is likely much higher as an additional 1,500 cases are under investigation.

With the number steadily rising, Khater said it is important to stay vigilant.

“The most important thing is to be aware,” he said. “If you eat fresh produce, wash it thoroughly and wash your hands. And if you are sick and develop an explosive, watery diarrhea that doesn’t go away within a few days, seek treatment because it won’t get better on its own if it’s cyclosporiasis.”