Nikki Sommer, a nurse practitioner from Key West Surgical Group Incorporated and Med Spa, joined Good Morning Keys on Keys Talk 96.9/102.5FM this morning for Medical Matters.
The cyclospora parasite is causing havoc across the country.
Sommer said, “According to the CDC, 843 laboratory confirmed cyclospora infections that have been acquired in the United States, and it’s been reported across the states, Florida being one of them. They’re reviewing more than 1500 additional illness reports, meaning the total number of confirmed cases is expected to grow. Here in Florida, the Department of Health has reported confirmed cases this year, with the occurring during June and early July. Don’t throw away your salad just yet.”
Unlike bacteria such as Salmonella E. coli, cyclospora infects your small intense intestines.
Sommer said, “It causes an illness known as cyclosporiasis. People generally generally don’t spread cyclospora directly to one another, so that’s kind of a good thing. We talk about the other bacterias that you can spread from person to person if not treated. This one is not the case. So this one comes directly from contaminated food or contaminated drinking water. You cannot spread it from person to person. So there’s that. So if somebody in the family has it, it’s most likely you will not spread it to your partner or your friends.”
It’s been found in fresh produce.
Sommer said, “Americans eat more fresh fruits and veggies, especially in summertime, because we barbecues. When it’s hot, you want something refreshing, so you go to grab the fruits, the veggies. A lot of times people put out fruits and vegetables with a nice little ranch dip. So that’s why. And second, many different fruits and vegetables are imported from different countries where growing and sanitation practices may differ. So today’s laboratory testing also is better in detecting cyclospora than it was 20 years ago. So that is why we are able to diagnose it, and now we give a name and a condition to what is causing our infectious diarrhea.”
There’s really not a single food responsible.
Sommer said, “There could be a couple of different reasons, different foods that are causing issues. So most reasons, well, most foods that have been linked to cyclospora over the years are bagged salads. It’s not bad, but a lot of times we grab them on the go and take it to work, and you don’t rinse them. So you should rinse the bag salad. If the bacteria traveled when it was packaged in the plant. So those bag salads are great, but I don’t necessarily rinse them either, and they will say on the package now it’s washed. However, in times like these, when there’s an outbreak like this, it’s really a good idea just to make sure you rinse everything. So bag mixed salads, romaine lettuce. They’re usually in a bag, so make sure you cleanse those with some water. Cilantro, basil, parsley, all those fresh fruits and vegetables that are in the shelves in the grocery store. Fresh raspberries, blackberries, snow peas, sugar snap peas, and mixed vegetables. You should wash and handle them properly before you eat them, especially if you’re going to eat them raw, because cooking can kill the bacteria. So you need to make sure you rinse them.”
What are the symptoms?
Sommer said, “About one week after exposure, and it can come from anywhere. It can be from two to 14 days. So, the most common symptom is profuse watery diarrhea. Other symptoms include severe stomach cramps, bloating, gas, nausea, loss of appetite, weight loss, and low-grade fever. One thing that makes cyclospora different from many stomach viruses is that the symptoms often improve, but they can suddenly come back again. Without treatment of the illness, they last for weeks, sometimes even longer than a month.”
Who is most at risk?
Sommer said, “Certain groups are more likely to become more seriously ill, and it’s usually the groups we always talk about: young children, adults over the age 65, anybody receiving chemotherapy, anyone who has received organ transplant, individuals living with HIV, or anyone with weakened immune system. So sometimes we talk about those patients that are on those, they have immune disease, and they’re on those immune suppressing drugs. These patients that we’re talking about, prolonged diarrhea can quickly lead to dehydration and hospitalization.”
What are the warning signs of dehydration?
Sommer said, “Dry mouth and extreme thirst. And a lot of times, when you start to feel that, that means you’re really dehydrated. Dark urine. If your urine is not pale yellow, if it’s not clear, if it’s darker like orangey or tea colored, that can mean that you’re severely dehydrated. If you have dizziness, fatigue, or you feel like your heart is racing or rapid heartbeat, those are signs of dehydration. And older adults, older adults tend to appear confused before they tell you about any of the symptoms. So just be wary if you have an older person and they’ve been having issues with diarrhea and they seem to be confused. They could be severely dehydrated. Again, we’re in the summer. We’re in Florida. The heat makes dehydration happen even faster, so if you’re having persistent diarrhea during the summer months, making sure you’re hydrated is just as important as treating the infection itself.”
How do we diagnose cyclospora?
Sommer said, “Doctors will order stool studies, but the general ones do not detect cyclospora. So you need to specifically test the cyclospora, or there’s a gastrointestinal PCR panel that includes the parasite, because this is a parasitic infection, not a bacteria infection.”
What is treatment?
Sommer said, “Bactrim is the recommended treatment for this type of parasitic infection. Usually, most people feel better within a couple of days. This is in the sulfa family, so if you have a sulfur allergy or intolerance, they may consider two different types of medications, but these might not be as effective as bactrim. If you have an allergy, then you need to let your provider know so they can provide a correct medication.”
How can cyclospora be prevented?
Sommer said, “Just simple things you can do: wash your hands before preparing food, rinse your fresh fruits and vegetables thoroughly. Keep produce separate from meat. Refrigerate all perishable foods promptly. Don’t leave them out, especially if you’re in a hotter environment. If you’re camping, if your AC is broken, make sure you keep them refrigerated. Drink safe water when traveling internationally. I’m guessing that means don’t necessarily drink from the tap. While washing fruits and vegetables is recommended, it may not completely remove cyclospora, especially from delicately leafy green vegetables. That is one reason public health officials work so hard to identify contaminated food sources.”
When should you see a healthcare provider?
Sommer said, “Anything that lasts more than two or three days, you want to seek a healthcare provider because anything that’s a quick, a 24 to 48 hour virus, once you pass that 48 hour mark, if you’re still having diarrhea, see a healthcare provider. Any type of blood in your stool is a red flag. It could be inflammation, bacteria, a parasite. You need to seek medical attention. If you have any severe abdominal pain associated with the diarrhea, with or without it, again seek your medical provider. Fever, unable to keep fluids down. Dizzy, if you’re dizzy or think you’re dehydrated or know you haven’t been drinking enough, seek medical care. And of course, if you do, like we mentioned, have problems, you to have a weakened immune system, you need to seek medical help. Again, persistent diarrhea is not something you should ignore. Fresh fruits and vegetable still remain the healthiest choices. Just practice good food safety. So even though it’s in a bag and it’s a grab and go, and you think it’s easy, out of the bag, throw it in a bowl and rinse it. Just give it an extra wash. Stay hydrated. Know your symptoms, and just don’t ignore any type of diarrhea that lasts longer than two to three days.”
For more information on how Key West Surgical Group can help, click here: https://www.keywestsurgicalgroup.com/