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Hundreds of Americans in 11 states have come down with a stomach "virus" that is transmitted on fresh produce. Here is what you need to know to keep your family safe.

At least 285 people in 11 states of the United States, the greatest number in Iowa and neighboring Nebraska, but also in Georgia, Illinois, Kansas, Minnesota, New Jersey, Ohio, Texas, and Wisconsin, have been infected with Cyclospora, a microbial infection that can cause flatulence, belching, "purple burps" (essentially flatulence in reverse), diarrhea, stomach cramps, and low-grade fever.

What Is Cyclospora?

Cyclospora is often misidentified as a stomach virus or stomach flu, but actually it is caused by an infection with a protozoan, a tiny, one-celled animal that spends part of its life cycle traveling from place to place as cyst. The microorganism that is causing the current outbreak was first identified in New Guinea.

Where Is Cyclospora Found? Who Gets Cyclospora Infections?

The Cyclospora parasite is native to moist areas of Bangladesh, Brazil, Chile, China, Cuba, Dominican Republic, Egypt, Guatemala, Haiti, India, Indonesia, Jordan, Mexico, Morocco, Nepal, Nigeria, Pakistan, Peru, Puerto Rico, Romania, Saudi Arabia, Tanzania, Thailand, Turkey, Venezuela, Viet Nam, and Zimbabwe. It lies dormant in the soil until dirt is swallowed by a human being. (Oddly enough, this microorganism cannot survive in sewage itself, whether treated or untreated.) The microbe only infects humans. It travels to the small intestine, where it reproduces itself first by splitting in two and then by having sex with itself, shedding its offspring into feces with reaches the ground again after bowel movement.

In countries where the parasite is native, up to 94% of the population has been infected at one time or another. Generally, only children develop symptoms after swallowing contaminated soil or feces. About 4% of cases of traveler's diarrhea are caused by this microbe. When the microbe is transmitted on the surface of vegetables, herbs, and fruit contaminated with its cysts, however, people of all ages get sick, depending on how many of the cysts they have consumed.

Why Is Cyclospora Serious?

The primary danger of cyclosporiasis, the technical name for the condition caused by infection with Cyclospora, is dehydration. Body fluids are depleted by explosive diarrhea that can occur as often as 10 times per day. When cyclosporiasis causes dehydration, the patient "looks sick." The skin may look dry, blood pressure may run low, and there may be severe fatigue.

Cyclospora responds best to an antibiotic called TMP-SMZ. Most American pharmacies don't carry it, and other antibiotics commonly prescribed for similar infections, such as cyclosporin, don't work as well. With TMP-SMZ treatment, most people get over the infetion in 2 or 3 days, but without TMP-SMZ, the diarrhea may linger for as long as 3 months.

Continue reading after recommendations

  • Ortega YR, Sterling CR, Gilman RH, Cama VA, Díaz F. Cyclospora species--a new protozoan pathogen of humans. N Engl J Med. May 6 1993. 328(18):1308-12.
  • Ortega YR, Sanchez R. Update on Cyclospora cayetanensis, a food-borne and waterborne parasite. Clin Microbiol Rev. 2010 Jan. 23(1):218-34. doi: 10.1128/CMR.00026-09.
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