The recent Cyclospora outbreak in the Midwest is causing a great deal of consternation in the board rooms of major food retailers. An outbreak of Cyclospora has spread across 15 states because an imported ingredient for (likely) Mexico was introduced into McDonald’s salads and into the popular Del-Monte veggie trays sold at Kwik Stop locations. The disease presents with nausea, abdominal cramping, bloating and diarrhea. These can be accompanies by vomiting (in the early stages), headaches, fatigue, and dehydration that ca lead to onsets of tachycardia and other serious health problems. The symptoms are cyclical and initially last for days to a week, and then subside, only to return again in a similar fashion. Detection is difficult because the parasite does not manifest in a stool culture and is very often missed in a routine ova and parasite screening test. A specific Cyclospora screen must be selected by the doctor when requesting a gastrointestinal study (GI Study). The screener then looks for oocysts left by the parasite in the fecal material.
While diagnosis is difficult, a cure is relatively easy for most. A sulfate antibiotic like Bactrim will usually rid the body of live Cyclospora in two days. The evidence in the stool can remain for up to a week afterwards because unlike in a stool culture looking for bacteria the antibiotic does not destroy evidence of the pathogen as it kills the pathogen. Bactrim is effective while preserving the evidence of the pathogen, an important point when trying to determine what made a person ill. The only caveat, and an important one at that, is that there are a significant number of people with an allergy to Bactrim and other sulfate antibiotics. Those with such an allergic reaction are often stuck between allowing the Cyclospora to run its course (6 to 10 weeks) or trying an expensive (and unproven) alternative.