As of this week, 25 people in Johnson County have officially tested positive for Cyclosporiasis, the “intense” stomach bug caused by a parasite found on some fruits and vegetables.
That accounts for almost half of the 55 cases so far documented in Kansas, which are presumed part of a multi-state outbreak linked to the parasite Cyclospora that has no confirmed source as of Thursday afternoon.
It’s also likely an undercount, said Charlie Hunt, director of the Johnson County Department of Health and Environment. For one thing, the illness itself can be hard to track since an official diagnosis requires a test from a doctor, which people with minor symptoms might not seek out.
“We only know about the cases that get reported based on testing,” he told the Post. “If people experience these symptoms, and they kind of come and go, and they’re not severe, and they don’t go to the doctor, then we won’t know about them.”
The most common symptom associated with Cyclosporiasis is “watery diarrhea,” and it can take a couple of weeks for symptoms to show up after exposure.
Though this particular outbreak is much larger than usual, contaminated fresh fruits and vegetables like lettuce, bagged salad kits, leafy herbs and berries have caused past outbreaks in the U.S.
Don’t swear off fruits and veggies wholesale
Though contaminated fresh produce does tend to be the cause of these outbreaks, Hunt said people shouldn’t just stop eating them.
“I don’t want to make a blanket recommendation for people to stop eating fresh produce, fruits and vegetables, and so forth,” he said.
But he did say it’s important to apply “common sense recommendations” and potentially avoid some types of produce.
In particular, products like pre-cut greens or raspberries and other fruits with bumpy surfaces have previously been the culprit in Cyclospora outbreaks.
Hunt urged people to avoid those specific products by opting for whole heads of lettuce instead and peeling off the outer layer before washing it thoroughly. He also said it could be a good idea to select produce with smooth rinds that can be cleaned and peeled, such as melons and bananas.
Cooking your produce is also an option. While that isn’t always sensible advice for fruits and veggies like raspberries and lettuce, which people usually don’t consume cooked, Hunt said heat “will take care of” the parasite.
“I can understand why people are concerned, and my hope is that a source will be identified soon, so we can give more specific information to people,” he said.
What should I do if I think I have Cyclosporiasis?
The most common symptom of Cyclosporiasis is what Hunt referred to as “intense watery diarrhea,” which can take a couple of weeks to emerge after someone is infected. It can also last for a few days or potentially a few weeks.
“Most people will recover from this without treatment,” Hunt said, though medications are available.
The real concern is for individuals who might be immunocompromised, as well as young children and older adults, who might have a greater risk of developing dehydration during prolonged gastrointestinal illnesses.
Dr. Mary Devers, the medical director of HCA Midwest’s CareNow urgent cares, said in an emailed statement that people experiencing “diarrhea that lasts more than three days should seek medical care promptly.” She encouraged these patients to inquire about Cyclospora specifically.
She said HCA Midwest has treated and tested more than 120 people with suspected Cyclospora infections across the Kansas City area since early July. However, some tests are still pending, so it’s hard to say for sure just how many cases the health care system has encountered.
This outbreak of the Cyclospora parasite is larger than normal
Hunt said seeing cases of Cyclosporiasis around this time of year isn’t completely abnormal, since cases tend to increase in the summer months. In a normal year, Johnson County might see 15 to 20 cases annually.
However, with 25 cases confirmed in Johnson County as of the state health department’s most recent report on Wednesday, this outbreak is shaping up to be abnormally large, Hunt said.
And, without a certain source for the outbreak and the length of time it can take to develop symptoms, cases are likely to continue to emerge.
In the past, Hunt said, it hasn’t typically taken this long to identify the food source contaminated with the parasite that’s causing the outbreak.
However, this specific outbreak, which has spread to multiple states and seems to be particularly concentrated in Michigan, is more complex than normal given its size.
Additionally, outbreaks from parasites like Cyclospora can be harder to keep track of than bacterial outbreaks for a myriad of reasons.
It also comes after the Centers for Disease Control and Prevention scaled back on surveillance of Cyclospora and other food-borne illnesses, like Listeria and Campylobacter, last year.
Hunt views this all as a reminder that public health investment matters.
“This does highlight the importance of having a really robust public health system, from the federal to the state to the local levels,” he said.
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