Cyclospora in Florida: Symptoms, Foods to Avoid and How to Stay Safe

An unwanted guest has shown up this summer in Florida, which is among more than a dozen states reporting cases of the foodborne stomach parasite that causes explosive diarrhea, Cyclospora. Cyclosporiasis is caused by ingesting a parasite through fruits and vegetables contaminated by poor sanitation practices.

Is the Cyclospora outbreak in Florida?

Of the more than 9,000 explosive diarrhea cases confirmed or under investigation since May 1, most are in the Midwest. Miami has reported 53 cases since May.

And while there’s nothing like the fear of spending days in the bathroom with explosive diarrhea to spark panic, the truth is cases in Florida remain relatively low. Plus, there are food-purchasing and preparation measures you can take to protect yourself and your fellow dinner guests.

Cyclosporiasis infection isn’t new. The CDC tracks cases throughout the year, which typically peak in spring and summer.

Which fruits and vegetables have the parasite?

Health officials have yet to identify a specific grower or supplier as the source of the outbreak, but past outbreaks have been linked to the following products:

• Bagged salad mixes
• Fresh cilantro
• Fresh basil
• Snow peas
• Green onions
• Raspberries

In 2022, Florida health officials traced an outbreak to Caesar salad kits, resulting in over 500 cases.

How do I avoid getting infected?

As disgusting as this is, people become infected by consuming food or water contaminated with feces containing Cyclospora. Washing all your produce thoroughly can help, but it might not prevent infection.

The parasite is microscopic, so there’s no way to see the organisms with the naked eye.

Not everyone is affected the same by Cyclospora, so it’s possible to share a meal with others who have only mild or no symptoms while one person ends up with severe diarrhea. Having a weaker immune system puts you at greater risk of a severe infection.

The CDC updated their investigation into this summer’s bout. Here are some tips to consider to avoid or other food-related illness.

• Follow current food safety alerts and avoid recalled or implicated products.
• Thoroughly wash any fresh produce even if it is labeled prewashed. Adding cleaning agents may not add any value, as Cyclospora can be resistant to disinfectants.
• Clean cutting boards and utensils that you use for preparing fresh produce because Cyclospora does stick to surfaces.
• Cook foods associated with prior outbreaks to at least 158 degrees Fahrenheit to kill the parasite.

Besides that, Bhavarth Shukla, M.D., M.P.H., medical director for infection control at the University of Miami Health System, says, “Diarrheal illnesses are common in summer months, so keeping our hands, food and food prep areas clean can help prevent not just Cyclospora, but other pathogens as well.”

How long does it take to get infected?

Symptoms typically begin about one week after exposure, although they can appear anywhere from two to 14 days after exposure. The long incubation time makes it particularly difficult to track the parasite’s source. Most people don’t remember what they ate yesterday, let alone two weeks prior.

What are the symptoms and how long do they last?

The most common symptom is “watery diarrhea with frequent and sometimes explosive bowel movements,” according to the CDC.

What makes this parasite particularly unpleasant is that it can cause chronic, on-and-off diarrhea for several weeks.

The parasite can also cause:

• Severe stomach cramps and bloating
• Excessive gas
• Loss of appetite
• Nausea
• Slight fever
• Fatigue

What should I do if I get infected?

If you have persistent diarrhea, tell your health care provider about your symptoms and ask whether you should be tested for Cyclospora. Routine stool tests don’t always test for the parasite.

You’ll likely need plenty of fluids to prevent dehydration and rest.

Your provider can also prescribe antibiotics such as Bactrim, Septra and Cotrim, which can help resolve the explosive diarrhea. Without treatment, symptoms resolve on their own but may last a few days to over a month, on and off.

Cyclospora generally does not spread directly person to person. Even sharing a bathroom with someone infected won’t spread the parasite.

Recovering from cyclosporiasis

Most healthy people recover completely with appropriate treatment. Without treatment, symptoms can linger for weeks or recur over time. Prompt diagnosis, staying hydrated and following your healthcare provider’s treatment plan can help you get out of the bathroom and back to your life.

Written by Wendy Margolin. Reviewed by Bhavarth Shukla, M.D., M.P.H.,