Long Island cases of infection with parasite, cyclospora, on the rise

Cyclospora, a microscopic parasite that contaminates fresh produce, causing what the Centers for Disease Control and Prevention calls "explosive" bowel movements in its victims, is on the move on Long Island.

By Monday, 17 cases of cyclosporiasis had been reported in Nassau County, compared with 10 by this point last year, wrote Alyssa Zohrabian, a spokesperson for the county Department of Health, in an email.

New York State had the second highest reported number of cases nationwide behind Michigan late last week, according to the CDC. A spokesperson for the New York State Department of Health, Marissa Crary, wrote in an email Monday that about 511 cases had been reported across the state since May 1, versus between 500 and 700 for each of the past two years.

Since May, CDC has reported 843 cases across the nation with 86 hospitalizations and another 1,500 cases awaiting further analysis. There have been no reported deaths. A representative for Suffolk's health department did not respond to a request for comment.

The CDC said that "multiple jurisdictions" had reported an increase in cases over the last two weeks compared to the same period last year, and that it expected case counts would continue to rise. 

Past outbreaks of cyclosporiasis in the United States have been linked to basil, cilantro, mesclun lettuce, raspberries and snow peas, according to the U.S. Food and Drug Administration.

Dr. Bruce Farber, an infectious disease specialist with Northwell Health, said the number of reported cases was likely a "tiny fraction of the real number," because they represent only those cases that have been diagnosed by a laboratory.

"A lot of people are going to get diarrhea but they’re not going to run to the doctor," Farber said. "That’s going to be the overwhelming majority of people."

Cyclospora measure no more than 10 microns. The gastrointestinal infections they cause rarely lead to hospitalizations but are unpleasant, Farber said: "bad diarrhea, nausea, muscle aches, malaise ... It will certainly ruin a vacation, make you miserable for a couple days to a week."

The sources of the outbreaks are unclear, but Farber said it could be linked to fecal contamination of reservoirs used for crop irrigation, or irrigation by reclaimed water. The infection’s incubation period is longer than a week, in some cases, making infection tracing difficult.

Crary, the New York State Department of Health spokeswoman, wrote that there was no evidence of a single cyclospora outbreak linking all the infections. "While cyclosporiasis is generally not life-threatening, as many people with healthy immune systems recover without treatment, the Department encourages all New Yorkers to be aware of the best practices to prevent cyclosporiasis and other infections common in the summer months." 

To prevent the spread of infection, the CDC recommends washing hands with soap and water before and after preparing raw fruits and vegetables; washing all fresh produce under running water before eating, cutting and cooking; scrubbing firm fruits and vegetables with a clean produce brush; cutting away damaged areas on fruits and vegetables before preparing; and refrigerating cut, peeled or cooked fruits and vegetables. Produce labeled "pre-washed" does not need to be washed again at home.

The CDC recommends rest and plenty of fluids for people who contract the infection. Antibiotic treatments are available.

By Nicholas Spangler

nicholas.spangler@newsday.comspanglernewsday

Nicholas Spangler is a general assignment reporter and has worked at Newsday since 2010.