'Explosive diarrhea' caused by intestinal parasite is spreading in the US, with cases growing rapidly.

Cases of infection with a parasite that causes "explosive diarrhea" have increased by more than 400% in the hardest-hit state of Michigan in a week. The nationwide number of cases of infection with the parasite, which can cause severe watery diarrhea, has risen to 681 in a matter of days from 170, according to New York Post.

A New York state official reported that 120 cases have been recorded in the state since May 1. As of July 6, 48 cases have been recorded in Texas, the state official said.

Illinois also has an alarming number of cases—between 11 and 80, according to the U.S. Centers for Disease Control and Prevention (CDC), which only has information through mid-June.

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Some infected people may not show symptoms, but in severe cases, the disease is accompanied by watery, explosive diarrhea, the CDC notes.

Cyclosporiasis is typically transmitted through contaminated food, primarily fresh vegetables and herbs, but the specific source of the current outbreak has not yet been identified.

Even in those who become ill, identifying the infection can be difficult. Diagnosis requires specialized laboratory tests specifically designed to detect Cyclospora, which are not included in standard stool tests. This is one reason why a significant number of cases may remain undetected.

What is cyclosporiasis?

Cyclospora is a microscopic parasite that is most often transmitted through drinking water or raw foods such as basil, cilantro, and lettuce contaminated with feces.

The parasite is known to enter the body through raw food, but the specific foods that were the source of infection in this case are still unknown. The CDC emphasizes that the cases are not linked to any single source, and the investigation is ongoing.

The parasite causes the disease cyclosporiasis, which can be accompanied by diarrhea, severe cramps, nausea, vomiting and severe fatigue.

The disease is generally not life-threatening. However, severe diarrhea and vomiting can lead to dehydration, which is dangerous if left untreated, especially for young children, the elderly, and those with weakened immune systems.

In June, cases were also reported in other states, including Alaska, Wisconsin, Colorado, Ohio, Pennsylvania, New Jersey, Connecticut, Massachusetts, Tennessee, Virginia, North Carolina, Georgia, Louisiana, and Florida.

The CDC's June 16 report listed 145 cases in 17 states—Michigan wasn't even on the list at the time. The agency clarified that all cases were infected in the United States and had no recent travel abroad. Twenty people were hospitalized. There were no deaths.

What is important to know about cyclosporiasis?

Christie Cooper, 51, shared her experience: "This is worse than any flu I've ever had. I'm completely exhausted."

The first symptom, she says, was "unbearable" diarrhea that began on June 25. Over the next two days, other signs of cyclosporiasis appeared: severe gas, fatigue, intense vomiting, nausea, painful cramps, and a fever of 37,9°C.

During the most difficult period, she visited the toilet at least 30 times a day.

Cooper is currently in the hospital. She is undergoing dialysis and is considered a patient with a weakened immune system, which complicates her treatment. For most people with a healthy immune system, the disease resolves on its own with rest, hydration, and a gentle diet.

In Christie's case, fluid intake had to be strictly controlled, as excess could cause complications, including increased blood pressure and additional strain on the heart.

Once excreted in the feces, Cyclospora takes one to two weeks to become infectious. Therefore, the likelihood of person-to-person transmission is extremely low. Treatment typically involves sulfa-based antibiotics. Cooper has completed the course of treatment and is currently recovering.

Cyclosporiasis is known to sometimes subside after antibiotic treatment, only to return with renewed vigor. This occurs when the first course of medication fails to completely eradicate the parasite, allowing it to re-proliferate and cause a relapse.

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How to reduce the risk of contracting cyclosporiasis

• Whenever possible, heat-treat greens. Rinse all fresh produce thoroughly under running water, paying attention to hard-to-reach areas where microorganisms can hide.
• Buy whole heads of lettuce instead of pre-washed and packaged leaves or salad mixes. Remove the outer leaves and rinse the inner leaves thoroughly under running water.
• Rinse herbs such as cilantro and basil under running water, separating the leaves. Do the same with green onions and snap peas.
• Choose frozen raspberries over fresh ones - this reduces, although does not completely eliminate, the risk of parasite infection.

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