North Carolina health officials are investigating the source of an outbreak of intestinal parasites after 135 cases have been identified in Wake County since the start of May.
Roughly 22 of these cases are believed to be connected to three local restaurants. However, inspections of the implicated premises were inconclusive.
"We are currently investigating all individuals that have been reported and continue to look for similarities in food trends," Arevik Badalyan-Drewek, a spokesperson for the Wake County Government, told Newsweek.
"[However, the parasite is] most attributed to produce and herbs exposed to contamination during growing and packaging which is transmitted to individuals through consumption of food."
The culprit at the center of these outbreaks is a microscopic, gut-infecting parasite called Cyclospora cayetanensis.
The parasite is passed on through the feces of infected individuals, mostly via contaminated food and water.
Once inside, it attacks the small intestine, resulting in an illness known as cyclosporiasis. Not everyone who gets infected with Cyclospora will develop symptoms, but those who do usually experience watery diarrhea with frequent (and often "explosive") bowel movements, as described by the CDC. Some people may also experience flu-like symptoms, including fever, fatigue and aches and pains.
Symptoms usually occur about one week after you are exposed to the parasite and can last from a few days to over a month. Infections can become more severe in young children, older adults and those who are immunocompromised.
While the parasite usually goes away on its own, it can be very uncomfortable for several weeks. In most cases, treatment involves antibiotics and antidiarrheal medications. In serious cases, patients need IV hydration to make up for the lost fluids.
The CDC said that you are most at risk of contracting the parasite when living or traveling in tropical or subtropical regions. However, from time to time outbreaks also occur in the U.S., usually in relation to fresh produce.
"Similar clusters of cyclosporiasis cases associated with herbs and vegetables have been reported in other states this summer, and case increases are not limited to North Carolina," Badalyan-Drewek said.
In recent years, cases of cyclosporiasis in the U.S. have dramatically increased—in 2016, the CDC reported 537 cases, which had risen to 4,703 by 2019. However, some of this rise in cases may be down to more widely available diagnostic tests.
So what should you do to minimize your risk of cyclosporiasis?
"Wash your hands often with soap and water, especially before eating or preparing food and after you use the bathroom, cough, or sneeze," Badalyan-Drewek said. "If soap and water are not available, use an alcohol-based hand gel with at least 60 percent alcohol.
"Follow food safety handling recommendations for safe preparation and storage."
Badalyan-Drewek added: "If you are experiencing symptoms of Cyclospora infection, please see your healthcare provider."
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