As of July 14, Indiana has reported 206 cases of cyclosporiasis, a stomach infection caused by a parasite found in contaminated food.
Marion County has 28 of the state’s cases.
That represents a major increase in Indianapolis, which usually sees about three to four of this type of infection per year. It’s part of a nationwide outbreak with an epicenter in the Midwest. Thousands of cases combined have been reported in states bordering Indiana, including Michigan and Ohio.
Health officials haven’t traced the exact source of the outbreak, but they suspect contaminated produce such as leafy greens. Cyclosporiasis comes from a parasite that generally spreads from food contaminated by feces.
Here’s what you need to know about the parasite and how to protect yourself.
What are the symptoms of cyclosporiasis?
Cyclosporiasis causes explosive diarrhea and watery stools. These bowel movements are frequent and severe.
“This is really the hallmark,” said Nicole Stone, the epidemiology director for the Indiana Department of Health.
The infection can also cause a low-grade fever, nausea, gas, cramping, bloating and a loss of appetite. People usually start experiencing symptoms about a week after they eat or drink contaminated food.
The infection is rarely life threatening, but it can cause severe dehydration. That’s especially dangerous for children, older adults and people who are immunocompromised.
What is the source of the outbreak?
The short answer: We don’t know.
Stone, the epidemiology director, said Indiana health officials are tracking cases and looking for common threads between the people who are infected — such as the type of food they’ve eaten, or the grocery stores and restaurants they went to recently.
Past outbreaks have been caused by contaminated leafy greens, salad mixes, cilantro, basil, green onions, raspberries and snow peas.
Michigan’s health department said the state’s 2,800 cases may be linked to lettuce and salad greens.
“It could be one distributor for multiple brands, stores or restaurants,” said Melissa McMasters, an infectious disease administrator for the Marion County Public Health Department. “We just don’t know yet.”
How can I protect myself from infection?
To lower your risk, wash your hands — especially before food prep. Make sure to clean your food properly, and opt to cook greens instead of consuming them raw.
If you still want to have raw vegetables, McMasters said to wash all greens, even the ones labeled as ‘prewashed’ at the store. She recommended buying a whole head of lettuce instead of bagged greens or salad mixes. You can discard the outer 2-3 layers of lettuce leaves and wash the inner leaves under running water.
For cilantro and basil, wash the herbs thoroughly under water and separate the leaves. You should trim the root end of green onions and remove the outer layer before washing. Raspberries are harder to clean and can require a produce brush: Cooking them or using frozen options can be safer.
You may want to avoid ordering dishes with these ingredients at restaurants during the outbreak, since you cannot see the food prep or washing process. Other people may feel safer by temporarily cutting out these foods altogether.
“It is really about personal risk and comfort,” said Stone, the state epidemiologist. “We’re not necessarily saying not to eat certain produce items, but it is an option people should be aware of to potentially avoid any exposure.”
If I’m experiencing stomach illness, what should I do?
If you are experiencing severe dehydration and cannot keep any water down, go to the emergency room for fluids and treatment.
Otherwise, call your doctor and ask for a stool test. This will confirm if your illness comes from the parasite. You can receive antibiotics for the infection, which can rebound if left untreated.
Once your case is confirmed, look out for a call from the Indiana Department of Health. Officials will ask about what you’ve eaten recently, and where.
“Your answers could help solve the outbreak,” Stone said.
How do I track cases?
Stone said Indiana’s health department is building a webpage that will share updated cyclosporiasis case numbers with the public.
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Mirror Indy reporter Mary Claire Molloy covers health. Reach her at 317-721-7648 or email maryclaire.molloy@mirrorindy.org. Follow her on X @mcmolloy7.
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