The May 30th issue of the Morbidity and Mortality Weekly Report recorded outbreaks of another cause of diarrheal disease. The Centers for Disease Control have reported eight different events (e.g. wedding receptions) in which several people may have acquired an organism from raspberries and strawberries that causes diarrhea. These fruits were imported from Guatamala and possibly from Chile.
The diarrhea is caused by a parasite called Cyclospora cayetanensis. This parasite is present in the diarrhea of infected people. The parasite is not immediately infectious and must mature a bit before it can infect another person. Therefore, person to person contact does not result in infections. The organisms are transmitted to other people when they ingest water or food that is contaminated with human waste (feces) containing Cyclospora cayetanensis. Treatment of human waste is very expensive. Most developing nations do not have the resources to properly treat their drinking water. As a result, many of their water supplies are contaminated with human waste. Watering the fruit-bearing plants can then contaminate the surface of the fruit. It is difficult to determine if the fruit is contaminated with this parasite.
This parasite does not cause diarrhea right away. It usually takes about seven days before symptoms begin. The diarrhea is watery, very frequent, and sometimes explosive. The person may have increased gas, stomach cramps, nausea, vomiting, muscle aches, low fever, and fatigue. If the diarrhea is not treated, symptoms can last for a month or longer. Some people have no symptoms at all.
Stool samples are needed to determine if Cyclospora is the cause of the diarrhea. However, this organism is not what a laboratory normally looks for as a cause of diarrhea. Special tests must be asked for to properly identify this parasite in the stools.
This infection is treatable with antibiotics. The most effective is Trimethoprim/sulfamethoxazole (Bactrim, Septra, or Cotrim). No other antibiotics have been shown to be effective in killing this parasite.
To avoid infections with Cyclospora cayetanensis do not buy imported fruits and vegetables and wash all fresh produce before eating. To get more information look at the Centers for Disease Control's site, the May 30th issue of Morbidity Mortality Weekly Report and the Medical Sciences Bulletin.
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