Have you ever suddenly had a stomach ache and been left with a watery stomach for days? You've probably been suffering from this for a while. The cause may be different than you think. Today we're going to talk about one such condition, a condition called Cyclosporiasis.
What is this Cyclosporiasis?
Simply put, Cyclosporiasis is a type of food poisoning . It is caused by a tiny parasite called Cyclospora cayetanensis (also known as C. cayetanensis). When this parasite enters our bodies, the main symptom is watery diarrhea . Sometimes this can come on suddenly and very suddenly. In addition, there may be a number of other gastrointestinal symptoms, and these symptoms can last for a long time.
How serious can this be? Who is most affected?
Cyclospora infection can be mild and resolve on its own in some people. However, it can be very serious in others. If your immune system is weakened (for example, if you have HIV/AIDS, have cancer, or are taking immunosuppressive medications), you are at higher risk of serious complications.
Just think, if you don't get this treated properly, you could be sick for a long time. Sometimes the symptoms may subside a bit, but then they may reappear.
Cyclosporiasis is most commonly seen in countries with warm and humid climates (tropical or subtropical) and in areas with poor sanitation . This includes countries in Central and South America, the Middle East, and Southeast Asia. Since Sri Lanka is also a tropical country and there can be sanitation problems in some areas, we should also be concerned about this. If you live in such areas, travel to them, or eat fruits and vegetables imported from those areas, you are at risk of developing this disease. As mentioned earlier, if you have a weak immune system, the disease can be severe.
What are the symptoms? How do you recognize it?
Symptoms of cyclosporiasis usually begin within a week of exposure to the parasite (i.e., by ingesting contaminated food or water). The main symptoms are:
- Watery, sometimes sudden, hard stools (diarrhea).
- The food is tasteless.
- Bloating and flatulence (gas).
- Extreme tiredness and fatigue.
- A low-grade fever.
- Nausea.
- Stomach ache, feeling like your stomach is turning.
- Vomiting.
If one or more of these symptoms persist, especially if you have severe stomach pain, it is best to seek medical advice.
Why does Cyclosporiasis occur? How is it transmitted?
The main reason for this is that food or water contaminated with the parasite `(C. cayetanensis)` enters our bodies.
So how does it spread? The problem starts when the parasite gets into the environment through the feces of someone with a Cyclospora infection, and somehow ends up in water sources . You can get it by drinking untreated water, or by eating fruits and vegetables that have been grown in such dirty water, or by eating them unwashed.
For example, some outbreaks in the United States have been caused by imported fresh herbs (such as basil and cilantro), raspberries, and snow peas. So, it's a good idea to be careful with some fruits and vegetables we import from abroad, especially when there is doubt about their purity.
How does this parasite get into food?
As mentioned earlier, the parasite `(Cyclospora)` enters food through contaminated water . There is a high chance that this parasite will be present in food that is grown or washed in water that is not properly treated.
Is this contagious from person to person? Is this a virus? Is it bacteria?
No , Cyclosporiasis is not a disease that can be transmitted directly from one person to another. That is, it is not spread through things like shaking hands or talking.
This is not a disease caused by a virus or bacteria. Cyclospora is a parasitic illness . To be precise, it is a very small (single-celled) organism belonging to the class Protozoan. We can only see it with a microscope.
How do you know for sure if you have a Cyclospora infection?
Only a doctor can tell for sure if you have this or not. However, if you have a severe watery diarrhea, and if you have recently traveled to an area where Cyclospora is common, or if you have eaten fruits or vegetables imported from such an area, you may suspect this infection.
How is the diagnosis made? What tests are done?
The main thing a doctor will do to confirm this is to take a stool sample . In addition, they will examine you and ask about your symptoms, recent food intake, and places you have traveled.
A stool test is the main test for this. Your doctor will give you a sample of your stool in a clean bottle. The lab will then examine it to see if the Cyclospora parasite is present. Sometimes, you may need to give several stool samples over several days to make sure.
How is Cyclosporiasis treated?
The main treatment for this is antibiotics . Depending on your condition, your doctor may also prescribe oral fluids, IV hydration, and medications to reduce diarrhea.
What is good to eat in this situation? What is bad to eat?
If you have cyclosporiasis, it is important to stay away from things that make diarrhea and dehydration worse . For example, avoid alcohol and drinks that contain caffeine (such as tea and coffee). Certain foods can help reduce diarrhea. Ask your doctor about what you should and shouldn't eat.
What medications are used for treatment?
Your doctor may give you some or all of these treatments:
- Antibiotics: A combination of two antibiotics called trimethoprim/sulfamethoxazole (TMP/SMX) is most effective for Cyclospora infections. If you are allergic to sulfa drugs, your doctor may prescribe a drug like ciprofloxacin instead.
- Antidiarrheal medications: Your doctor may prescribe or recommend antidiarrheal medications, such as diphenoxylate-atropine or loperamide. These can help prevent dehydration and help your body retain essential nutrients.
- Hydration: Your doctor may prescribe special fluids to rehydrate your body and restore electrolytes that are essential for your body to function.
Are there any complications or side effects of the treatment? What happens if treatment is not given?
Taking antibiotics when they are not needed can lead to antibiotic resistance . So, sometimes the doctor may want to wait a while to see if the infection clears up on its own before prescribing antibiotics.
If you don't get treatment for a Cyclospora infection, your symptoms can last for a month or more . This puts you at risk of severe dehydration and other complications.
How do you manage symptoms at home?
The best thing you can do at home when you have symptoms of cyclosporiasis is to stay hydrated and take care of your nutrition .
- Drink plenty of fluids. Water, broth, sports drinks, or oral rehydration solutions (e.g., Jeevani, `(Pedialyte®)`, `(Enfalyate®)`, `(CeraLyte®)`) will hydrate you better than other beverages.
- Over-the-counter medications such as loperamide (Imodium®, Diamode) and bismuth subsalicylate (Pepto-Bismol®, Kaopectate®) can help stop diarrhea. However, be sure to ask your doctor before taking these.
- Pay attention to your symptoms. If you can't keep anything down, or if your stomach is very upset, see a doctor right away. You may need IV fluids or nutrition.
How to protect yourself from Cyclosporiasis?
The best way to protect yourself from this disease is to practice proper food handling . This can help prevent the ingestion of contaminated food or water. Remember, not all disinfectants or sanitation methods will kill the Cyclospora parasite.
Here are some things you can do to prevent Cyclosporiasis:
- Wash your hands thoroughly with soap before, during, and after preparing food.
- Wash fresh fruits and vegetables thoroughly before eating, and remove the skin if possible.
- Do not leave peeled, cooked, or cut fruits and vegetables outside the refrigerator for more than two hours.
- Keep vegetables and fruits separate from raw meat, seafood, and poultry.
- Wash all food preparation surfaces, dishes, and utensils thoroughly with hot water and soap (detergent) after use.
- Do not drink untreated water. If in doubt, drink bottled water and use the same water for cooking.
- Avoid eating vegetables and fruits from areas where Cyclospora is common (if known).
What can I expect if I get cyclosporiasis? How long will it last?
If your immune system is healthy, you can recover completely from cyclosporiasis. It may resolve on its own or with antibiotics. Symptoms may last a week or more before they resolve.
However, if your immune system is weak and you develop this disease, your doctor will monitor you very closely because if your body is unable to fight off this parasite, Cyclospora can cause a persistent and severe illness.
The duration of this disease can vary from person to person. For some, it is self-limiting. For others, symptoms may go away and then recur. If left untreated, symptoms can last for months.
What are the possible complications of Cyclosporiasis?
Cyclosporiasis can make it difficult for you to stay properly hydrated. When you lose too much fluid from your body, serious complications can occur. Some of these include:
- Severe dehydration.
- Electrolyte imbalance. This can cause problems with your heart and other organs.
- Decreased body fluid volume (Hypovolemia).
Will a Cyclospora infection go away on its own? How can I take care of myself?
Sometimes a Cyclospora infection can clear up on its own. However, it can last for a long time and put you at risk of dehydration. Therefore, it is best to see a doctor to see if you need to be treated with antibiotics.
To take care of yourself when you have this condition, drink plenty of water and eat as many nutritious foods as possible. Remember, severe diarrhea can be life-threatening.
- Drink plenty of fluids, such as broth, water, sports drinks, or oral rehydration solutions, to replenish lost fluids and prevent potentially life-threatening dehydration.
- Do not drink caffeinated beverages (tea, coffee) and alcohol.
- Eat small amounts of food as much as possible.
- Take all antibiotics prescribed by your doctor exactly as prescribed, for the full duration. Take the full course of medication, even if you feel better.
When should I see a doctor? When should I go to an Emergency Department (ETU) ?
If you think you have cyclosporiasis, especially if you have heavy, watery diarrhea several times a day, see a doctor. If you have a weakened immune system and you have symptoms of this contagious disease, see a doctor immediately.
If your symptoms get worse while you are being treated for cyclosporiasis, or if your symptoms return after you finish taking the medication, be sure to tell your doctor.
When to go to an Emergency Treatment Unit (ETU) :
If you are unable to keep any food or drink down and are passing watery stools several times a day, you may be dehydrated and should seek medical attention. If you have any of the following symptoms of severe dehydration, go to the nearest emergency room:
- Confusion or mental changes.
- Weakness or dizziness.
- Feeling dizzy when standing up.
- No or very little urine output.
- Dark-colored urine.
What questions should I ask my doctor?
When you see the doctor, you can ask questions like these:
- How do I take this medicine exactly?
- How can I manage my symptoms while at home?
- What medications can I take at home for my symptoms?
- What should I eat and drink? What should I not eat and drink?
- How do I keep my body hydrated?
- What do I do if my symptoms get worse or change?
- What symptoms should I see you for or go to the emergency room?
Finally, take-home message
Cyclosporiasis is not very common in some countries, but outbreaks can sometimes occur due to fresh fruits and vegetables imported from abroad. Also, if you live in or travel to tropical and subtropical regions where the parasite Cyclospora is common, you are at risk. Since Sri Lanka is also a tropical country, it is important for us to be aware of this.
Fortunately, Cyclosporiasis is not usually a life-threatening disease and can be treated with antibiotics.
If you have cyclosporiasis, it is very important to stay hydrated by drinking plenty of fluids. If you are having difficulty keeping food and drink down, don't hesitate to seek medical advice. Stay healthy!
` Cyclosporiasis, Diarrhea, Stomach ache, Food poisoning, Parasite, Cyclospora, Health
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