NMDOH Infectious Disease Epidemiology Supervisor Sarah Shrum Davis talks with KC Counts about the cyclosporiasis outbreak and how to stay safe. Here's a transcript of their conversation:
KC Counts:
We're talking about a parasite, a tiny little parasite that has people pretty concerned, even though so far, the New Mexico Department of Health is saying our risk is relatively low in New Mexico.
Sarah Shrum Davis:
That is correct. So, across the nation, we are seeing increases in cyclosporiasis, which is a disease caused, exactly like you said, by a tiny parasite. So, it's microscopic, can only be seen by a microscope. And Cyclospora causes, as you've probably heard about in the news, severe diarrhea, as well as stomach cramping, nausea, and vomiting. Here in New Mexico, we have not seen the big increases that they have seen in other places in the country, thankfully. We currently average, New Mexico historically averages about 8 or 9 cases a year. And we just received our fifth case this week. So we have not, seen anything that would indicate that anything unusual is going on here.
KC Counts:
Would we call this contagious?
Sarah Shrum Davis:
So Cyclospora does not transmit person to person in the way that we typically think of diarrheal diseases. Because it's a parasite, it acts a little bit differently and it actually needs a certain amount of time outside the human body in order to mature. So the only way that you can become infected with Cyclospora is by ingesting contaminated food or water.
KC Counts:
All right, now everybody's talking about where it's coming from, because there are more cases in Texas, right? So obviously a concern, when it's when there's more cases in a neighboring state, but I know it's hard to pinpoint the culprit.
Sarah Shrum Davis:
I think at the, at this point in time, we're not exactly sure. It may be that what is happening in Texas is different than what is happening in, for example, Michigan and the Midwest. It is common to see small clusters of Cyclospora indifferent locations in summer. I think at this point, we are just not exactly able to pinpoint whether they're related or not.
KC Counts:
Things get infected, or what's the proper word, contaminated?
Sarah Shrum Davis:
Yeah. So, it is a parasite that thrives on fecal/oral transmission. So, at some point there would have had to be fecal contact with food matter that was then ingested.
KC Counts:
So, people hear this and might be thinking, I need to do something anti-parasitic. And there are certain things out there, things we may have heard about in the recent past that people have turned to as a sort of cure for something that maybe doesn't have a cure. Talk about what people can do to stay safe.
Sarah Shrum Davis:
Absolutely. So, first things first, the best source of, the best way to stay safe is by prevention. So you're really going to, first of all, practice really good hand hygiene. This has the benefit of not only protecting against Cyclospora, but also against a number of other very common diarrheal diseases that peak at this time of year. The second thing is to wash produce really well under running water. And you can also, if you have a head of lettuce and things like that, some people can remove the outer leaves of the lettuce in order to really let the running water penetrate into the produce. And like I said, with hand washing, this is good advice for preventing a number of diarrheal pathogens.
KC Counts:
So just about the time we forget to sing the happy birthday song while we wash our hands, that we need to be reminded of that. So what I've been doing, I laughed at my mom when I saw her wash an avocado, you know, on the outside before, but apparently that is good practice.
Sarah Shrum Davis:
Yes, because when you slice into something, then if there is, not, again, parasites or bacteria or anything like that on the surface, then the knife can actually push it down into the flesh of the fruit.
KC Counts:
I was kind of hinting around at Ivermectin when I talked about people wanting to, you know, find an anti-parasitic thing to take as a preventative tool, but that's not effective, right? And people should know that.
Sarah Shrum Davis:
So we always recommend that if people are experiencing symptoms, they consult with their healthcare provider. So, your healthcare provider can order a test. You know, the symptoms I just described, diarrhea, nausea, vomiting, those could be cyclosporic, could be a variety of other pathogens. So, your doctor will be able to run a stool panel in order to determine what is causing the illness and the appropriate course of treatment. Most people are able to be treated with Bactrim, which is an antibiotic. It's a little bit unusual because it's a parasite, but it actually has a similar synthesis pathway that allows an antibiotic to be effective against it. But treatment decisions should always be made between the patient and their medical provider who is familiar with their history.
KC Counts:
Now, can animals get cyclosporiasis?
Sarah Shrum Davis:
So, the type of the species of Cyclospora that is causing this outbreak is Cyclospora cayetanensis. And no, humans are the only known reservoir. There are some other species of Cyclospora, but they're not known to be zoonotic, so they do not go back and forth between people and animals.
KC Counts:
Okay, well, what else is important for people to know that I may not have mentioned?
Sarah Shrum Davis:
Again, New Mexico Department of Health is monitoring the situation really closely. So, we're on all the CDC calls, we're watching everything unfold. But at this point, our Cyclospora trends look extremely normal. I would advise people to not panic, but to take the standard precautions that help protect us against a variety of diarrheal diseases.
KC Counts:
Well, thank you so much for sharing that important information. I'm going to go wash my hands. Have a great day.
Sarah Shrum Davis:
[laughter]Great.
Here is more information from the NMDOH on the topic:
