Cyclospora outbreak · Prolonged diarrhea after produce · Bactrim (TMP-SMX)
Ongoing U.S. cyclospora outbreak linked to imported fresh produce (berries, cilantro, basil, salad mixes). If you have watery diarrhea lasting more than a few days — often with fatigue, cramping, weight loss, and loss of appetite — a licensed provider can order stool testing and prescribe trimethoprim-sulfamethoxazole (Bactrim DS) when appropriate.
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Providers evaluate exposure to recalled produce (berries, cilantro, basil, salad mixes) and the classic cyclospora pattern: 1+ week of watery diarrhea, fatigue, cramps, appetite loss.
Cyclospora PCR (GI pathogen panel) or ova-and-parasite exam ordered to a lab near you — cyclospora is missed on routine stool cultures.
First-line treatment is trimethoprim-sulfamethoxazole DS twice daily for 7–10 days. Faxed to your pharmacy the same day if clinically indicated.
Cyclosporiasis is an intestinal infection caused by the parasite Cyclospora cayetanensis. In the U.S. it's usually linked to imported fresh produce — most commonly raspberries, blackberries, cilantro, basil, and pre-packaged salad mixes. Outbreaks recur every spring and summer.
Watery diarrhea (often 6+ times a day) lasting more than a week, severe fatigue, loss of appetite, weight loss, abdominal cramping, low-grade fever, and nausea. Symptoms can wax and wane for weeks if untreated.
Usually about 7 days (range 2–14 days) after exposure. Because of the long incubation, patients often don't connect the illness to the food.
A stool sample is tested for cyclospora — usually by GI pathogen PCR panel or a specific ova-and-parasite exam requested for cyclospora. Routine stool cultures do not detect it, which is why so many cases get missed.
Trimethoprim-sulfamethoxazole (Bactrim DS), one tablet twice daily for 7–10 days. Loperamide (Imodium) alone won't clear the parasite. Nitazoxanide is an alternative for sulfa-allergic patients — evidence is limited, and we'll discuss options on the visit.
Sometimes, but untreated cyclosporiasis can drag on for 6+ weeks with relapses. Prompt antibiotic treatment shortens the illness and reduces dehydration and weight loss.
Not directly — the parasite has to mature in the environment before it becomes infectious, so it doesn't spread by casual contact. But contaminated food or water can infect multiple people from the same source.
Historically: imported raspberries and blackberries, fresh cilantro and basil, bagged salad mixes, and snow peas. Check the FDA and CDC outbreak pages for the current recall list before your visit — bring the brand names if you can.