If it feels like everyone is suddenly talking about explosive diarrhea going around, you are not imagining it. A parasite is behind a nasty wave of stomach illness spreading across the United States this summer, and it has already made more than 2,000 people miserable across multiple states. The illness is called cyclosporiasis, and health officials are still racing to figure out exactly where it is coming from.
Here is what it actually is. The explosive diarrhea people are dealing with is caused by a microscopic parasite called Cyclospora cayetanensis. It is a foodborne illness, which means people get it from eating food or drinking water that has been contaminated with feces carrying the parasite. According to the Centers for Disease Control and Prevention, the main symptom is watery diarrhea with frequent and sometimes explosive bowel movements. One thing to know up front is that this is not the regular stomach flu, and it does not spread from person to person the way norovirus does. The parasite has to mature in the environment before it can infect anyone, so you catch it from contaminated food or water, not from the sick person next to you.
What makes this outbreak so rough is not how hard it hits, but how long it lingers. Doctors have pointed out that a bug like norovirus tends to hit hard and be over in a day or two, while cyclosporiasis drags on. Without treatment, the explosive diarrhea can last anywhere from a few days to a month or longer, and it has a cruel habit of easing up and then relapsing right when you think you are in the clear. Fatigue can hang around even after the stomach symptoms finally stop. Symptoms usually show up about a week after you eat the contaminated food, though it can be anywhere from two days to two weeks, which is part of why it is so hard to trace back to a single meal.
Beyond the diarrhea, people have reported severe stomach cramps, bloating, nausea, vomiting, gas, loss of appetite, weight loss, body aches, headaches, and a low grade fever. Dr. Sharon Welbel of Cook County Health described the classic combination as explosive diarrhea, bloating, cramping, and loss of appetite, with a low fever showing up in only some cases. It is not usually life threatening, and so far no deaths have been reported, but it is more than enough to wreck your week or your month.
The numbers are what have health officials paying close attention. More than 2,000 cases of the explosive diarrhea illness have been reported across several states, and Michigan has been hit the hardest by far. The state has confirmed roughly 1,000 cases and counting, which officials there are calling the largest outbreak in Michigan history and about 25 times the number the state usually sees in an entire year. Ohio, New York, Illinois, North Carolina, and Texas have all reported cases too, and the CDC and FDA are investigating clusters in more than two dozen states. Because there is often a lag between when people get sick and when it gets reported, officials expect the real number to climb.
Now the part that is frustrating for everyone, including the experts. No one has identified the source of the explosive diarrhea outbreak yet. The leading theory is contaminated fresh produce, because that is what past cyclospora outbreaks have been traced to. Over the years, the culprits have included bagged salad mixes, romaine and other leafy greens, raspberries, basil, cilantro, and green onions. The timing is especially bad, since the outbreak is peaking in the middle of cookout season, exactly when salads, herbs, and fresh sides are on every table. Washing produce helps, but health officials note it may not fully remove the parasite, which is part of what makes this one hard to prevent.
There is also a twist that has investigators concerned. Historically, most people who caught cyclosporiasis picked it up while traveling outside the country. This time, the majority of people who got sick had not traveled at all, which points to a source somewhere inside the United States food supply. The CDC has said it does not yet have evidence tying every case to one single nationwide outbreak, and that these may be several separate clusters, but the FDA and state health departments are digging into grocery purchases and food histories to find the common thread.
So what should you actually do. If you have had sudden, ongoing diarrhea that will not quit, especially the watery, explosive kind that keeps coming back, do not just wait it out. Cyclosporiasis often will not clear on its own the way a 24 hour bug does, but the good news is that it is treatable. A doctor can confirm it with a stool test and prescribe a course of antibiotics that clears the parasite. Michigan health officials have urged anyone dealing with sudden and ongoing stomach illness to contact their health care provider and their local health department, both to get treated and to help investigators track the outbreak. In the meantime, wash your fruits, vegetables, and herbs thoroughly, even though it is not a guarantee.
For now, the explosive diarrhea making the rounds has a name, a cause, and a treatment, even if the exact food behind it is still a mystery. With cases still being counted and the source still unknown, the smartest move is knowing the signs, cleaning your produce, and getting checked out fast if your stomach has been through it for more than a couple of days.
