CHI Health physicians say Nebraska has now joined the growing list of states reporting Cyclospora infections as a nationwide outbreak continues, although the number of confirmed cases in the state remains relatively small.
Dr. Dave Quimby, an infectious disease physician with CHI Health, said laboratory testing has identified only “a handful” of confirmed cases in Nebraska so far, but he cautioned that the actual number of infections is likely much higher because many people recover at home without seeking medical care.
Cyclospora is a microscopic parasite that causes intestinal illness after contaminated food is consumed. Dr. Vivekananda, CHI Health’s chief medical officer, said previous outbreaks have been associated with pre-packaged salad mixes, cilantro, basil, raspberries, snow peas, green onions and scallions, although investigators have not yet identified the source of this year’s outbreak.
Doctors emphasized that rinsing produce helps but isn’t guaranteed to eliminate the parasite. “The only verified way to get rid of it is by cooking over a certain temperature,” Quimby says, adding that freezing does not reliably kill Cyclospora.
One of the biggest challenges for investigators is the parasite’s lengthy incubation period. Symptoms typically don’t appear for seven to 10 days and can take as long as two weeks to develop, making it difficult for patients to remember everything they ate before becoming ill.
“It’s really hard to narrow it down, somebody might be infected, but it’s still incubating, That’s one of the biggest things, the incubation period,” Quimby says. Doctors say the illness usually causes prolonged diarrhea, fatigue and dehydration. Unlike norovirus, Cyclospora can be treated with antibiotics, although many mild cases resolve without hospitalization.
According to the physicians, no deaths have been reported from the current U.S. outbreak, and the risk of person-to-person spread is considered very low.