Nothing beats biting into a fresh slice of watermelon or popping a succulent strawberry into your mouth, maybe while floating in a pool, on hot summer days − and Cincinnati is definitely getting a lot of those. But what are we supposed to do now that a pesky parasite is hitching a ride on our favorite summer staples?
Well, the cyclosporiasis infection may not be as dire for your summer fun as you think, says Dr. Keith Luckett, medical professor in the infectious diseases division at the University of Cincinnati.
Luckett fields questions from patients every day about how to minimize risk of exposure to the parasite, cyclospora cayetanensis.
This interview has been edited for clarity and brevity.
As a doctor, what general advice would you give to help people avoid getting cyclosporiasis?
With 17 cases in Hamilton County and 366 across Ohio as of July 15, you can never be too careful. So, Luckett sat down with The Enquirer to share some tips.
Luckett: You should continue to live your lives.
What you should do is be sure that you’ve washed everything, even if the bag says prewashed, or even if you just saw the misters go off at Kroger and wash it, you should wash it yourself.
Making sure everything is thoroughly washed is the most important thing.
There hasn’t been a pinpoint to exactly one thing causing this yet. There’s some signal that maybe it’s lettuce causing this.
Just be vigilant. If you absolutely want to avoid all risk, you avoid leafy vegetables and you wash everything else you can very well and you eat mostly things that have rinds on them.
There’s a way that you can reduce your risk significantly just by ensuring that you’re eating lower risk fruits and vegetables, things with rinds, things with peels. And if you do want to eat the higher risk foods, just be absolutely certain that you have done your due diligence in washing them very well.
When it comes to eating produce, what’s the best way to stay safe?
Luckett: I don’t think we’re far enough into an outbreak that anybody should be so worried that they’re avoiding produce altogether.
The main vegetables that are implicated are the green leafy ones. So, things like parsley and lettuce. You just have to be really careful with those. Those get an extra rub.
If it has a peel, you can always peel that off. So, fruits like oranges are easy because you have to get rid of the outside covering anyway. Bananas, easy.
You can use a peeler and get the peel off of a zucchini or a squash or anything like that. So just being really careful with your produce, making sure you wash it yourself. ‘Trust but verify’ is what I always say. You can trust that somebody else washed it, but you should verify that by washing it yourself.
Anything with a rind, you can peel that, and the protozoa can’t actually penetrate the rind. It’s just on the surface. So peeling an orange, peeling a banana, you can wash your apples and then you can cut the peels off of them if you want to as an extra step. And the same with vegetables.
The only ones where there’s a problem are really the leafy ones, where you can’t wash them as great. And you just have to be extra careful. So if you have a handful of parsley, you need to wash it a little bit more thoroughly than you wash that zucchini, because it’s got the little nooks and crannies in the leaves where the protozoa can hide out.
What else should we do? Eat at home? Avoid swimming?
Luckett: We have to talk about restaurants, and we have to talk about swimming pools.
You have no control over what happens to the food that you order at a restaurant. If you’re going out to eat, would I order a salad today? Probably not. Just because there is this signal towards lettuce, and you cannot control what their staff has done with the lettuce in their prep room.
You can’t be too careful. I would avoid salads out to eat. I wouldn’t get lettuce on my hamburger. I would just try and be careful when you don’t have control of the food that you’re eating.
No. 2, swimming pools.
Anytime you go to a swimming pool, there is a placard that says, don’t get in the pool if you have diarrhea. And this is one of the reasons. Typically, chlorination of the swimming pool protects us from all the other bad poop germs, but cyclospora is sort of unique in that it is less sensitive to killing by chlorine. So just because the pool is sanitized appropriately doesn’t mean that you can’t get cyclospora if someone swimming with you also has it.
Am I avoiding pools? No. You know, I’ve still taken my 7-year-old to the swim club twice a week or something since this happened. But having the awareness that if he starts to have explosive diarrhea, well, I guess we should check for this, in addition to the other things that can cause that. I mean, it’s summer, it’s picnic season. People are leaving out their gross mayonnaise-based salads and they’re curdling and they’re getting food poisoning.
So I think that it’s important to think about cyclospora, but also not to anchor on it and to forget about all of the other things that can cause diarrhea in the summer months.
Wash your hands, especially after you have used the restroom, just in case you’re carrying it, so you don’t spread it to others. Wash your hands after touching anything that may have been contaminated with this parasite. So, after you’ve thoroughly washed your vegetables, then you can wash your hands with soap and water. If you come out of a swimming pool, wash your hands before you grab your food and put something into your mouth.
Basic infection control practices, wash your hands, wash your hands, wash your hands. And then wash your hands again.
Am I, or is my kid, at high risk?
Luckett: The people who are at highest risk are folks whose immune systems are compromised. Myself as a healthy 40-something, if I get cyclospora, I might have a couple of days of diarrhea, and then it might go away. Or I might have this sort of waxing and waning picture where I have it for weeks to months. But it’s probably not going to kill me.
Folks whose immune systems aren’t as robust as mine, for whatever reason, they might have a more severe disease, and it might be more prolonged. So, I’m really worried about those folks.
When should I go to a doctor?
It’s important that if you are worried that you’ve been exposed to this and you develop diarrhea, that you call your primary care doctor sooner rather than later so that we can get the tests done to determine if this is what’s going on.
Not everyone needs treatment. Some people will resolve on their own in several days. But some people get this more prolonged course. And on average, when you look at cyclospora, the average duration of illness is about three weeks. But there is a subset of patients who develop a more chronic diarrhea. And ideally, we would like to avoid that by knowing about it and getting you in for treatment.
The average time from exposure to development of symptoms is about seven days, but it’s a pretty wide range. It can be anywhere from two days to 14 days.
If you start experiencing symptoms, get in touch with a medical professional so that you can have testing done. The testing is done by taking a sample of your stool and looking at it under the microscope for the eggs of these protozoa. So, it’s a relatively easy test to do, but we can’t test you if we don’t know.
Treatment is just about a week of antibiotics.
This article originally appeared on Cincinnati Enquirer: What would you do, doc? 5 tips to avoid the cyclospora parasite
Reporting by Esther Launstein, Cincinnati Enquirer / Cincinnati Enquirer
USA TODAY Network via Reuters Connect
By Esther Launstein, Cincinnati Enquirer | USA TODAY Network
