The parasite affecting a nation: A cyclosporiasis Q&A

The phrase ‘explosive diarrhea’ has been used a lot recently to describe a cyclosporiasis outbreak that has been detected in at least 34 states, including Indiana.

Check out the Q&A below from IU Health Bloomington Infectious Disease physician Cody Jinnette, DO, to learn more.

What is the explosive diarrhea illness going around?

Cyclosporiasis is an infection caused by the Cyclospora parasite, which can’t be seen by the naked eye. It can be found in food or water that is contaminated and infects people who consume it.

How big is the outbreak?

The Centers for Disease Control and Prevention (CDC) has received reports of over 1,600 confirmed domestic cases since May 1, 2026. There are more than 5,100 suspected cases.

The Indiana Department of Health said around 206 cases have been reported as of July 14.

How can you reduce risk?

• Wash your hands frequently when handling raw produce.
• Wash your hands thoroughly with soap and water after using the restroom.
• Wash fresh fruits and vegetables thoroughly. A simple rinsing may not be sufficient.
• Cook vegetables before eating them. Cyclospora die at 158 degrees Fahrenheit.
• During this time, you may want to consider avoiding fresh fruits and vegetables that have harder to wash exteriors, like raspberries, blackberries, and asparagus.
• You may also want to avoid pre-packaged salad mixes as they have been linked to outbreaks, are difficult to wash, and are consumed without cooking.

What are the symptoms?

The primary symptom is frequent, watery and explosive diarrhea. These uncontrollable bowel movements are sudden, forceful and can be painful.

Symptoms can last days to over a month if left untreated, with some people experiencing a return of symptoms after the original symptoms stop.

Additional symptoms may include the following:

• Watery, explosive diarrhea
• Severe abdominal cramping and bloating
• Extreme fatigue (tiredness)
• Loss of appetite and weight loss
• Nausea and vomiting
• Low-grade fever

What should you do if you have symptoms?

If you are experiencing diarrhea, please reach out to your primary care provider to ask about possible infection.

While it may go away by itself for healthy individuals, the symptoms can last longer or come back without treatment. A 7- to 10-day course of antibiotics is the recommended treatment for Cyclospora infections. Individuals with compromised immune systems may require longer treatment.

Some individuals are more at risk of severe complications than others, including:

• The very young
• The elderly
• People with underlying medical conditions
• Anyone who is immunosuppressed

Symptom management includes staying hydrated with plenty of water or electrolyte-replacement fluids and getting plenty of rest. Based on individual circumstances, your primary care provider may suggest over-the-counter anti-diarrheal medication.

If you are experiencing fevers (>101 F), severe dehydration, or bloody diarrhea, please seek care at the Emergency Department.

Resources:

• https://www.cdc.gov/han/php/notices/han00531.html
• https://www.in.gov/health/idepd/diseases-and-conditions-resource-page/cyclosporiasis/
• https://www.cdc.gov/cyclosporiasis/about/index.html