A parasite that causes a nasty intestinal illness has sickened thousands nationwide and hundreds in Kansas and Missouri, cause some people to consider locally grown produce options
The parasite, called cyclospora, is spread by water or food contaminated by human waste. Federal officials are still working to identify the source or sources of the outbreak, but they’ve tentatively linked it to leafy greens.
Cyclospororiasis, which is the illness caused by the parasite, can come and go and make its human host sick for a month or more.
Wichita resident Jennifer, who asked to only be identified by her first name for medical privacy, said she’s been sick with cyclosporiasis for three weeks. She’s now undergoing treatment.
“I'll literally work for two hours and then I will have to take a nap,” she said. “It has completely disrupted my entire life.”
Because of the outbreak, some Kansans are changing their diets or considering more produce from small, local farms, hoping it’s a safer option. Experts say no farm is immune to food safety issues, but smaller farms have some advantages.
Cyclosporiasis symptoms
Cyclosporiasis has made headlines, and prompted a lot of jokes, for what experts call “explosive” diarrhea. Jennifer said she hasn’t experienced that.
“It wasn't explosive diarrhea. It was just … normal diarrhea,” she said.
The illness can cause a host of other symptoms, like nausea, a low-grade fever, loss of appetite and fatigue.
Jennifer said at first, she thought she had heat exhaustion. She’d been at a soccer game right before the symptoms hit. After the game, she said she felt extremely tired and had diarrhea that just wouldn’t go away.
Jennifer said she called a nurse line and explained her symptoms. She said the staff believed it simply sounded like she was dehydrated.
It took an urgent care visit and finally a trip to her regular doctor and a test to get confirmation that she has cyclosporiasis.
Jennifer said she works from home, but if she didn’t, she would’ve had to take a lot of time off from her job. It’s been pretty miserable.
“If I was in an actual workplace, there's no way I would have been able to work for the last two weeks,” Jennifer said. “It's like, work for a little bit, nap. ‘Ope, bathroom.’ Nap. ‘Ope, got to go back to the bathroom.’”
Jennifer said she’s almost completely avoiding all restaurant or store-bought produce for the time being.
Case numbers in Kansas and Missouri
Cyclospora isn’t a new parasite. Case numbers typically peak in spring and summer. What’s unique this year is the number of cases. Kansas, for example, had only 31 total confirmed cases last year. This year, as of the latest date published last week, the total was 289. Missouri’s case count, as of Monday, is 593.
Dr. Keisha Davis, a pathologist who hosts the podcast, The Medical Collective, has been studying cyclospora. She said it’s really hard to get off of produce.
“It sticks to the vegetables in a cyst form, kind of like a tortoise in a shell,” Davis said.
One reason this outbreak has grown so large is because it’s hard to trace. It can take a week or more for symptoms to show.
“Produce doesn't stay long,” she said. “If somebody waits three to four weeks to get sick and then get symptoms, we can't really go back to the produce. Produce is off the shelves by then.”
Davis said testing for cyclospora isn’t routine. Doctors have to request a specific type of panel to catch the parasite.
Cyclospora is changing some shopping habits
At KC Farm School at Gibbs Road in Kansas City, Kansas, there’s been a bump in customers. The school teaches people, regardless of their age or ability, how to grow food. It also operates a pay-what-you-can produce stand across the street and delivers fresh produce to people across the metro.
Co-founder Alicia Ellingsworth said some customers are more wary of the produce they’re eating.
“We've heard a lot of fear. People don't know where their food is coming from, will come from, how to know whether or not it's safe and just that uncertainty,” she said.
Ellingsworth said at KC Farm School, they follow federal safety guidelines.
“We have a very tight production plan. Our farmers know where the food is harvested from, which beds, and so we can track it that way,” she said. “We have very stringent food safety standards.”
According to Ellingsworth, connecting with a local grower is easier than people think. The KC Farm School accepts food assistance programs, like SNAP, to pay for produce.
She said her farm and multiple others in the metro also have a subscription program, called the Community Supported Agriculture Farm Share. Other farms also participate in the program nearby.
Ellingsworth said she hopes the bump in customers lasts longer than just the cyclospora outbreak.
“I think it's an opportunity for farmers to share more of the story,” Ellingsworth said. “And for people to maybe finally connect with their food and with the farm that's likely right down the road from them.”
Local doesn’t always mean safer
Manreet Bhullar, an assistant professor and researcher at the University of Kansas, specializes in agricultural food safety. He said it’s important for consumers to remember that no food is completely risk-free.
“It is important not to assume that local automatically means safer,” Bhullar said. “The food safety depends upon the practices used on the farm, not simply on the farm size.”
Small and medium farms aren’t legally required to follow federal safety guidelines like large, industrial farms. He said people should always wash their produce, and if you’re buying produce at a farmers' market, ask the farmer about what food safety protocols they follow and what types of water they use.
According to Bhullar, there are some advantages to buying produce from a small farm. He said the produce is typically fresher when it’s sold and is handled less.
“In addition, produce from local farms is generally not mixed with other products from hundreds of other farms, which typically happens at these larger-scale processing facilities,” he said.
Bhullar said cyclospora is a human parasite, meaning animals don’t spread it. It’s also not spread directly human-to-human. He said in farm settings, it’s typically spread when irrigation water is tainted with human feces or sanitation practices aren’t followed by workers.
“This particular outbreak, cyclospora, provides a reality check on how the big farms and the big processing facilities could lead to an outbreak of this scale if proper food safety practices are not used or implemented,” Bhullar said.
Bhullar said people and farmers with questions about produce safety or cyclospora are welcome to reach out to the K-State Fresh Produce Safety Extension at producesafety@ksu.org.
Being picky about produce
At the Overland Park Farmers' Market, cyclospora was on people’s minds. Chris Johnson sells lettuce, herbs and strawberries grown using hydroponics, a method that doesn’t use soil.
He was sold out of lettuce, and he said his customers had a lot to say about cyclospora.
“Almost everybody's been very concerned about it,” Johnson said. “They're grateful that they have the market so that they can feel safe in feeding their families.”
Sharon Rodriguez-Burns was shopping for produce. She said she’s leery of uncooked lettuce, herbs and tomatoes at restaurants and grocery stores.
“My gut feeling is that this is probably a little safer, of course, because it's not imported and it's not mass handled,” Rodriguez-Burns said. “I feel like I'm a little safer.”
Health experts say if you’re trying to avoid cyclosporiasis, you should wash and gently scrub even prewashed produce. And cook it, if you can. Also, watch for recalls.
Bhullar said not to give up on greens altogether — they’re still part of a healthy diet.
“In this case, the solution is not to eat less produce, but to continue improving food safety from farm to fork, while maintaining a diet rich in fruits and vegetables,” he said.
Bek Shackelford-Nwanganga reports on health care disparities and access for the Kansas News Service. You can email her at r.shackelford@kcur.org.
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