A recent outbreak of cyclosporiasis — a parasitic infection that causes watery, explosive diarrhea — has made headlines across the U.S.

The cyclosporiasis outbreak was linked to iceberg lettuce from California-based Taylor Farms, which obtained the produce from central Mexico.

Several retail stores and restaurant chains get produce from Taylor Farms and many saw a dip in customers after being linked with the product. Taylor Farms has since recalled the lettuce in question.

Several other sources have been identified in cyclosporiasis outbreaks since.

The U.S. Centers for Disease Control and Prevention has expanded the reach of the Taylor Farms outbreak to nine states, including Pennsylvania.

Patients with diarrhea related illnesses are regular at most hospitals or clinics.

“Certainly, when we have outbreaks like this — things that potentially cause diarrhea — we will generally start to see an increase in patients with those complaints,” said Brent Rau, emergency medical director for the Allegheny Health Network.

The biggest issue with cyclospora is the discomfort and inconvenience it causes, said Graham Snyder, medical director of infection prevention and hospital epidemiology at UPMC.

The good news is the infection rarely causes serious disease or hospitalization.

Cyclospora has been identified as a pathogen for just over 30 years, which makes it relatively new, Snyder said.

The pathogen does not spread from person to person, but is a foodborne illness, he said. The parasite sheds oocysts, or eggs, in the feces, where the eggs mature over time.

Cyclospora is watery, explosive diarrhea that can cause nausea, Snyder said. Some cases come with mild fever, but vomiting is not expected. Snyder said there is no cause for serious concern for a broadly healthy individual.

Most cases of cyclosporiasis are self limited, Rau said, and the majority don’t require any testing. In his last few shifts, he said he has not seen anything out of the ordinary.

In fact, with test results taking up to three or six days, patients who test have often recovered by the time the results are in, Rau said. Nonetheless, in response to the ongoing outbreak, both UPMC and AHN have made testing available for concerned patients.

Any hospitalization, which is rare, is due to other factors, such as severe dehydration or patients who are immunocompromised, according to Snyder.

Snyder said if the diarrhea persists for several days or is accompanied by high fever or blood, he recommends consulting a doctor. Patients with a weaker immune system or known vulnerability to dehydration should make a doctor’s trip as well.

Food supply and water are major sources of origin for parasitic infections, Rau said. In the case of cyclospora, contaminated produce or berries are a popular source.

Following the outbreak is not just a matter of interest for Snyder, but a critical component of his job.

In regards to the recent outbreak, Pennsylvania has, for the moment, avoided bearing the brunt of it.

“We are seeing nothing close to what they’re seeing in southeast Michigan and northwest Ohio, which is sort of the epicenter of this current outbreak,” said Snyder.

Tracking cases, however, can be challenging, he said, because cyclospora is not a reportable disease in Pennsylvania (he added UPMC is reporting all their cases to health departments anyway). Also, as cyclospora is a relatively tolerable illness, many people end up recovering in their own space without medical attention.

As a result, the reported number of cases might be lower in Pennsylvania than the actual number, he said.

Rau said outbreaks of food borne illnesses tend to be more common in summer, as leafy green produce may not be appropriately temperature controlled during storage.

“It feels like every summer, there’s some sort of outbreak, whether it's cyclospora (or) E. coli in the past,” said Rau.

While there is no series of steps which guarantee prevention, Butler County residents can take some measures to bring down their chances of contacting cyclospora.

Rinsing off produce is beneficial, but not enough to completely kill parasites. Boiling and cooking is the only way to substantially reduce chances of infections, said Rau. Washing hands before preparing or eating food and storing food properly can make a big difference, said Snyder. Buying produce locally or from trusted sources can play a role too, Rau said. It is also good for supporting the local community, Snyder added.

“Eating locally may be a way to reduce your risk,” Snyder said. “The idea is, if you consume produce from your local farmers, they’re less likely to be part of this outbreak.”

Diane Dallos, Penn State Extension Butler County Master Gardener coordinator, said gardeners growing their own food can take multiple steps to properly clean their food and avoid contamination. These include washing hands with soap and water for at least 20 seconds, both before and after harvest, and all stages of handling fresh produce.

It also includes rinsing all fruits and vegetables under cool running water that is suitable for drinking, removing outer leaves of leafy vegetables like lettuce and cabbage, and using proper kitchen hygiene and preparation to avoid cross-contamination.

She said a good tip for anyone is to ensure all water used in plant management and washing is from a clean source.

“From the home gardener perspective, the most important tools in prevention are proper cleaning and sanitation,” Dallos said. “During the growing process, risk can be mitigated by using clean water sources, as cyclospora is commonly spread through contaminated water.”

Other considerations include routinely cleaning everything from tools to boots and gloves, preventing animals in the garden, watching for animal feces and following proper composting temperatures and management practices if you are using animal compost.