Cyclospora Outbreak, Explosive Diarrhea, Coffee Benefits & This Week in Medicine

The cyclospora story has grown quickly.

Michigan is now reporting over seven hundred cases, with cases concentrated largely in the southeast part of the state around Detroit, and Ohio has reported a large number of cases also.

Earlier, the CDC national report listed a hundred and forty-five domestically acquired cases in seventeen states with twenty hospitalizations, but that number continues to climb.

The count always lags behind those state reports.

Public health officials are still trying to identify the source, and that is a frustrating part of this outbreak.

We know that what's making people sick before we know what food is responsible for it.

Now, just to make your day more charming, cyclospora is not a worm.

I know when people hear the word parasite, they imagine something long, squiggly, and horrifying enough to star in a late-night cable documentary, but this is a microscopic protozoan.

Now, a parasite is defined by how it lives, not by what it looks like.

It survives at the expense of another organism, a host, which makes cyclospora less like a tapeworm and more like the cousin who still lives in the basement, eats someone else's food, pays no rent, and leaves comments on my Substack.

But this thing is a tiny, tiny protozoan.

It's about eight to ten microns across.

Now, you may recall medieval philosophers pro-- supposedly debating about how many angels could dance on the head of a pin.

But physicians have different questions this week, like how many cyclospora could fit there? The answer is plenty.

You will not see it on your lettuce, smell it on your cilantro, or inspect the way before lunch.

The other important point about this is timing.

Does not make you sick the next morning.

Symptoms commonly begin about one to two weeks after exposure, which means the salad that made you sick is not the one you ate yesterday.

It may be the lettuce on the burger you gobbled up last week, or the cilantro in the tacos, or coriander for my British friends.

Or it could be the side salad that you barely remember because you were saving room for dessert.

By the way, unless your dessert was fresh fruit, it probably didn't do it.

Pick wisely, people.

But the delay in when this thing takes hold and begins to cause symptoms is why epidemiologists have such a difficult job, because they're asking people to remember what they ate a week ago, and most of us can barely remember what we had for breakfast.