Last week, the news reported that at least 160 people in 10 states had gotten sick after eating a salad from McDonalds. The cause of the illnesses was due to contamination of cyclospora. McDonalds is cooperating with the CDC and local health officials to determine the actual cause of the diseases and trace it back to where the contamination came from.

Salad contamination is not new this year as we are reminded of an outbreak of E. coli that sickened hundreds and left 5 dead. That contamination was traced back to romaine lettuce grown in the Yuma, Arizona area. E. coli is a bacterium that is normally found in many places in the environment including foods, animals and in people. There are many types of E. coli, most of which are benign, but some can cause diarrhea and others can cause respiratory illnesses, pneumonia and urinary tract infections.

Cyclospora is different than E. coli as it is not a bacterium. According to the CDC:

“Cyclospora cayetanensis is a parasite composed of one cell, too small to be seen without a microscope. This parasite causes an intestinal infection called cyclosporiasis.”

In the United States, most instances of cyclosporiasis occurs from eating produce that is imported from other countries, mostly those in tropical and subtropical regions where sanitary conditions are not that great. The spread of the parasite is usually due to food coming in contact with infected fecal matter, which can come from farm workers in other countries.

What are the symptoms of cyclosporiasis?

Per the CDC:

“The time between becoming infected and becoming sick is usually about 1 week. Cyclospora infects the small intestine (bowel) and usually causes watery diarrhea, with frequent, sometimes explosive, bowel movements. Other common symptoms include loss of appetite, weight loss, stomach cramps/pain, bloating, increased gas, nausea, and fatigue. Vomiting, body aches, headache, fever, and other flu-like symptoms may be noted. Some people who are infected with Cyclospora do not have any symptoms.”

One thing to watch is that cyclosporiasis may seem to go away and then return again and again. Usually, it’s because the cyclospora parasite has not been fully eliminated before treatment is stopped, so it will begin to regain strength enough to cause a second infection.

Determination of cyclosporiasis is made by testing a stool sample using special laboratory methods.

Generally, treatment of cyclosporiasis consists of a combination of two antibiotics. These include trimethoprim-sulfamethoxazole, also known as Bactrim, Septra, or Cotrim. Since these are sulfa drugs and many people are allergic to sulfa drugs, one should consult with their doctor, although the CDC does not list an alternative treatment at this time.

I’m not saying you shouldn’t eat salads at McDonalds or anywhere else, but you need to be aware of the possibility. So far, the infections have occurred in Florida, Illinois (majority of cases), Iowa, Kentucky, Minnesota, Missouri, Nebraska, Ohio, South Dakota and Wisconsin.

Eating healthy salads is great, but if the produce used has not been properly grown, harvested and washed, eating healthy is not always the healthy thing to do.