I got the diarrhea parasite Cyclospora after a work lunch. These were my tell-tale symptoms.
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courtesy of Chase Strangio
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- A man in New York City contracted the cyclospora parasite in May, after eating chopped lettuce.
- He experienced 10 days of watery diarrhea, severe indigestion, and stomach pain, with no appetite.
- Lettuce has been identified as a potential source of the outbreak.
This as-told-to essay is based on a conversation with Chase Strangio, a 43-year-old attorney from New York City who recently tested positive for the cyclospora parasite. It's been edited for length and clarity.
I am not someone who normally skips dinner; I love food. But on a busy Wednesday evening in late May, I just couldn't bring myself to eat anything.
I had no idea at that time that I had become a victim of the mysterious US outbreak of cyclosporiasis, which has so far sickened thousands of people across the US. Cyclosporiasis is a parasite that travels through fecally-contaminated water and food, but it took me a long time to realize I had it, in part because the bacteria can incubate in your body for a few weeks before you feel sick.
I'm sharing my story because I believe we all deserve access to clean water and clean food. Perhaps by sharing my painful experience with this summer's enemy parasite No. 1, I can play some small part to improve the administration of public health nationwide.
I thought I had norovirus — but I wasn't vomiting
Electrolyte drinks, saltine crackers, and applesauce were his staple foods.Pawel Kacperek/Getty Images
I lead a pretty stressful existence as an attorney working in New York City, and my first thought when I lost my appetite was "God, I'm really tired." So, I put myself to bed.
But I simply couldn't sleep. I was up throughout the night, feeling nauseous, unable to rest.
By the time morning came, I was convinced I had a stomach bug, maybe some kind of 24-to-36-hour food poisoning incident like a case of norovirus. I had a fever, felt sick to my stomach, but I wasn't vomiting as much as you'd necessarily expect for that type of illness. I was feeling sicker and sicker as the day went on. I Googled "Can you have norovirus and no vomiting?" Turns out, it's possible. So I decided to ride this illness out.
Watery diarrhea that comes and goes was a good indication of cyclosporiasis
In addition to the watery diarrhea, which made it difficult to stay hydrated, the lawyer suffered from frequent gas and indigestion.Creative Images Lab/Getty Images
One of my earliest tell-tale symptoms of the cyclosporiasis infection was severe diarrhea, unlike anything I'd ever experienced before. These weren't particularly painful trips to the bathroom, but it was the volume of water coming out that impressed me.
I felt gassy and hungry, but my body just rejected the notion of food altogether. By Saturday, about three days into the illness, I couldn't bring myself to drink water. It was like my internal eating and drinking switches had shut off.
I was also dealing with some pretty bad stomach cramps. I went to a Broadway show Saturday night and was in extreme discomfort. I could barely sit down. By Monday, five days into the illness, things were getting dire. I had a big legal brief due, but I couldn't get out of bed. I pushed through the pain to get the work done, and thought "maybe I'm just getting old. This is taking me out more than I expected." I did two virtual urgent care visits, pounded some Tums and was prescribed anti-nausea medication, but I wasn't improving.
A corporate lunch with leafy greens is suspect No. 1
The lunch bowl included both chopped lettuce and cilantro. Investigators are now zeroing in on lettuce as a prime suspect in this outbreak.Westend61/Getty Images
Suddenly, other people in my life started coming forward with similar symptoms. We'd all shared lunch together exactly a week before my symptoms started. We ordered from one of those ghost kitchen places that serve boxed lunches for corporate events. Some of us had vegetarian options, others had meat. But the common denominator among all the people who got sick was lettuce and cilantro, two leafy ingredients that have been connected with cyclosporiasis outbreaks in the past.
No one has identified the cause of the current US outbreak, but lettuce is a prime suspect. I can't know, without testing the food I ate, whether I definitely got sick from my lunch that day, but given the chain of events and the fact that none of my loved ones at home got sick as I did, it does seem suspicious.
By this point, I was living off electrolyte drinks like Pedialyte, saltine crackers, and applesauce. It was frustrating because you're trying to work and you're trying to live your life, and I wasn't getting enough calories to be able to function in the way that I wanted. I lost seven pounds, and it was a huge drain on my workflow. The illness was becoming all-consuming. I was feeding myself in a way that I would feed a toddler: "OK, just one more bite, you can do this." It felt insane. I thought, "What is happening to me? I love food."
The other thing about cyclosporine diarrhea is that it comes and goes in waves. So all of a sudden, you've got watery diarrhea all over again. It makes it extremely difficult to stay hydrated, and I started getting dehydration headaches. My partner floated the idea that I'd been poisoned. I thought that seemed like a crazy idea, but it was the push I needed to recognize this was not just a short-term stomach bug; something was really wrong with me.
A stool test confirmed my diagnosis, and antibiotics cleared the infection
A combination antibiotic treated the infection.janceluch/Getty Images
Finally, someone who was at lunch with me on May 13 tested positive for cyclosporine through a stool sample. I made an appointment with my doctor and said, "You've got to put me on Bactrim." Though they insisted I also perform a stool test, they gave me a prescription for the antibiotic. Within two days, I was feeling a lot better, and I tested positive for the parasite on June 4, more than three weeks after that fateful meal, and 14 days since my first symptoms surfaced.
Since my illness, my routines have changed a little bit. First of all, I wake up every day and thank antibiotics for my existence. I cook everything now. It is definitely a change. I will not be eating that salad out in the New York City streets. Absolutely not. I am a new evangelist for food safety regulation.
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