Parasitic infections causing ‘explosive diarrhea’ double in Maryland since last week

Cases of cyclosporiasis remain low but are rising in Maryland, with 69 people suffering from the parasitic infection that can cause “explosive diarrhea,” according to state officials on Wednesday.

That’s more than double the 32 cases reported last week, with almost all of the cases confirmed since May 1. The cause of it all remains a mystery, state officials said.

“Investigations into cyclosporiasis cases are conducted by local health departments and reported to the Maryland Department of Health,” department spokesperson Amanda Hils said. “Investigations are ongoing and, to date, Maryland’s health departments have not identified a common link for cases reported in 2026 to present.”

The state reports roughly 100 to 200 cases every year, but public health officials across the country have been warning people about the sharp rise this year.

Though there’s no official culprit identified anywhere in the country, officials in Michigan, where there are thousands of cases, said their investigation indicates lettuce or salad greens could be among the sources.

The infections are caused when people ingest microscopic parasites through contaminated water or food, typically produce. Officials have usually traced that produce to countries where the parasites are endemic. But more often now, they are found in locally grown fruit and vegetables, too.

Federal officials had stopped tracking cases of cyclosporiasis under the Trump administration, but have since relaunched surveillance. The rollback followed a year of layoffs and funding cuts within federal food safety infrastructure, which states lean on to help track outbreaks in the food supply.

The federal Centers for Disease Control and Prevention now reports about 6,745 confirmed or suspected cases in 34 states. The CDC also reports that 141 people have been hospitalized, but there have been no deaths.

State and federal officials say there isn’t a reliable way to avoid the parasite, but they recommend washing produce and hands thoroughly.

Other tips include cooking vegetables to 185 degrees to kill the parasites, scrubbing firmer fruits and vegetables, and buying whole heads of lettuce instead of bagged lettuce and peeling away the outer layers.

Berries can be tougher to clean because they have lots of crevices, though no cases have been linked to frozen or canned fruits or vegetables so far.

Most people recover from an infection on their own, though symptoms can persist for days or a month or longer. They include fatigue, loss of appetite, weight loss, increased gas or bloating, fever, cramps, nausea and — perhaps the worst part — watery, sometimes explosive diarrhea.

Officials say it can be tough to trace to a source because symptoms can appear up to two weeks after eating contaminated food, and people have to remember what they ate.

Those with symptoms should call their doctors for guidance and report possible cases. Some people may benefit from taking an antibiotic, TMP-SMX.