How to avoid the parasite Cryptosporidiosis and the "explosive" symptoms

Explosive watery diarrhea is not just “something you ate” and during a national outbreak, it’s worth knowing the real culprit. Speaking of Women's Health Podcast Host Dr. Holly Thacker walks you through cryptosporidiosis, a waterborne and foodborne illness caused by the parasite Cryptosporidium that can hit hard, spread quietly, and ruin a summer week fast.

She gets practical about what works and what doesn’t. Vinegar rinses and baking soda washes can help remove dirt and some contaminants, but they do not reliably kill this parasite. The most dependable kill step for fresh produce is heat: cooking to 158°F (70°C) or higher. She also shares smarter shopping and kitchen habits during an outbreak, like scrubbing firm produce under running water, peeling when possible, avoiding cross-contamination when slicing melons, and leaning more on cooked, frozen, canned, or peeled options when risk is higher.

She also talks prevention beyond the kitchen: soap-and-water handwashing (hand sanitizer won’t do it here), avoiding swallowing pool or lake water, and why you should never swim with diarrhea. Subscribe, share this with a friend who lives at the pool, and leave a review so more people can find these outbreak safety basics.

Transcript

Why Crypto Is In The News

Dr. \ 0:05

Welcome to the Speaking of Women's Health Podcast. I'm your host, Dr. Holly Thacker, and I am back in the Sunflower House for a new and pretty timely podcast this summer of 2026, and it's all about cryptosporidiosis. You've probably been hearing about this parasite in the news. It's really kind of been an explosive uh news title, pun not intended. So, cryptosporidiosis is a parasitic disease, and we've had a lot of cases around the United States in the last several weeks. In fact, Ohio, which is where our sunflower house is originated and located, even though we're in a hundred different countries, is the second most common state for this outbreak. Now, the beginning part of the name of this parasite, crypto, crypto kind of means a cult. Crypto makes me think of my youngest son, a gen zier, who's very much into cryptocurrency, and he's trying to get his old mother up with the new way to own private property, as he says. And so crypto can mean occult or hidden, maybe hard to understand. Um, and in this case, crypto sprutiosis, this parasite likes to hide in the crevices of a lot of fruits and vegetables. Now, my husband was telling me, just have bourbon and steak, dear, and you'll be fine. Which I guess technically he's right, but that's not exactly a balanced diet. Uh, but I've certainly seen a lot of jokes and memes on the internet that this is, oh, a revenge against the vegetarians. Well, we know fruits and vegetables have a lot of antioxidants, a light of a lot of vitamins and minerals, and are an important staple of most people's uh diets. So we we certainly don't want to make light of anyone's dietary preferences. Although food is very important, we've had columns on food as medicine, we've had columns on food freedom and how there's so many different foods that are available in the United States that are actually banned in other countries because they probably don't have the best ingredients or health factors. So generally, we've pushed a lot of superfoods, which tend to be certain fruits and vegetables. Now, when this was first hitting the news, I thought, well, you know, I rinse my vegetables and fruits and vinegar and sometimes baking soda too. Um, and I picked up a couple extra containers of baking soda and vinegar containers at the grocery store the other day. But apparently, neither baking soda or vinegar completely reliably kill the cyclospora. So, because this microscopic parasite is encased in a really remarkably tough microscopic shell, also known as an oocyst, it can easily survive a lot of abuse. Chemical sanitizers, household disinfectants, and even the natural digestive acids in your stomach, which is very important for digestion and for infectious control. Now, I am not an infectious disease expert, nor am I a gastroenterologist. And this is not medical advice. This is edutainment to kind of empower you to be strong, be healthy, and be in charge. But since this has really kind of been a gut punch to a lot of people and is really kind of taking the nation and a lot of attention, I thought this would be a really good topic to

Why Heat Beats Vinegar

Dr. \ 3:42

go over. And it was nice for me to get educated myself. So the only reliable way to destroy cyclospora on fresh produce is through good old heat. So cooking, baking, boiling fruits and vegetables to an internal temperature of 158 degrees Fahrenheit, which is 70 degrees Celsius or higher, will kill this parasite. So while I still recommend vinegar and baking soda as being an excellent mechanism to remove dirt, pesticides, and some bacteria, they will not repeat, not eradicate cyclospora. So some public health officials are giving some recommendations on how we handle raw produce. Certainly rinsing it under plain, running water, and gently rubbing the produce, scrubbing firm produce using one of those clean vegetable brushes for things that have tough skins. And a lot of times, like cucumbers and melons, I don't necessarily clean because I cut them, but it's probably a good extra step. And for now, particularly if you live in one of these areas that there's been a lot of reported cases, and you can Google your zip code and ask and find out how many cases have been reported. Certainly knowing that lab positive cases are certainly only probably the tip of the iceberg people who go in and actually get the appropriate microscopic evaluations. Uh, it's a good idea just to get in the habit of scrubbing your produce, peeling when possible, especially now. So when I just got back from the grocery store tonight, I tended to pick uh fruits and vegetables that I could peel. And I planned to do more cooking and baking than I normally do in the summer. So

Travel Stories And Pool Water Risk

Dr. \ 5:23

my family just got back from a great vacation at the Greenbrier in West Virginia. It's uh was the previous White House, uh Southern White House, because back in the days of no air conditioning, God forbid, a lot of times the presidents would go to the mountains of West Virginia and uh work there. So there's a lot of history. It was a great, great, great place to have a celebration of our country's 250th anniversary of freedom. If you didn't hear my Fourth of July podcast on freedom and food, that was a good one to go back to. So as we were driving, I was getting reports, people saying that they thought they might have this, reports in the news. And I was looking at the state distribution, and voila, West Virginia didn't have any cases then. But of course, now they do. And that's how is true of many infectious diseases. In fact, at the beginning of COVID, I remember going with my middle son Emerson and his then girlfriend, now wife, to go to the greenbrier. And that was the only state that didn't have any COVID reported. Well, of course, eventually it did. And so that's what happens with infectious diseases. But while we're at the lovely Greenbrier in the infinity pool, I was with my current youngest grandchild, Caspian, who just loved the water and his little tongue was like a little dog like licking in the water. And of course, you don't want to be drinking pool water for a variety of reasons. And I was thinking, oh no, you know, we just can't indiscriminately put potentially contaminated water in your mouth, especially any water that could at all have any fecal contamination. So

Symptoms That Should Raise Alarm

Dr. \ 6:59

let's kind of go back to the very beginning and discuss what is cryptosprudiosis. So medically, the symptoms can be watery explosive diarrhea, like 10 or more times in a day. That's a lot. There can be stomach pain and cramping. My brother called me a few days ago, worried that he might have appendicitis, which of course, anytime you have abdominal pain, especially if it's in the right lower quadrant, even if it might be infectious, you know, appendicitis can rupture and cause sepsis and death. So, of course, you want to be concerned about that. I've done prior podcasts on irritable bowel syndrome, which is a very common cause of stomach upset, diarrhea, and bowel changes. Sometimes cryptosporidiosis can cause fever, and usually it's associated with some loss of appetite as well. And the most common symptom, though, is profuse watery diarrhea. And it's caused by the parasite cryptosporidium. And most people get it after accidentally getting water or food that has cryptosporidium in it. So public pools, hence why I love to take my grandchildren in the water. Get them swim lessons, because we want to avoid drowning deaths, of course. We want everyone to become a good swimmer, but you've got to worry about this parasite. It reproduces inside your GI tract and it can cause GI symptoms, especially the diarrhea. And this cryptosporidiosis is unfortunately common. In general, there's almost a million cases in the United States every year. And in children, I learned this fact. It's the second most common cause of diarrhea in children. Certainly, norovirus causes a lot of GI problems. That's a virus. So for most of us, thankfully, cryptosporidium isn't too terribly serious. But if you don't have a healthy immune system, it can cause long-lasting diarrhea. And severe diarrhea can be life-threatening, particularly for those people at advanced ages, very, very young and very, very old. So watery frequent diarrhea might be a tip-off, stomach pain, cramping, nausea, even vomiting. Obviously, anytime your GI tract is all messed up, you're not going to have much of an appetite, low fever. Loss of ability to eat food is like classic for appendicitis. And I think some of my listeners may remember when I was talking about my bout of appendicitis last year. I still could eat a little food. And I was taught in medical school that if you had appendicitis, you wouldn't eat anything, even your favorite, favorite food. So personally, that wasn't exactly true for me. And I've always kind of had a pretty strong GI tract. So some people can just have the parasite without symptoms, interestingly, and they can just pass it on. There are a few different species of Cryptosporidium, but the Cryptosporidium hominus, which means human, and Cryptosporidium parvum are the most common types that cause infection. It's a protozoal parasite, which is a one-celled organism that can only live off animals and people. And it's so small you, of course, can only see it with a microscope. So it's a microscopic parasite. And the way it spreads is primarily fecal oral root through contaminated water, contaminated drinking, contaminated recreational waters, especially pools and lakes, unpasteurized milk, any infected surface or contact with infected animals. Usually the symptoms come two to four, two to ten days after the infection and last for about one to two weeks. And you have been listening to the Speaking and Women's Health podcast. I am your host, Dr. Holly Thacker in the Sunflower House. I am the executive director of Speaking and Women's Health. I am the director of our Center for Specialized Women's Health at Cleveland Clinic. I run our specialized women's health fellowship, and we are getting ready to accept in this new academic summer year a brand new specialized fellow who will be spending two years with us. And hopefully I'll have her on one of our future podcasts. So getting back to cryptosporidiosis symptoms, if you're lucky, last two days but can last longer, over 10 days, even a few weeks, even be relapsing. Because of the watery diarrhea and abdominal pain and cramps, we worry about dehydration. Anytime anyone vomits, uh, there's always the chance for aspiration. Uh mild fever and weight loss are not uncommon. So if you suspect you have crypto, and I don't mean crypto in your crypto wallet, which may be a good thing to have, and if you do have crypto, make sure you don't forget your keys because you can lose that forever. So I've been learning all about these old storage wallets and everything for my younger son. It's really kind of fun when your offspring have a lot more expertise and knowledge in a certain area compared to what you have. So

Testing And Getting A Diagnosis

Dr. \ 11:49

if your healthcare provider, clinician suspects that you have cryptosporidiosis, usually a stool test is ordered. And I remember years ago when my family had recurrent diarrhea and vomiting. Oh, it was terrible. It kept going through the whole family. It would happen at night. My one son would get up in the middle of the night and start vomiting and it'd fall down the stairs. It was just a complete nightmare. And sometimes it's very hard to get a fresh stool specimen, especially in children. And then I remember eventually just treating the whole entire family. I suspected we might have giardia. Sure enough, the metronazole flagell did the trick. But it's really best if you can get a microscopic examination. And it might require a special modified acid fast stain. But a lot of labs now utilize a sensitive molecular PCR test to detect the actual parasites DNA. And I'm taking some of this information from our Cleveland Clinic Health Essentials. And folks can check out Cleveland Clinic Labs for the exact testing requisition required in your area.

Treatment Options And Medication Costs

Dr. \ 12:54

So for individuals that have a healthy immune system, usually the illness is self-limiting, clears on its own, people don't necessarily need medication. But oral rehydration therapy, drinking plenty of good clean water, potentially pediolite in children, maybe Gatorade, getting some of the electrolytes back is very important. Now, if you've got a weakened immune system, unfortunately these symptoms can be chronic, severe, and even life-threatening. So your physician or healthcare team might prescribe an antiparasitic medicine called nitazoxinide. Now, this is an old, previously cheap, safe, effective medication for the most part. However, because of pharmacy benefit managers and just kind of the whole warped thing related to drug pricing, when I was looking online at the cost on GoodRx and pharmacies, I was really shocked how expensive it was. And if you haven't heard my two prior podcasts on how to save money on medicine, it's a good one. But unfortunately, if you need medicine for an acute infection, you really don't have the time to be ordering on Canada drug. So I think that people that are going to endemic areas, people that might be immunocompromised, people that are traveling, you know, it may be a good idea to talk to your healthcare team about if you need certain medications on hand. Like I was very glad that I was carrying some antibiotics with me when I got appendicitis and had a high fever, because I was able to take that on my physician's instruction as I was going into the emergency room and preparing for surgery. So a lot of my patients who travel to Europe want to have bladder infection medicines or traveler's diarrhea medications, along with peptobismol, which of course has aspirin, so it's not appropriate for really young children. So it may be worth talking to your healthcare team. I know there's also online uh companies, wellness company and other online places that will give you kind of an emergency health kit. So depending on your personal preferences and healthcare needs, it might be something worth considering, especially if you're immunocompromised or have a lot of chronic illness. So prevention,

Prevention That Actually Works

Dr. \ 14:56

that's always generally the best thing as opposed to treatment. Wash your hands frequently. Soap and water for at least the amount of time that you would sing happy birthday, at least 20 seconds. Note alcohol-based hand sanitizers, which a lot of people have used since COVID, are not effective against cryptosperdiosis. Good old soap, water, and friction. Wash your hands often. And please avoid swallowing recreational water. And so I really had to pay attention to keeping Caspian's cute little head above water. And this kid's got a big head. I think he's gonna be very smart. Be careful with what you drink. So unpasteurized milk, especially contaminated drinking water from lakes or rivers. If you suspect that your water is contaminated, boil it if you've got access to that. And uh avoid swimming when you're ill. And please, please, do not swim if you have diarrhea. I just I keep thinking about that one scene with Caddyshack. I think it was just a chocolate candy bar, but like everybody thought it was excrement. Anyway, anytime there's an accident in a pool, usually everything has to be cleared out, it has to be all filtered, and usually people can't get in the pool for at least 24 hours afterwards. So I think it's a good idea to avoid swimming in public pools or bathing with other people for about two weeks after any infectious diarrhea. Now, there's a lot of official places you can go for resources, like the centers for disease control and prevention. The Cleveland Clinic has an educational offerings online as well. And it's also important to know like, do you think you have a personal exposure? Have you been exposed at work or school projects? Do you work with livestocks? Are you working in farming? Now, luckily, cryptosperdiosis usually goes away on its own in just a few weeks. But if your immune system is weakened, it can last a lot longer. And it can affect your entire biliary system, spreading through the intestinal lumens and causing watery diarrhea. And uh the parasite germs live in the fecal material of infected people. So if you think that you are infected or have symptoms, of course, you need to seek medical attention. In

How It Spreads And Who’s At Risk

Dr. \ 17:18

terms of how this parasite is spread, as I mentioned, it's at the fecal oral root. And I know it sounds gross, you certainly don't see poop that you're putting into your mouth, maybe unless you're a dog. But the most common ways this happens is through contaminated water or contaminated food. So lakes, swimming pools, hot tubs, water parks. Who doesn't like water parks this time of year? I love taking my grandkids uh to the water park. And unfortunately, chlorine does not kill Cryptosporidium. So contaminated food, uh, especially unwashed fruits and vegetables, unpasteurized apple cider and milk. Uh, there was an outbreak that was traced, I think, to some lettuce in Michigan recently. Infected animals. You know, petting zoos are really fun to take the grandkids and your young children to and farm animals. I can emphasize how much you need to wash hands with soap and water before putting things in the mouth. We all know how kids like, little kids like to put things in their mouth. Sexual intercourse with an infected person. Uh, it's not typically a sexually transmitted infection, but you know, depending on how close and intimate obviously you are, there can be the fecal oral type of contamination. So anyone can get this infection. Children between ages one and four, which I have a lot of those people in my family, are most likely to get it. And it really spreads easily among children because they don't have the best hand washing habits and they don't exactly understand the germ theory and how germs spread. Also, if you're dealing with a lot of infected poop and diapers, that can be an issue. If you work with young children or have them in your family, if you're over age 75, if you're traveling, hiking, camping, if you work with farm animals or livestock, if you spend a lot of time in public pools, lakes, rivers, in a white water rafting, or if you are taking care of someone medically or socially, you know, who has cryptosporidiosis. If you have a weakened immune system, that includes HIV AIDS, any cancer patients, particularly people getting chemotherapy, anyone who's been treated with an organ transplant or stem cell transplant, getting immunosuppressive medications. A lot of women are on immunosuppressants for rheumatic conditions. So we have to avoid dehydration. Gotta care about the young children, the pregnant women, and the elderly people in particular. Avoid electrolyte, potassium, magnesium, sodium imbalances. Low blood volume, hypovolemia can lead to hypotension. Other crypto spritiosis complications can include bile duct, gallbladder problems, and even pancreatic problems. And chronic infection can lead to slow growth in children. So if you think you might have this, get together your health history, your symptoms, see a healthcare clinician, get a physical exam. You probably are gonna need a stool poop test to check for crypto spritium. Um, some days you may have more parasite in your stool than others. So you might have to give a couple of stool specimens over a few days. Generally, healthy immune system, it usually goes away on its own in a couple weeks, but you've got to drink a lot of fluids, you've got to stay hydrated, have to have good hand hygiene. Maybe you might be recommended to take loperamide amodium, depending if you're an adult, uh, peptobismol, which is bismuth, subsalacylate, subsalacylate may help. Other medicines like lomodal, which is diaphenyloxamine, atropine slows the gut down, and sometimes they can prevent dehydration. Some people do need IV fluids to treat dehydration. I remember having a GI infection. I was going around my family, mother of young children. I was breastfeeding, I was dehydrated, very dizzy, went into the emergency room with my family, and I'll never forget my three-year-old son Emerson. Shocking toehead, bright hair, very loud and ebuliant. He announced the entire ER staff. The party's over. Let's get to work, people. Oh, it was so funny. I'll never forget that. That was like more memorable than the GI problems and the need to get IV fluids. So try to push IV fluids, I mean oral fluids, so that you don't need IV fluids, but you might. If you have HIV infection aids, then maybe you'll need more intensive therapy, antiviral therapy, other supportive immunological therapy. Recovery time. Usually people feel better in a couple weeks, but it can really knock you out. And it can come and go for a month. So if you end up getting a prescription with a nidosoxinide and anti protozool, Medicine, sometimes trimethoprim sulfamethoxazole, bacterum DS might be prescribed. You need to take the medicine for the full course and take it even when you start to feel better. Don't just stop, try to save it, or give it to someone else. You have to finish the course. But if your immune system's weakened, it can take a lot, lot longer. Some people never get rid of it when they're severely immunocompromised, but certainly your symptoms can be managed. If you start having several bouts of watery diarrhea and you're in an area where there's been reported cases, I would contact your healthcare team. If you get confused or lightheaded, if your urine gets real dark and concentrated, or your child's not, baby's not wetting diapers, that can all be signs of dehydration. When you go for your appointment, you should ask about how you manage your symptoms, what things you should eat or drink, how you can avoid spreading it. Generally, the outlook is is good, but it can come and go. So water and clean water, broths, sports drinks, pediolite. In general, you should be avoiding alcohol, caffeinated drinks. You might want to take a bland kind of brat diet. Bread, rice, bananas, applesauce, kind of tea and toast. Always make sure that you wash your hands before and after using the bathroom. And teach children how to wash their hands. I have some grandchildren who are very good at doing this, and others who just don't like to do it. Obviously, avoid swimming or uh wait a couple weeks before you get in the water before everything gets better. And if you're having active diarrhea, it's probably best to avoid sexual activity. And obviously, people with HIV or immunocompromise may need additional treatments.

Higher Risk Foods And Safer Prep

Dr. \ 23:42

Now, I mentioned some of the different treatments. The expense of previously very inexpensive medicine may be an issue. And um, we are seeing, you know, increased cases. So any vegetable or fruit that has a lot of crevices, whether it's berries or even cauliflower or broccoli, I just got back from the grocery store and I was really intentionally thinking. I didn't buy any pre-bagged lettuce. And normally a lot of these foods are very good and healthy, but I was trying to avoid some of the foods that were reported to be a little bit more likely to have been contaminated. But of course, I still bought fruits and vegetables. I did not decide to go with the bourbon and souvet steak, even though my husband makes a really killer souvet steak. Oh, it's so soft. It's like it's like butter. But the historically commonly contaminated foods, like raspberries, basil, oh, I love basil, cilantro, oh, I love cilantro. About 10% of people genetically think it tastes like soap and they don't like it. But I love cilantro, and it's an herb that actually kind of reduces anxiety. Green onions, snow peas, lettuce, salad mixes. Those have been some of the most commonly purported carriers of this cryptosperidiosis. But it's been found in blackberries, watercress, mangoes, you know, pre-made vegetable trays. I mean, everybody's having picnics and office parties. We've got one coming up. That speaking of women's health is helping to sponsor, actually. Um, it's time to get together for summer fun. So you have to be a lot more careful. So Michigan's been hit a little bit harder than Ohio, but Ohio is getting pounded. So some of the salad greens and lettuce lettuce has been suspected. And, you know, delicious, healthful, seasonal foods. It's annoying when those get contaminated. But it seems like frozen foods, and I always keep frozen berries and I always keep frozen vegetables and cooked foods seem to be in the clear. So you can still have a varied diet. So far to date, and I'm taping this, you know, in uh the height of the summer of 2026, there haven't been commercially frozen products, peeled fruit that have been associated with cyclospora infections. And a stool test is really best to find out if you have this. Again, basic hygiene for so many different reasons is important. Alcohol-based hand sanitizers do not work. You've got to do it the old-fashioned way. Um, if you are using green onions and you scrub them, rinse them vigorously with water, uh, I would cut off the roots, remove the entire outer layer, and rub the surface. I still am washing my fruits and vegetables and vinegar and some baking soda just because it helped it helps remove pesticides and dirt and some other bacteria. If you're going to use a big bowl, most people put three parts of water to one part of vinegar and swish it around. Some people use a salad spinner to kind of get all the fluid off. Again, things that have all these tiny crevices like broccoli cauliflower, which broccoli can have tiny little insects in them as well. Berries, a lot of times it's just too challenging to scrub. So you could cook them, bake them, put berries in jam. You certainly don't need to waste uh produce of what you have. You just need to cook it. Any vegetable that's got thick dirt, like carrots, potatoes, and radishes, need to be really scrubbed. If you can peel the fruit and vegetables, so much the better. I've gotten some melons and watermelons, but you again, you really want to wash it, scrub it first because the knife can carry the germs through. The temperature of 158 degrees Fahrenheit will kill it. And don't forget to wash your cutting boards, your countertops, and use a clean brush. And generally you scrub first, peel, and always cut out the bruises or any damaged area on fruits. I just had this delicious peach that my lovely administrative assistant gave me, and it was a little bruised area. Just cut it, cut it right away. Hopefully, I can get her on a future podcast to talk about tips to scheduling physician appointments. That's always a perennial, interesting topic. So, you know, we talked to about prevention. Sometimes it still happens. We've talked about treatment. You know, when there's a peak outbreak, you might want to switch to some frozen fruits, you know, or canned fruits and vegetables. You know, it's really interesting in terms of the genetic imprint. Other it with this protozoa, it's a little bit harder to genetically track the version of it, but there have been some inroads into doing

Key Takeaways And Listener Requests

Dr. \ 28:27

this. So I hope you've enjoyed this episode on cryptosporidiosis. We have prior episodes on gastrosophageal reflux and inflammatory bowel disease. I'm going to have an upcoming podcast on the hot topic of fiber maxing. But remember, we want you to enjoy the summer, have a colorful, great diet with a wide variety of good foods. But we want you to be smart and particularly if you're in a high-risk group or you just don't really want to be sick with watery explosive diarrhea for a couple of weeks. Really take to heart uh some of these recommendations. And remember, be strong, be healthy, and be in charge. If this episode was helpful to you, give us a five-star rating. You can share it with any of your friends and family. And if you don't already subscribe to the Speaking and Women's Health podcast, make sure to hit follow or collect. It's free. That way you'll be notified anytime there's a new podcast. If there's any topics or questions you have, you can go on speakingandwomen's health.com and hit the contact us form and send us a question or what you're interested in hearing about. I'll see you next week in the Sunflower House.