Cyclospora Outbreak Reaches 40 States

As of September 13, 2017, the Centers for Disease Control and Prevention (CDC) was notified of 988 laboratory-confirmed cases of cyclosporiasis in 2017.

Cyclospora cayetanensis is a single-celled parasite that causes an intestinal infection called cyclosporiasis. The cyclosporiasis infection usually is not life threatening.

On Aug 7, 2017, the CDC sent a Health Alert Network Advisory notice to health providers that said health departments were probing an increase in cyclosporiasis cases, which had already exceeded the number of cases for the same period in 2016.

Previous U.S. outbreaks of cyclosporiasis have been linked to various types of imported fresh produce such as basil, cilantro, mesclun lettuce, raspberries, snow peas.

These cyclosporiasis cases in 40 states include persons who reported traveling internationally, as well as 56% persons who did not travel.

These 553 non-traveling persons were from the following 36 states: Arizona (1), California (10), Colorado (6), Connecticut (23), Florida (68), Georgia (10), Illinois (17), Indiana (4), Iowa (14), Kansas (2), Louisiana (7), Maryland (12), Massachusetts (13), Michigan (3), Minnesota (11), Mississippi (1), Missouri (13), Montana (2), Nebraska (5), New Hampshire (4), New Jersey (19), New Mexico (1), New York (excluding NYC) (15), New York City (30), North Carolina (45), Ohio (16), Pennsylvania (2), Rhode Island (2), South Carolina (7), South Dakota (4), Tennessee (3), Texas (163), Utah (1), Virginia (7), Washington (1), West Virginia (2), and Wisconsin (9).

The CDC reports, at this time, the investigations to identify a potential source (or sources) of infection are ongoing. It is too early to say whether cases of Cyclospora infection in different states are related to each other or to the same food item(s).

Most people who have healthy immune systems will recover without treatment. If not treated, the illness may last for a few days to a month or longer.

Symptoms of cyclosporiasis begin an average of 7 days after ingestion of sporulated oocysts (the infective form of the parasite). People who are in poor health or who have weakened immune systems, may be at higher risk for severe or prolonged illness.

If a person ill with cyclosporiasis is not treated, symptoms can persist for several weeks to a month or more.

Some symptoms, such as diarrhea, can return, and some symptoms, such as muscle aches and fatigue, may continue after the gastrointestinal symptoms have gone away.

Some infected persons do not have any symptoms, particularly persons from areas where cyclosporiasis is endemic.

According to the CDC, Trimethoprim / sulfamethoxazole (TMP/SMX), sold under the trade names Bactrim*, Septra*, and Cotrim*, is the usual therapy for Cyclospora infection.

The CDC says anecdotal or unpublished data suggest that the following drugs are ineffective: albendazole, trimethoprim (when used as a single agent), azithromycin, nalidixic acid, tinidazole, metronidazole, quinacrine, tetracycline, doxycycline, and diloxanide furoate.

Anti-diarrheal medicine may help reduce diarrhea, but a health care provider should be consulted before such medicine is taken.