CDC Issues Advisory on the Rise of Cyclosporiasis

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The standard treatment for cyclosporiasis is trimethoprim/sulfamethoxazole (TMP/SMX). <i>Photo Credit: CDC/DPDx-Melanie Moser.</i>
The standard treatment for cyclosporiasis is trimethoprim/sulfamethoxazole (TMP/SMX). Photo Credit: CDC/DPDx-Melanie Moser.

The Centers for Disease Control and Prevention (CDC) Health Alert Network has issued an advisory regarding an increase in cases of the intestinal illness cyclosporiasis. 

The CDC, Food and Drug Administration (FDA), along with state and local health departments are recommending clinicians consider a diagnosis of cyclosporiasis in patients with prolonged or remitting-relapsing diarrheal illness. Testing for Cyclospora can be requested by ova and parasite (O&P) examination, through molecular methods, or by a gastrointestinal pathogen panel test. As Cyclospora testing is not routinely performed in most US labs, providers must specifically order this test. 

A total of 206 cases of Cyclospora infections have been reported to the CDC as of August 2, 2017 among individuals who became ill on or after May 1, 2017. Of these, 18 cases have resulted in hospitalization; no deaths have been reported. Agencies are investigating the potential source of infection. This number marks an increase from the 88 cases of Cyclospora infections reported as of August 3, 2016 among individuals who became ill on or after May 1, 2016. 

Individuals can become infected with Cyclospora cayetanensis through food or water that is contaminated with the parasite; fresh produce (eg, basil, cilantro, mesclun lettuce, raspberries, snow peas) has been linked to previous outbreaks. Cyclospora is not transmitted from person to person. The most common symptom is watery diarrhea that may be profuse. Anorexia, fatigue, weight loss, nausea, flatulence, abdominal cramping, myalgia, vomiting, low-grade fever are other common symptoms. After ingestion of the parasite, symptoms may develop in about seven days. The illness may last a few days to a month or longer if untreated with a possible remitting-relapsing course.

The standard treatment for cyclosporiasis is trimethoprim/sulfamethoxazole (TMP/SMX). For patients who are allergic or intolerant to TMP/SMX, symptomatic care is recommended as no effective alternative treatments have been identified. Clinicians are being asked to report cases of cyclospriasis to local health departments. 

Reference

Increase in reported cases of cyclospora cayetanensis infection, United States, Summer 2017 [press release]. Atlanta, Georgia: Centers for Disease Control and Prevention. Published August 7, 2017. Accessed August 23, 2017.

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