Organism

Cyclosporiasis is a gastrointestinal disease caused by a microscopic parasite called Cyclospora cayetanensis. 

For more information about cyclospora: CDC Cyclospora.

How it Spreads

Cyclosporiasis is caused by eating food or drinking water contaminated with human poop (stool). Past outbreaks in the United States have been associated with imported fresh produce, including: 

• Fresh cilantro
• Pre-packaged salad mix
• Raspberries
• Basil
• Snow peas
• Mesclun lettuce

Cyclospora does not appear to be spread through direct person-to-person contact.

People living or traveling in countries where cyclosporiasis is regularly present may be at increased risk for infection. 

Symptoms

Symptoms of cyclosporiasis usually begin two to 14 days after consuming contaminated food or water. The major symptom is watery diarrhea lasting a few days to a few months. People infected with cyclosporiasis may also experience their symptoms going away and coming back (relapsing).  

Additional symptoms may include: 

• Anorexia
• Fatigue
• Weight loss
• Abdominal cramps
• Bloating
• More gas than usual
• Nausea
• Vomiting
• Low grade fever

Diagnosis

Diagnosis of cyclosporiasis requires submitting stool samples for lab tests that are not routinely done. When cyclosporiasis in suspected in patients with diarrhea lasting more than a few days or accompanied by severe anorexia or fatigue, healthcare providers should specifically request “Ova and Parasite” testing with additional specific orders for Cyclospora identification.

Diagnostic Information for Healthcare Providers

Clinicians should order testing for patients who have symptoms consistent with cyclosporiasis. Submit stool specimens for “ova and parasite” testing with a modified acid-fast stain, modified safranin (“hot”) stain, and/or UV autofluorescence screen with specific orders for Cyclospora identification. Due to intermittent shedding of the parasite, one negative test does not rule out cyclosporiasis. Collecting three stool samples at least 24 hours apart gives the best chance of finding the infection. 

Prevention

Thoroughly wash fresh produce before eating and scrub firm produce with a clean produce brush. However, washing may not completely remove Cyclospora because the parasite can stick to some produce. Cooking foods to at least 158°F (70°C) can kill the parasite and reduce your risk of infection

There is currently no vaccine for cyclosporiasis.

Recent Texas Trends

From 2019-2024, the average number of cyclosporiasis cases per year in Texas has been 628 (312-1,039) cases per year.

Get the latest information on cyclosporiasis trends

School Exclusion Policy

Children with confirmed cyclosporiasis should be kept out of school or childcare until they are diarrhea- and fever-free. Rules for exclusion of sick children from school and childcare are outlined in the Texas Administrative Code, specifically Rule 97.7 for schools and Rule 746.3603 for childcare.

Reporting

Report Cyclosporiasis within one week: Initial report form.

Healthcare providers, hospitals, laboratories, schools, and others are required to report patients who are suspected of having a notifiable condition (25 Tex. Admin. Code §97.2). Cyclosporiasis is one of the listed conditions.

Resources

• Cyclosporiasis Information l CDC
   
• Preventing Cyclosporiasis l CDC
   
• Surveillance of Cyclosporiasis l CDC