The Texas Department of State Health Services (DSHS) recommends testing patients for the parasite Cyclospora if they have diarrheal illness lasting more than a few days or diarrhea accompanied by severe anorexia or fatigue. Diagnosis of cyclosporiasis requires submission of stool specimens for "Ova and Parasite" testing with additional specific orders for Cyclospora identification. DSHS says a single negative stool specimen does not exclude the diagnosis; three specimens are optimal.
Texas has experienced a large number of cyclosporiasis cases during the past four summers. DSHS reports at least some of the Texas cases in 2012–15 were associated with consumption of fresh cilantro imported from Mexico. Rapid reporting to public health authorities, enabling prompt investigation to identify possible common exposures, is essential to preventing additional cases of cyclosporiasis this year.
Symptoms of cyclosporiasis usually begin two days to 14 days after ingestion of Cyclospora oocysts in contaminated food or water. Profuse diarrhea can last weeks to months and may relapse. Additional symptoms may include anorexia, fatigue, weight loss, abdominal cramps, bloating, increased gas, nausea, vomiting, and low-grade fever. Learn more about Cyclospora from the Centers for Disease Control and Prevention.
Various types of imported fresh produce besides cilantro have been linked to U.S. outbreaks of cyclosporiasis, including raspberries, basil, snow peas, mesclun lettuce, and bagged salad mix. As always, thorough washing of fresh produce is recommended but may not eliminate the risk for transmission as Cyclospora can be difficult to wash off produce. DSHS says direct person-to-person transmission of the parasite is highly unlikely to occur.
Physicians and laboratories should promptly report confirmed cyclosporiasis cases to their respective local health department or DSHS. Contact DSHS at (800) 705-8868.
Action, June 1, 2016
Last Updated On
October 11, 2016