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Cyclospora - What You Need To Know

Graphic of magnifying glass over bowl of salad with text "Cyclosporiasis: What You Need To Know"

By John Baloga, Public Affairs Specialist/Outreach Coordinator

What is cyclospora? Cyclospora is a tiny parasite that can make you sick. It causes an intestinal infection called cyclosporiasis. You may get cyclosporiasis by ingesting food or water with the parasite.

Common Signs and Symptoms 

Most people who consume food or water contaminated with Cyclospora do not get sick.

For people who get sick, symptoms usually start about 1 week after eating or drinking something with the parasite. Sometimes, symptoms can start as soon as 2 days or as late as 2 weeks after. These symptoms may include: 

  • Frequent watery diarrhea
  • Stomach cramps
  • Loss of appetite
  • Bloating or increased gas
  • Nausea
  • Fatigue
  • Low-grade fever (rare)
  • Weight loss if illness lasts a long time  

Most people get better without treatment. But for some, symptoms can last for weeks and may come and go until they take specific antibiotics.

Diagnosis

  •  Stool test (Gastrointestinal PCR Panel positive for Cyclospora)

Who is at higher risk for Cyclosporiasis?

Anyone can become infected. Some people are more likely to get very sick, including: 

  • Adults over 65 years old
  • Young children
  • People with weakened immune systems
  • People with long-term health problems 

Treatment

▪    Cyclosporiasis is treated with a prescription antibiotic called trimethoprim-sulfamethoxazole 1 DS twice daily       X 7 days. Do not take antibiotics unless prescribed by your health care provider.
▪    Alternative: Ciprofloxacin 500 mg twice daily X 7 days
▪    Rest and drinking plenty of fluids
▪    Healthy immune systems may not need treatment

Transmission/ How it Spreads

  • Fecal-oral route by ingestion of contaminated food or water.

Prevention - How can you protect yourself from Cyclosporiasis? 

  • Wash your hands with soap and water before eating or preparing food.
  • Rinse fresh fruits and vegetables thoroughly under running water before eating, cutting, or cooking. This includes produce labeled as pre-washed.
  • Peel off and discard the outer layers of fruits and vegetables.
  • Cooking can kill the parasite. Cook produce to a temperature of at least 158°F (70°C). Prioritize eating produce that can be cooked since washing alone cannot guarantee removal of Cyclospora.
  • Follow any public health alerts about recalled or suspected foods. 

Early investigation results indicate lettuce or salad greens as possible source. Previous outbreaks of Cyclospora in the US have been linked to: 

  • Bagged salad mixes and kits
  • Fresh cilantro (coriander leaves)
  • Fresh basil
  • Raspberries
  • Snow peas
  • Green onions (scallions)

Isolation

▪    Isolation: Contact Plus precautions
▪    PPE: Gown, gloves

Testing

  • Order in Cerner
    • Gastrointestinal PCR Panel (GI Panel PCR)

Disinfection

  • Wipe: PDI Bleach

Hand Hygiene

  • Soap and water

Questions?

If you have symptoms or think you were exposed, call your health care provider.

Learn more about food safety

References: 

CDC - Cyclosporiasis

CDC - Cyclosporiasis- prevention