Centers for Disease Control and Prevention (CDC) released a Health Advisory to raise awareness of cyclosporiasis due to a large increase in domestically acquired disease in multiple states. CDC’s national surveillance page provides state level data on cases acquired in the U.S. and can be found here.

HCA Communicable Disease Control has not seen any increase in cyclosporiasis to date in Orange County. Statewide California not seen an increase in cyclosporiasis per a CDPH Press Release.

Cyclosporiasis cases historically increase during the summer months. In OC, most cases of cyclosporiasis identified are associated with international travel.

• Health care providers should consider cyclosporiasis in patients presenting with prolonged or relapsing watery diarrhea. Particularly in patients with recent international travel or travel to states currently involved in the outbreak.
• Specifically request Cyclospora laboratory testing on stool specimens because routine ova and parasite (O&P) examinations might not reliably detect the parasite. Consider molecular (PCR-based) diagnostic testing where available, because it can improve detection. OC Public Health Laboratory will accept positive specimens for submission to CDPH Microbial Disease Laboratory (MDL) for genomic characterization.
• Treat confirmed cases of cyclosporiasis with 7-10 days of trimethoprim-sulfamethoxazole (TMP-SMX) for immunocompetent adults and children over age 2 months; consider longer courses for patients with immunocompromising conditions. Consult current CDC clinical guidance for recommended dosing.
• Advise patients to stay well hydrated, especially if diarrhea is frequent or severe.

• California Department of Public Health - Cyclosporiasis
• Centers for Disease Control and Prevention - Cyclosporiasis

For questions or concerns, please contact the Communicable Disease Control Division at 714-834-8180.