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Articles » Cyclospora Infection: DPD

Cyclospora Infection: DPD

Article title: Cyclospora Infection: DPD

Conditions: Cyclospora

Source: DPD




What is Cyclospora?

Cyclospora cayetanensis (SIGH-clo-SPORE-uh KYE-uh-tuh-NEN-sis) is a parasite composed of one cell, too small to be seen without a microscope. The first known human cases of illness caused by Cyclospora infection (i.e., cyclosporiasis) were reported in 1979. Cases began being reported more often in the mid-1980s. In the last several years, outbreaks of cyclosporiasis have been reported in the United States and Canada.

How is Cyclospora spread?

Cyclospora is spread by people ingesting something, for example, water or food that was contaminated with infected stool. For example, outbreaks of cyclosporiasis have been linked to various types of fresh produce. Cyclospora needs time (days or weeks) after being passed in a bowel movement to become infectious. Therefore, it is unlikely that Cyclospora is passed directly from one person to another. It is unknown whether animals can be infected and pass infection to people.

Who is at risk for infection?

People of all ages are at risk for infection. In the past, Cyclospora infection was usually found in people who lived or traveled in developing countries. However, people can be infected worldwide, including the United States.

What are the symptoms of infection?

Cyclospora infects the small intestine (bowel) and usually causes watery diarrhea, with frequent, sometimes explosive, bowel movements. Other symptoms can include loss of appetite, substantial loss of weight, bloating, increased gas, stomach cramps, nausea, vomiting, muscle aches, low-grade fever, and fatigue. Some people who are infected with Cyclospora do not have any symptoms.

How soon after infection will symptoms begin?

The time between becoming infected and becoming sick is usually about 1 week.

How long will symptoms last?

If not treated, the illness may last from a few days to a month or longer. Symptoms may seem to go away and then return one or more times (relapse).

What should I do if I think I may be infected?

See your health care provider.

How is Cyclospora infection diagnosed?

Your health care provider will ask you to submit stool specimens to see if you are infected. Because testing for Cyclospora infection can be difficult, you may be asked to submit several stool specimens over several days. Identification of this parasite in stool requires special laboratory tests that are not routinely done. Therefore, your health care provider should specifically request testing for Cyclospora. Your health care provider may have your stool checked for other organisms that can cause similar symptoms.

How is infection treated?

The recommended treatment for infection with Cyclospora is a combination of two antibiotics, trimethoprim-sulfamethoxazole, also known as Bactrim*, Septra*, or Cotrim*. People who have diarrhea should rest and drink plenty of fluids.

I am allergic to sulfa drugs; is there another drug I can take?

No alternative drugs have been identified yet for people who are unable to take sulfa drugs. See your health care provider for other treatment recommendations.

How is infection prevented?

Avoiding water or food that may be contaminated with stool may help prevent Cyclospora infection. People who have previously been infected with Cyclospora can become infected again.

For more information:

  1. CDC. Outbreak of cyclosporiasis -- northern Virginia-Washington, D.C.-Baltimore, Maryland, metropolitan area, 1997. MMWR 1997; 46:689-91.
  2. Herwaldt BL, et al. An outbreak in 1996 of cyclosporiasis associated with imported raspberries. N Engl J Med 1997;336:1548-56.
  3. Herwaldt BL, et al. The return of Cyclospora in 1997: another outbreak of cyclosporiasis in North America associated with imported raspberries. Ann Intern Med 1999;130:210-20.
  4. Hoge CW, et al. Placebo-controlled trial of co-trimoxazole for cyclospora infections among travellers and foreign residents in Nepal. Lancet 1995;345:691-3.
  5. Hoge CW, et al. Epidemiology of diarrhoeal illness associated with coccidian-like organism among travellers and foreign residents in Nepal. Lancet 1993;341:1175-9.
  6. Huang P, et al. The first reported outbreak of diarrheal illness associated with Cyclospora in the United States. Ann Intern Med 1995;123:409-14.
  7. Ortega YR, et al. Cyclospora species - a new protozoan pathogen of humans. N Engl J Med 1993;328:1308-12.
  8. Soave R. Cyclospora: an overview. Clin Infect Dis 1996;23:429-37.
  9. Soave R, et al. Cyclospora. Infect Dis Clinics N Amer 1998;12:1-12.

* Use of trade names is for identification only and does not imply endorsement by the Public Health Service or by the U.S. Department of Health and Human Services.

This fact sheet is for information only and is not meant to be used for self-diagnosis or as a substitute for consultation with a health care provider. If you have any questions about the disease described above or think that you may have a parasitic infection, consult a health care provider.



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