CDC: Cyclospora outbreak 145 cases

The Centers for Disease Control and Prevention said on July 1 that it had received reports of 145 cases of cyclosporiasis acquired in the United States across 17 states, covering people who became sick from May 1 through June 16. The illness is caused by the microscopic parasite *Cyclospora cayetanensis*, according to the agency. (cdc.gov) CDC said 20 people had been hospitalized and no deaths had been reported. The agency also said there is no evidence so far that all of the cases are tied to one national outbreak, even as federal and state officials investigate several clusters. ### If there are 145 cases in 17 states, is this one outbreak? (cdc.gov) The CDC said the 145 cases are a surveillance count, not proof of one nationwide event. “There is currently no evidence of a single, multistate Cyclospora outbreak linking all cases,” the agency said on its surveillance page. As of June 16, the agency said local, state and federal public health authorities, including the Food and Drug Administration, were investigating several clusters in more than one state. The people who got sick reported no international travel in the 14 days before illness, which points investigators toward domestic food or water exposures. (cdc.gov) ### What exactly is Cyclospora, and how do people get it? CDC says cyclosporiasis is an intestinal illness caused by *Cyclospora cayetanensis*. People become infected after consuming food or water contaminated with stool containing the parasite, and the agency says it is not spread directly from one person to another. (cdc.gov) The CDC says cases in the United States usually rise in the spring and summer, and the agency defines the 2026 cyclosporiasis season as May 1 through Aug. 31. Outbreaks in past years have often been linked to fresh produce, though CDC has not identified a confirmed food source for the current clusters. (cdc.gov) ### What symptoms are health workers being told to watch for? CDC says watery diarrhea is the most common symptom. Other symptoms can include loss of appetite, weight loss, cramping, bloating, increased gas, nausea and fatigue, with vomiting, body aches, headache and low-grade fever reported less often. (cdc.gov) The Infection Control Today report, citing CDC guidance for clinicians, said health care workers should consider Cyclospora in patients with acute watery diarrhea, abdominal pain, nausea, vomiting and fatigue, especially when there is a foodborne exposure history. CDC says symptoms usually begin about one week after infection, though onset can range from two days to more than two weeks. (cdc.gov) ### Why does diagnosis take extra attention? CDC says clinicians should specifically request testing for Cyclospora if they suspect it. The agency says diagnosis can involve stool microscopy or molecular methods such as PCR, and oocysts can be easy to miss because shedding may be intermittent and at low levels. (cdc.gov) The Infection Control Today report said multiple stool samples may be needed and some laboratories use special staining techniques to improve detection. That is why CDC’s provider guidance stresses suspicion in patients with compatible symptoms and exposure histories rather than assuming routine stool testing will catch every case. (infectioncontroltoday.com) ### What treatment and next steps did CDC outline? CDC says trimethoprim-sulfamethoxazole, or TMP-SMX, is the treatment of choice for cyclosporiasis. The agency says most healthy people eventually recover without treatment, but illness can be prolonged, and supportive care such as fluids is important for patients with diarrhea. (cdc.gov) The CDC’s July 1 update said the 145 U.S.-acquired cases included patients ages 5 to 86, with a median age of 42, and 61% were female. CDC and FDA said their investigations are continuing, and the agency’s surveillance page is where future case counts and any confirmed source information would appear. (infectioncontroltoday.com) (cdc.gov 1) (cdc.gov 2)