By NewsDesk  @infectiousdiseasenews

New York City health officials are advising clinicians to be on the alert for patients with diarrhea due to Cyclospora infection.

Cyclospora oocysts
Oocysts of C. cayetanensis viewed under differential interference contrast (DIC) microscopy.
Image/CDC DPDx

From the beginning of the year through July 15, officials report 90 cases, including 40 cases since the beginning of the month. Approximately 30 percent of patients have reported travel outside of the United States in the two weeks prior to symptom onset, primarily to Latin America.

This compares with 56 cases in 2018, and 43 cases in 2017 during the same time period.

Epidemiologic investigations are ongoing to determine if there is a possible common food source for cases with no travel outside of NYC.

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Cyclospora is a coccidian parasite that causes watery diarrhea, nausea, loss of appetite, abdominal cramping and fatigue. Untreated, diarrhea and other symptoms may persist for weeks. Diarrhea may become intermittent and other symptoms may predominate. People become infected by ingesting food or water contaminated with fecal matter.

Person-to-person transmission does not occur, because the parasite requires time (days to weeks) after it is excreted to sporulate in the environment before it is infectious again.

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The incubation period is approximately 1 week, but can range from 2 – 14 days or more.

People living or traveling in tropical or subtropical regions of the world may be at risk due to endemic cyclosporiasis. In the United States, prior foodborne outbreaks of cyclosporiasis have been linked to various types of imported fresh produce (including raspberries, lettuce, and cilantro).