Texas health officials have issued a health advisory today in light of the surge of infections with the protozoan parasite, Cyclospora. During the past week, Texas has seen 42 cases.

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

During the past three summers, a large number of cyclosporiasis cases have occurred in Texas. Last year, Texas had 200 cases, some of which were associated with cilantro from the Puebla Region in Mexico.

Rapid reporting to public health enabling prompt investigation to identify possible common exposures is essential to preventing additional cases this year.

Symptoms of cyclosporiasis usually begin 2 to 14 days after ingestion of oocysts in contaminated food or water. Profuse diarrhea can last weeks to months, and may relapse. Additional symptoms may include anorexia, fatigue, weight loss, abdominal cramps, bloating, increased gas, nausea, vomiting, and low grade fever.

Although no common exposure source for this increase in cases has yet been identified, past outbreaks in the U.S. have been associated with consumption of imported fresh produce, including fresh cilantro, pre-packaged salad mix, raspberries, basil, snow peas, and mesclun lettuce.

Thorough washing of fresh produce is recommended, but may not eliminate the risk of transmission since Cyclospora can be difficult to wash off all types of produce. Infection is generally not transmitted directly from person-to-person.

Texas has reported 54 cases of cyclosporiasis in 2015 to date.