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The number of Cyclospora infections in New York City have doubled during the first half of the year prompting city health officials to advise clinicians to be on the alert for patients with diarrhea due to the parasitic infection.

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

A total of 27 cases were reported between January 1 – June 30, 2017 compared to 13 cases in 2016, and 21 cases in 2015 during the same time period. In June 2017 there were 22 cases reported, compared to 18 in June 2015 and 10 in June 2016.

Approximately half of cases reported in 2017 had history of travel to endemic locations during the two weeks before illness onset, mainly Latin America.  Epidemiologic investigations are ongoing to determine if there is a possible common source.

Cyclospora cayetanensis is a single celled coccidian parasite. Cyclosporiasis occurs in many countries, but it seems to be most common in tropical and subtropical regions.

The parasite causes watery diarrhea, nausea, anorexia, abdominal cramps and weight loss. Fever is a rare symptom.

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People get infected with Cyclospora through foodborne or waterborne means. Swimming in contaminated water is also a way someone can get infected.

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Cyclospora has been implicated in numerous outbreaks with contaminated fruits and vegetables being the common culprits (raspberries, basil and lettuce all washed with contaminated water), especially those imported from developing nations.

All fruits and vegetables should be thoroughly washed before eating though this does not guarantee safety. Cyclospora is resistant to chlorination.

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Treatment is usually successful after a course of the antibiotic Septra. Patients with HIV or otherwise immunocompromised usually require higher dosages for a longer period of time. Untreated infections can last from a few days to over a month.

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