Texas health officials warn about Cyclospora

Posted at 4:36 AM, Jul 16, 2018
and last updated 2018-07-16 05:36:34-04

During the past five summers, a large number of cyclosporiasis (cy·clo·spo·ri·a·sis  ) cases have occurred in Texas. 

The Texas Department of State Health Services is advising healthcare providers to consider testing patients for the parasite.

Symptoms from this parasite usually begin 2 to 14 days after ingestion of contaminated food or water. 

Texas health officials are warning people about an outbreak of illnesses caused by the parasite Cyclospora. According to the CDC, Cyclosporiasis is an intestinal illness. People get sick after consuming food or water that’s been contaminated by the microscopic parasite.

"Cyclospora are single cell organisms that have been around for a very long time, typically water born and food born," said Corpus Christi Medical Center Emergency Room Assistant Medical Director Dr. Kelly Campbell.

Since May, state health officials say 74 cases of Cyclospora have been reported in Texas. 16 cases in Travis County, 4 cases in Harris County, 6 cases in Hidalgo County, and there have not been any cases reported here in Nueces County.

"It is preventable. If you are going to get fresh fruits or vegetables, wash them really well, get them from well-known sources. But also, if there is an outbreak, you will be notified and watch your drinking water, but we do not have any problems with it right now locally," said Dr. Campbell.

Lab tests can confirm if a patient is sick from this small parasite, but a positive test doesn’t reveal the common source.

"Other areas have had outbreaks usually associated with the food outbreak. If you find yourself having these symptoms, the watery diarrhea, abdominal cramping, dehydration, sunken eyes, and start getting light headed along with this watery diarrhea, you need to see your doctor because it istreatable, and you have to test for it," said Dr. Campbell.

Health officials are still investigating the source of the infections.

"People that are most at risk for this problem are people that are immunocompromised. Patients that are on chemotherapy, patients who are HIV, any kind of immunosuppressant can make your body more susceptible to getting this Cyclospora," said Dr. Campbell.

Previous outbreaks of cyclosporiasis have been associated with consumption of imported fresh produce, including: fresh cilantro, pre-packaged salad mix, raspberries, basil, snow peas, and mesclun lettuce.

Although washing may not eliminate all risk of transmission since Cyclospora can be difficult to completely remove from produce, thorough washing of all fresh produce is recommended. 

Cyclospora does not appear to be spread through direct person-to-person contact.

Cyclospora infection (cyclosporiasis) causes watery, and sometimes explosive, diarrhea. The one-celled parasite that causes cyclospora infection can enter your body when you ingest contaminated food or water.

Fresh produce is the culprit in many cases of cyclospora infection.

Because diarrhea can be caused by many things, it can be difficult to diagnose cyclospora infection unless a specialized stool test is done. 

Treatment for cyclospora infection is antibiotics. Food safety precautions may help prevent the disease.


Some people infected with the microscopic parasite that causes cyclospora infection develop no signs or symptoms. For others, signs and symptoms – which usually begin within two to 11 days of eating contaminated food or drinking contaminated water – may include:

  • Frequent, watery diarrhea
  • Bouts of diarrhea alternating with bouts of constipation
  • Loss of appetite and weight loss
  • Bloating, flatulence and burping
  • Stomach cramps
  • Nausea and vomiting
  • Muscle aches
  • Fever
  • Fatigue – this symptom may last long after the active infection has gotten better
  • General feeling of unwellness (malaise)

The diarrhea may end by itself within a few days, or it may last for weeks. If you have HIV or another condition that compromises your immune system, the infection can last for months if not treated.

When to see a doctor:

Many conditions can cause diarrhea and other gastrointestinal signs and symptoms. If you develop persistent diarrhea that lasts several days or recurs, contact your doctor so that he or she can identify the cause and recommend treatment. If you’ve eaten a food that’s been recalled because of a cyclospora outbreak or traveled in an area where parasites such as cyclospora are common, be sure to tell your doctor.

If you experience dehydration due to diarrhea, see your doctor. Warning signs of dehydration include:

  • Sunken eyes
  • Dry mouth and tongue
  • Reduced production of tears
  • Decreased urine output


  • A one-celled parasite, Cyclospora cayetanensis, causes cyclospora infection. You get it by drinking water or eating food that’s been contaminated by a person infected with the parasite.
  • A person infected with cyclospora passes the parasite in stool. However, unlike some other food borne parasites, cyclospora doesn’t become infectious until days or weeks after it’s passed in a bowel movement. So it’s unlikely that you can get the infection directly from a person infected with cyclospora, such as a restaurant worker who doesn’t wash his or her hands adequately after using the toilet.


Treatment for cyclospora infection is a combination antibiotic known as trimethoprim-sulfamethoxazole (Bactrim, Septra). If you’re unable to take trimethoprim-sulfamethoxazole, your doctor may prescribe ciprofloxacin or nitazoxanide (Alinia).