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Cyclospora Infection
(SIGH-clo-SPORE-uh)
What is Cyclospora?
Cyclospora
cayetanensis (SIGH-clo-SPORE-uh KYE-uh-tuh-NEN-sis) is a parasite
composed of one cell, too small to be seen without a microscope. The first
known human cases of illness caused by Cyclospora infection (i.e.,
cyclosporiasis) were reported in 1979. Cases began being reported more
often in the mid-1980s. In the last several years, outbreaks of
cyclosporiasis have been reported in the United States and Canada.
How is Cyclospora
spread?
Cyclospora
is spread by people ingesting something, for example, water or food that
was contaminated with infected stool. For example, outbreaks of
cyclosporiasis have been linked to various types of fresh produce. Cyclospora
needs time (days or weeks) after being passed in a bowel movement to
become infectious. Therefore, it is unlikely that Cyclospora is
passed directly from one person to another. It is unknown whether animals
can be infected and pass infection to people.
Who is at risk for infection?
People of all ages are
at risk for infection. In the past, Cyclospora infection was
usually found in people who lived or traveled in developing countries.
However, people can be infected worldwide, including the United States.
What are the symptoms of
infection?
Cyclospora
infects the small intestine (bowel) and usually causes watery diarrhea,
with frequent, sometimes explosive, bowel movements. Other symptoms can
include loss of appetite, substantial loss of weight, bloating, increased
gas, stomach cramps, nausea, vomiting, muscle aches, low-grade fever, and
fatigue. Some people who are infected with Cyclospora do not have
any symptoms.
How soon after infection will
symptoms begin?
The time between
becoming infected and becoming sick is usually about 1 week.
How long will symptoms last?
If not treated, the
illness may last from a few days to a month or longer. Symptoms may seem
to go away and then return one or more times (relapse).
What should I do if I think I
may be infected?
See your health care
provider.
How is Cyclospora
infection diagnosed?
Your health care
provider will ask you to submit stool specimens to see if you are
infected. Because testing for Cyclospora infection can be
difficult, you may be asked to submit several stool specimens over several
days. Identification of this parasite in stool requires special laboratory
tests that are not routinely done. Therefore, your health care provider
should specifically request testing for Cyclospora. Your health
care provider may have your stool checked for other organisms that can
cause similar symptoms.
How is infection treated?
The recommended
treatment for infection with Cyclospora is a combination of two
antibiotics, trimethoprim-sulfamethoxazole, also known as Bactrim*, Septra*,
or Cotrim*. People who have diarrhea should rest and drink plenty of
fluids.
I am allergic to sulfa drugs;
is there another drug I can take?
No alternative drugs
have been identified yet for people who are unable to take sulfa drugs.
See your health care provider for other treatment recommendations.
How is infection prevented?
Avoiding water
or food that may be contaminated with stool may help prevent Cyclospora
infection. People who have previously been infected with Cyclospora
can become infected again.
For more information:
- CDC. Outbreak of
cyclosporiasis -- northern Virginia-Washington, D.C.-Baltimore,
Maryland, metropolitan area, 1997. MMWR 1997; 46:689-91.
- Herwaldt BL, et al.
An outbreak in 1996 of cyclosporiasis associated with imported
raspberries. N Engl J Med 1997;336:1548-56.
- Herwaldt BL, et al.
The return of Cyclospora in 1997: another outbreak of
cyclosporiasis in North America associated with imported raspberries.
Ann Intern Med 1999;130:210-20.
- Hoge CW, et al.
Placebo-controlled trial of co-trimoxazole for cyclospora infections
among travellers and foreign residents in Nepal. Lancet
1995;345:691-3.
- Hoge CW, et al.
Epidemiology of diarrhoeal illness associated with coccidian-like
organism among travellers and foreign residents in Nepal. Lancet
1993;341:1175-9.
- Huang P, et al. The
first reported outbreak of diarrheal illness associated with Cyclospora
in the United States. Ann Intern Med 1995;123:409-14.
- Ortega YR, et al.
Cyclospora species - a new protozoan pathogen of humans. N Engl J Med
1993;328:1308-12.
- Soave R. Cyclospora:
an overview. Clin Infect Dis 1996;23:429-37.
- Soave R, et al.
Cyclospora. Infect Dis Clinics N Amer 1998;12:1-12.
* Use of trade names is
for identification only and does not imply endorsement by the Public
Health Service or by the U.S. Department of Health and Human Services.
This fact sheet is for
information only and is not meant to be used for self-diagnosis or as a
substitute for consultation with a health care provider. If you have any
questions about the disease described above or think that you may have a
parasitic infection, consult a health care provider.
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