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Federal and state health officials are investigating a rise in infections caused by a microscopic parasite that can trigger days or weeks of severe diarrhea, with Texas among the states reporting illnesses this spring and summer.
The Centers for Disease Control and Prevention says 145 people in 17 states contracted cyclosporiasis in the United States between May 1 and June 16 without recent international travel. Twenty people were hospitalized, and no deaths have been reported.
Investigators have not identified a single food source linking all of the illnesses, and several separate clusters remain under investigation.
However, federal and state health officials emphasize that this number represents a baseline count through June 16, meaning the actual number of cases in the U.S. could be even higher.
Cyclosporiasis is an intestinal illness caused by the parasite Cyclospora cayetanensis. According to the CDC, people become infected by eating food or drinking water contaminated with the parasite. Unlike many gastrointestinal illnesses, cyclosporiasis does not typically spread directly from one person to another because the parasite must spend time in the environment before it becomes infectious.
The Texas Department of State Health Services issued a health advisory in May reminding health care providers to consider Cyclospora infection in patients with persistent watery diarrhea, particularly during the warmer months when cases typically increase.
The agency says symptoms usually develop two to 14 days after exposure and can include prolonged watery diarrhea, stomach cramps, bloating, nausea, fatigue, loss of appetite, weight loss and, in some cases, low-grade fever. Without treatment, symptoms may last for several weeks or even return after temporarily improving.
Health officials say previous U.S. outbreaks have been linked to fresh produce, including cilantro, basil, raspberries, parsley, broccoli, snow peas and packaged salad mixes.
However, neither the CDC nor the U.S. Food and Drug Administration has identified a specific food responsible for the current illnesses. Investigators continue tracing multiple clusters to determine whether contaminated produce is involved.
Texas has also historically reported some of the nation's highest numbers of cyclosporiasis cases, according to CDC surveillance data.
Because washing fresh produce may not remove every Cyclospora parasite, the CDC recommends practicing good hygiene and washing hands thoroughly. The agency also recommends washing fruits and vegetables before eating them and seeking medical care for diarrhea that lasts several days or is accompanied by dehydration or significant weight loss. The illness can be diagnosed through laboratory testing and is treatable with prescription antibiotics.
