Christopher Attaway, MD, FCAP, member of the CAP Microbiology Committee, shares insights on common questions for cyclospora.
What is Cyclospora?
Cyclospora is a microscopic parasite that infects the small intestine and causes an illness called cyclosporiasis. Most people become infected after eating fresh produce or drinking water contaminated with the parasite.
What are the symptoms of Cyclospora infection?
The most common symptom is prolonged, watery diarrhea. People may also experience loss of appetite, stomach cramps, bloating, nausea, fatigue, and weight loss. Symptoms can last for days to weeks and may come and go if left untreated.
How is Cyclospora diagnosed?
Cyclospora is diagnosed by testing a stool sample. Because the parasite can be difficult to detect, laboratories may use specialized microscopic techniques, molecular tests such as Polymerase Chain Reaction (PCR), or both to identify the infection quickly and accurately.
Why can Cyclospora be difficult to diagnose?
Its symptoms overlap with many other causes of diarrhea, and the parasite may not be present in every stool sample. In some cases, patients need to submit multiple specimens collected over several days to improve the chance of detection.
Can Cyclospora be detected on a routine stool test?
Not always. Some routine stool examinations may not detect Cyclospora unless the laboratory performs specific testing or the clinician suspects the infection and requests appropriate evaluation.
When should someone be tested for Cyclospora?
Testing may be appropriate for someone with persistent watery diarrhea, especially if they have recently eaten food linked to an outbreak, traveled to an area where Cyclospora is more common, or have symptoms that are not improving.
What role do pathologists play in diagnosing Cyclospora?
Pathologists and laboratory professionals play a critical role in diagnosing Cyclospora infection. They identify the parasite through laboratory testing and help distinguish Cyclospora from other causes of diarrheal illness, ensuring patients receive the correct treatment.
How does Cyclospora spread?
People become infected by swallowing food or water contaminated with the parasite. Unlike many stomach viruses, Cyclospora is not typically spread directly from one person to another because the parasite needs time in the environment before it becomes infectious.
Is Cyclospora contagious?
The risk of direct person-to-person transmission is very low. Most infections are linked to contaminated food or water rather than close contact with an infected person.
What foods are commonly associated with Cyclospora outbreaks?
Outbreaks have often been linked to fresh produce, including leafy greens, herbs, and berries. Because these foods are frequently eaten raw, contamination before they reach consumers can lead to illness.
How is Cyclospora treated?
Cyclospora is typically treated with prescription antibiotics. Most people improve with appropriate treatment, although recovery may take longer if diagnosis is delayed.
Who is most at risk for Cyclospora infection?
Anyone can become infected, but the risk increases for people who consume contaminated food or water, particularly during outbreaks. Travelers to areas where Cyclospora is more common may also have a higher risk of exposure.
Can washing produce prevent Cyclospora infection?
Washing fruits and vegetables is an important food safety practice, but it may not completely remove Cyclospora. Preventing contamination during growing, harvesting, and food processing is an important part of reducing outbreaks.
How do laboratories help during a Cyclospora outbreak?
Clinical laboratories confirm infections, while public health laboratories may perform additional testing to help identify outbreak patterns. Together, these efforts support patient care and help investigators trace the source of contaminated food.
Why is identifying Cyclospora quickly important?
An accurate diagnosis helps patients receive effective treatment sooner and reduces unnecessary testing for other conditions. Confirmed cases also provide important information for public health officials investigating potential outbreaks.