Keys to the “explosive diarrhea” that keeps people in more than 30 US states in suspense.
Cyclosporiasis is primarily transmitted through contaminated food and water. Imported fresh products are the most affected
The Centers for Disease Control and Prevention (CDC) reports a notable increase in cyclosporiasis cases in the United States, with a total of 2,944 confirmed cases distributed in 32 states since May 1, 2026.
Particularly in California, the number of reported cases ranges between 1 and 10, suggesting a potential unaccounted increase. The highest numbers are recorded in Michigan, with 1,562 cases.
How cyclosporiasis is transmitted
Cyclosporiasis is primarily transmitted through contaminated food and water. The investigation has indicated that imported fresh products, such as raspberries and lettuce, are the most affected.
Food contaminated with the Cyclospora cayetanensis parasite is not usually passed directly from one person to another, because the parasite needs several days in the environment to become infectious.
Sprouts are often associated with fresh produce, especially leafy green vegetables, fresh herbs, and berries.
Preventive measures
Most common symptoms
The most common symptoms of cyclosporiasis are watery diarrhea and intestinal discomfort; Other common symptoms include loss of appetite and weight, abdominal cramps, bloating, gas, nausea, and vomiting. The infection can also cause fatigue, muscle aches, and a mild fever; Some patients have relapses and untreated diarrhea can last for several weeks.
If you suspect cyclosporiasis (persistent diarrhea, especially after traveling or after consumption of raw fruits/vegetables), consult a health professional for diagnosis and treatment; There is effective therapy that reduces the duration and severity of symptoms.
Recommended treatments
Experts consider cyclosporiasis a significant intestinal parasitic infection, especially in tropical and subtropical regions, but with cases increasingly reported in non-traditional areas due to increased international travel and food imports.
The general opinion is that, although in immunocompetent people it is usually a mild and resolving disease, it can be serious, prolonged and complicated in immunosuppressed patients (for example, with HIV, transplant recipients or undergoing chemotherapy).
From within the CDC, specialists highlight that many antibiotics (metronidazole, azithromycin, albendazole, etc.) are considered ineffective based on anecdotal data and limited studies.
The Merck Manual for Professionals reaffirms that the recommended treatment is TMP-SMX, and that in immunosuppressed patients the infection may persist and require prolonged management.
On the other hand, the importance of improving diagnosis (special microscopy, molecular techniques) and considering cyclosporiasis in patients with chronic diarrhea is emphasized, especially if they have a history of travel or consumption of imported fresh foods.
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