CYCLOSPORIASIS

Wisconsin Division of Public Health Disease Surveillance Manual (EpiNet, February 2005)

I. IDENTIFICATION

A. CLINICAL DESCRIPTION: An illness of variable severity caused by the protozoan Cyclospora cayetanensis and commonly characterized by watery diarrhea, loss of appetite, weight loss, abdominal bloating and cramping, increased flatus, nausea, fatigue, and low-grade fever. Vomiting also may be noted. Relapses and symptomatic infections can occur.

B. REPORTING CRITERIA: Laboratory confirmation.

C. LABORATORY CRITERIA FOR CONFIRMATION:

• Demonstration Cyclospora oocysts (by morphologic critera or by demonstration of sporulation) in stool, OR
• Cyclospora DNA (by polymerase chain reaction) in stool, OR
• Duodenal/jejunal aspirates or small-bowel biopsy specimens.

D. WISCONSIN CASE DEFINITION: A case that is laboratory confirmed.

II. ACTIONS REQUIRED / PREVENTION MEASURES

A. WISCONSIN DISEASE SURVEILLANCE CATEGORY II: Report to the patient's local health officer on an Acute and Communicable Disease Case Report (DPH 4151) or other means within 72 hours of the identification of a case or suspected case.

B. EPIDEMIOLOGY REPORTS REQUESTED: Acute and Communicable Diseases Case Report (DPH 4151).

C. PUBLIC HEALTH INTERVENTIONS:

• Source investigation by LHD. Obtain travel history for the month preceding onset of symptoms.
• Exclusions for persons in high-risk settings not necessary. Transmission of Cyclospora is by the fecal-oral route, but person-to-person transmission is very uncommon because excreted oocysts take days to weeks to develop environmental conditions to become infectious.

 
III. CONTACTS FOR CONSULTATION

A. BCDP / COMMUNICABLE DISEASE EPIDEMIOLOGY SECTION: (608) 267-9009.

B. REGIONAL STAFF: See Epinet Introduction: “REGIONAL OFFICE CONTACTS”.

C. WSLH / PARASITOLOGY: (608) 263-3421.

IV. RELATED REFERENCES

1. “Cyclosporiasis” DPH Disease Fact Sheet Series: View a list of all current Communicable Disease Fact Sheets

2. Heymann DL, ed. DIARRHEA CAUSED BY CYCLOSPORA. In: Control of Communicable Diseases Manual. 18 th ed. Washington , DC : American Public Health Association, 2004:141-142.