Texas officials warned the public Monday about a seasonal increase in infections from Cyclospora parasites, reporting there have been 56 confirmed cases since the beginning of May.

Neither this week’s outbreak notice nor a June 21 health advisory from the Texas State Department of Health Services (DSHS) referenced an ongoing cyclosporiasis outbreak in four other states. At least 185 people are infected in that outbreak, which is associated with trays of pre-cut fresh vegetables from Del Monte. 

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“DSHS is working with local health departments around the state and health departments in other states seeing an outbreak to gather information about the cases and determine whether there is a common source for the infections,” according to the outbreak notice from Texas public health officials.

This is the sixth consecutive year that the Texas health department has recorded a large number of illnesses from Cyclospora. Every year the concentration of cases has been from late spring through the end of summer. Investigations showed contaminated fresh cilantro from Mexico as the source of the parasites several times.

“Texas has had multiple outbreaks linked to cilantro,” the state health department reported. “… Cyclospora can be very difficult to wash off. Cooking will kill the parasite. Infection is generally not transmitted directly from person-to-person. There were 319 cases of cyclosporiasis in Texas reported last year.

“Rapid reporting to public health is essential to preventing additional cases of cyclosporiasis. Healthcare providers and laboratories are required to report confirmed cyclosporiasis cases to their respective local health department.”

Other outbreaks of cyclosporiasis in the United States in recent years have been associated with consumption of imported fresh produce, including fresh cilantro, pre-packaged salad mix, raspberries, basil, snow peas, and mesclun lettuce.

Symptoms of Cyclospora infection are often similar to intestinal viruses that resolve without medical treatment. Consequently, the state health department is urging people to seek medical attention if they have diarrhea for more than a few days.

Similarly, public health officials have advised health care providers to consider testing patients for the parasite if they have diarrheal illness lasting more than a few days or diarrhea accompanied by severe anorexia or fatigue.

In addition to producing symptoms that can be confused with other illnesses, cyclosporiasis requires special lab tests with specific doctor’s orders. Even then, “a single negative stool specimen does not exclude the diagnosis; three specimens are optimal,” according to the warning from the Texas health department.  

Cyclosporiasis is an intestinal illness caused by consuming food or water contaminated with the microscopic Cyclospora parasite. Symptoms usually begin 2 to 14 days after ingestion of the parasite. 

The main symptom is watery diarrhea lasting a few days to a few months. Additional symptoms may include loss of appetite, fatigue, weight loss, abdominal cramps, bloating, increased gas, nausea, vomiting and a low fever. Symptoms may come and go multiple times over a period of weeks or months.

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