Key Links

Keylinks Right Menu 

Licensure Key Links

Keylinks Licensure

All questions or comments should be directed or sent to LDH Dept of Public Health.

Domestically Acquired Cyclosporiasis Cases, 2026

Multiple states are investigating cases of domestically acquired cyclosporiasis. Since May 1, 2026, the Centers for Disease Control and Prevention (CDC) has received reports of 1,645 confirmed domestic cases of cyclosporiasis and is aware of more than 5,100 cases that require further analysis to confirm the illness as domestically acquired cyclosporiasis. This is substantially higher than the 249 cases reported nationally by this same time last year. Of the 1,645 case-patients with available information, 141 (9%) were hospitalized, and none have died. CDC, the 

, and state and local health departments are working together to investigate multistate outbreaks of Cyclospora infections and to identify the sources of illness. Because cyclosporiasis is often underdiagnosed and underreported, the true number of illnesses is likely higher than what has been reported to CDC. This Health Advisory provides background information about cyclosporiasis, current U.S. surveillance data, and recommendations for clinicians, laboratorians, and public health departments to support recognition, diagnosis, and reporting.

Cyclosporiasis is a gastrointestinal illness caused by the microscopic parasite Cyclospora. People can become infected by consuming food or water contaminated with the parasite. This illness is not usually spread directly from person to person. Case counts typically rise during spring and summer months, and CDC considers May 1-August 31 the annual cyclosporiasis season. Previous outbreaks have been linked to consuming contaminated fresh produce.

Symptoms of cyclosporiasis typically begin about 1 week after exposure. Onset of symptoms can occur 2-14 days after being exposed. The most common symptoms include watery diarrhea, which can be frequent, along with loss of appetite, weight loss, bloating, nausea, and fatigue. Less common symptoms include low-grade fever and vomiting. Without treatment, symptoms can follow a remitting-relapsing course that can last from a few days to a month or longer. Illness can be severe, but is not usually life-threatening. Complications can include malabsorption, cholecystitis, and reactive arthritis.

As of July 14, 43 cases of cyclosporiasis have been reported in Louisiana during 2026. By comparison, over the past five years, Louisiana confirmed an average of 30 cases during the same time period.

Cyclosporiasis cases have been reported among Louisiana residents in nearly every region of the state. The parishes with the highest number of reported cases are East Baton Rouge and Lafayette. Five patients have been hospitalized, and none have died. Eighty percent of the cases were domestically acquired.

Recommendations for Healthcare Professionals

Consider cyclosporiasis in patients presenting with prolonged or relapsing watery diarrhea, particularly during the May–August cyclosporiasis season, even without a history of international travel.

Ask patients with suspected or confirmed cyclosporiasis about their recent food and travel history to assist local investigations.

Laboratory detection of Cyclospora in stool can be challenging even in symptomatic patients, and standard ova and parasite exams might not detect it reliably. Clinicians should specifically request diagnostic testing for Cyclospora when it is clinically suspected. Consider molecular (PCR-based) diagnostic testing where available, because it can improve detection.

Treat confirmed cases of cyclosporiasis with 7-10 days of trimethoprim-sulfamethoxazole (TMP-SMX) for immunocompetent adults and children over age 2 months; consider longer courses for patients with immunocompromising conditions. Consult current 

Advise patients to stay well hydrated, especially if diarrhea is frequent or severe.

Cyclosporiasis is a Class B reportable condition in Louisiana, which requires public health reporting within one business day. Cases can be reported electronically, via fax (504-568-8290), or reported to the respective LDH 

. To reach LDH’s on-call epidemiologist, call 800-256-2748. Cyclosporiasis cases can sometimes be identified in clusters due to common exposures.  Outbreaks or clusters of any infectious disease are considered Class A Conditions in the State Sanitary Code, which require immediate reporting by phone to LDH’s clinician hotline: 800-256-2748.

Recommendations for Disinfecting Cyclospora in Healthcare Settings

Given the typical lifecycle of Cyclospora, person-to-person transmission is unlikely, even within healthcare settings. If an affected patient is continent of stool, the level of environmental contamination is probably small.

Cyclospora is unlikely to be killed or inactivated by routine chemical disinfection. No EPA-registered disinfectant products have been demonstrated to be effective against Cyclospora. When affected patients are incontinent or diapered, the risk of contamination of healthcare surfaces might be higher. Facilities should clean surfaces initially with a detergent to remove any visible soil and scrub the surfaces thoroughly. After this cleaning, an EPA-registered hospital disinfectant should be used. Immediately after cleaning, healthcare personnel (HCP) should remove gloves used during cleaning and clean their hands.

HCP should always use Standard Precautions, including wearing gloves when there might be direct contact with feces. A gown, facemask, and eye protection, or face shield should be used if splashing might occur. Hand hygiene should be performed before and after every patient contact. If hands are visibly soiled, HCP should wash them with soap and water, scrubbing vigorously for 15-20 seconds. If hands are not visibly soiled, alcohol-based hand sanitizer may be used. For patients with gastroenteritis who are diapered or incontinent of stool, HCP should use Contact Precautions when providing direct patient care in healthcare settings.