Abstract
Cyclospora cayetanensis is an intestinal coccidian parasite transmitted to humans through the consumption of oocysts in fecally contaminated food and water. Infection is found worldwide and is highly endemic in tropical and subtropical regions with poor sanitation. Disease in developed countries is usually observed in travelers and in seasonal outbreaks associated with imported produce from endemic areas. Recently, summertime outbreaks in the United States have also been linked to locally grown produce. Cyclosporiasis causes a diarrheal illness which may be severe in infants, the elderly, and immunocompromised individuals. The increased adoption of highly sensitive molecular diagnostic tests, including commercially available multiplex panels for gastrointestinal pathogens, has facilitated the detection of infection and likely contributed to the increased reports of cases in developed countries. This manuscript reviews important aspects of the biology, epidemiology, and clinical manifestations of C. cayetanensis and provides an in-depth discussion of current laboratory diagnostic methods.
Highlights
Cyclosporiasis is a foodborne and waterborne intestinal parasitic disease caused by the coccidian parasite Cyclospora cayetanensis
While other Cyclospora species have been described from non-human primates [1], C. cayetanensis is the only species known to infect humans and to date has only been isolated from humans, isolates from captive chimpanzees and macaques in Europe have been found to have isolates genetically similar to C. cayetanensis [2]
Cyclospora cayetanensis can be identified in biopsy specimens of the small intestine; it should be noted that endoscopy and biopsy are not routinely ordered for the diagnosis of cyclosporiasis, as several more sensitive and less invasive diagnostic alternatives exist
Summary
Cyclosporiasis is a foodborne and waterborne intestinal parasitic disease caused by the coccidian parasite Cyclospora cayetanensis. Cyclospora cayetanensis occurs worldwide, with hot spots of endemicity including tropical and subtropical regions of Latin America (including the Caribbean), Central and Southeast Asia, the Middle East, and North Africa [3,4]. This parasite is prevalent in settings with poor sanitation where the environment is contaminated with human feces from infected individuals. Given the ongoing annual outbreaks of cyclosporiasis in the United States, the FDA formed the Cyclospora Task Force in 2019, and this group produced the “Cyclospora Prevention, Response and Research Action Plan” to combat foodborne illness associated with imported and domestically grown produce [19]
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