{"id":2823,"date":"2026-07-16T16:55:44","date_gmt":"2026-07-16T16:55:44","guid":{"rendered":"https:\/\/www.vdh.virginia.gov\/clinicians\/?page_id=2823"},"modified":"2026-08-06T18:16:06","modified_gmt":"2026-08-06T18:16:06","slug":"updates-on-cyclosporiasis-in-virginia","status":"publish","type":"page","link":"https:\/\/www.vdh.virginia.gov\/clinicians\/clinician-letters\/updates-on-cyclosporiasis-in-virginia\/","title":{"rendered":"Updates on Cyclosporiasis in Virginia"},"content":{"rendered":"
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Update<\/span>s<\/span>\u00a0on<\/span>\u00a0Cyclosporiasis\u00a0<\/span>in Virginia<\/span><\/span>\u00a0<\/span><\/span><\/strong><\/p>\n

July 17, 2026<\/strong><\/span><\/p>\n

Dear Colleague,<\/span>\u00a0<\/span><\/p>\n

This letter provides an update on cyclosporiasis\u00a0in Virginia.<\/span>\u00a0<\/span><\/p>\n

As of<\/span>\u00a0July 4,\u00a02026,<\/span>\u00a0VDH has\u00a0publicly\u00a0reported<\/span>\u00a037 c<\/span>ases of cyclosporiasis in 2026.\u00a0Although\u00a0this is more than double the 5-year average number of cases\u00a0<\/span>reported<\/span><\/a>\u00a0year to date<\/span>,\u00a0t<\/span><\/b>here\u00a0is not currently evidence that Virginia is experiencing an outbreak.\u00a0<\/span><\/b>This information is preliminary and subject to change as more information becomes available.\u00a0Cases include\u00a0people\u00a0who travelled internationally before illness onset and others who were\u00a0likely infected\u00a0domestically.\u00a0The number of cyclosporiasis cases reported to VDH typically increase<\/span>s in the\u00a0spring\u00a0and summer months,\u00a0and it is expected that case counts may increase in the coming weeks due to the seasonal nature of this illness.\u00a0Due to the heightened interest in this topic, beginning the week of\u00a0<\/span>July\u00a020, 2026<\/span>, weekly case counts in Virginia will be posted on the\u00a0<\/span>VDH Cyclosporiasis webpage.<\/span><\/a>\u00a0<\/span><\/p>\n

Several states<\/a>, including several in the midwestern region of the United States, are currently experiencing a significant increase in cases of cyclosporiasis and some have detected clusters or outbreaks. States are working together with federal partners to investigate these outbreaks. On July 16, the Centers for Disease Control and Prevention (CDC) and the US Food and Drug Administration (FDA) reported<\/a> that shredded iceberg lettuce served at Taco Bell locations in Indiana, Kentucky, Michigan, Ohio, and West Virginia has been identified as a likely exposure source; consumers should avoid eating shredded iceberg lettuce at Taco Bell locations in these states. For more information on the multi-state outbreak investigations in the United States, visit the CDC Cyclospora webpage.<\/a><\/p>\n

Cyclosporiasis<\/span><\/a>\u00a0is a gastrointestinal illness caused by the microscopic parasite\u00a0<\/span>Cyclospora<\/span><\/i>. People can become infected by consuming food or water contaminated with the parasite. This illness is not usually spread directly from person to person.\u00a0Symptoms of cyclosporiasis usually appear within one week after exposure.\u00a0The 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\u00a0from a few days to a month or longer.\u00a0Untreated illness may last from several days to several weeks and may be remitting and relapsing.\u00a0Illness can be\u00a0severe but\u00a0is not usually life-threatening.\u00a0Healthcare providers should report cases of cyclosporiasis to VDH.\u00a0<\/span>\u00a0<\/span><\/p>\n

Stool specimen tests for ova and parasites usually do not include examination for\u00a0<\/span>Cyclospora<\/span><\/i>\u00a0unless such testing is\u00a0requested. Similarly, not all gastrointestinal polymerase chain reaction (PCR) panels include a target for\u00a0<\/span>Cyclospora<\/span><\/i>. Therefore, when evaluating persons with symptoms consistent with cyclosporiasis, specifically request testing for this parasite. If\u00a0indicated, stool specimens also should be checked for other pathogens that can cause a similar illness.<\/span>\u00a0<\/span><\/p>\n

Most healthy people will eventually recover from cyclosporiasis without treatment,\u00a0although their illness may be prolonged. Trimethoprim-sulfamethoxazole (TMP-SMX) is the treatment of choice for cyclosporiasis. Consult\u00a0<\/span>CDC clinical guidance<\/span><\/a>\u00a0for more information on recommended dosing.\u00a0<\/span>\u00a0<\/span><\/p>\n

To\u00a0reduce the risk of\u00a0cyclosporiasis, VDH\u00a0advises people to\u00a0take the following\u00a0steps:\u00a0\u00a0<\/span>\u00a0<\/span><\/p>\n