Title: Diarrheal Disease Outbreak in the US<br/>Author: Andrea Tenner<br/><a href='http://umem.org/profiles/faculty/1069/'>[Click to email author]</a><hr/><p>
<strong><em>General Information:</em></strong></p>
<p>
As of July 30<sup>th</sup>, 2013, there have been 378 cases of <em>Cyclospora </em> infection from multiple states in the US. <em>Cyclospora</em> is most common in tropical and sub-tropical regions, and is spread via fecal-oral route. While the cause of the most recent outbreak is unknown, outbreaks in the US are generally foodborne.</p>
<p>
<strong><em>Clinical Presentation:</em></strong></p>
<p>
- Symptoms usually begin 7 days after exposure</p>
<p>
- Watery diarrhea, cramping, bloating, nausea, fatigue, increased gas, vomiting, low grade temperature</p>
<p>
- Can persist several weeks to > 1 month</p>
<p>
<strong><em>Diagnosis:</em></strong></p>
<p>
- Concentrated Stool Ova and Parasites— viewed under modified acid fast or fluorescence microscopy (labs can submit photos to the CDC for “telediagnosis”)</p>
<p>
<strong><em>Treatment:</em></strong></p>
<p>
- TMP-SMX DS one tab po bid x7-10 days</p>
<p>
- No effective alternate for failed treatment or sulfa allergy</p>
<p>
- Most will recover without treatment but S/S can persist for weeks to months</p>
<p>
<strong><em>Bottom Line:</em></strong></p>
<p>
Consider <em>Cyclospora</em> as a cause of prolonged diarrheal illness, treat with TMP-SMX.</p>
<p>
<strong>University of Maryland Section of Global Emergency Health</strong></p>
<p>
<strong>Author: Andi Tenner, MD, MPH</strong></p>
<fieldset><legend>References</legend>
<p>
www. cdc. gov/parasites/cyclosporiasis/outbreaks/investigations-2013.html</p>
<p>
www.cdc.gov/parasites/cyclosporiasis</p>
</fieldset>