Cyclosporiasis Illnesses in the United States, 2023
LAST AND FINAL UPDATE FOR 2023
OCTOBER 26, 2023
CDC, along with state and federal health and regulatory officials, monitor cases of cyclosporiasis in the United States to detect outbreaks linked to a common food source. Cyclosporiasis, caused by the parasite Cyclospora cayetanensis, causes diarrhea, loss of appetite, and cramping. Cyclosporiasis cases are reported year-round in the United States, with increases in case counts seen during the spring and summer months. This year, CDC began to receive reports of cases in April.
Fast Facts
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Illnesses: 2,272
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Hospitalizations: 186
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Deaths: 0
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States reporting cases: 40
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Investigation status: Closed
- If you have symptoms of cyclosporiasis, see your healthcare provider.
They can test and treat you for cyclosporiasis.
- If your patient has a confirmed case cyclosporiasis, report the case to your local health department.
Final Update
As of October 24, 2023, 41 jurisdictions, including 40 states and New York City, have reported a total of 2,272 laboratory-confirmed cases of cyclosporiasis. These individuals had not traveled outside of the United States during the 14 days before they got sick. This is an increase of 315 cases since the last update on August 31, 2023.
Sick people ranged in age from 2 to 96 years, with a median age of 51, and 57% were female. The median illness onset date was June 24, 2023 (range: April 1 to August 31). Of 2,242 people with information available, 186 have been hospitalized. Zero deaths have been reported.
Local, state, and federal (CDC, FDA) public health authorities investigated multiple potential clusters of cases during 2023. The total case count (2,272) included the clusters that were under investigation by the FDA.
This map shows where the 2,272 people with cyclosporiasis acquired in the U.S. during April 1 to August 31, 2023, lived. Cyclosporiasis cases may not be limited to these states with known cases. The true number of people sick with cyclosporiasis was likely higher than the number reported. This is because some people recover without medical care and are not tested for Cyclospora.
* These data include case data reported directly to the Cyclospora surveillance program at CDC. Case counts may not match exactly with what is listed in the Nationally Notifiable Diseases Surveillance System tables. New York State includes case reports from New York City. In Pennsylvania, cases are reported voluntarily. Data are preliminary and subject to change. For questions related to the number of cases reported in each state, contact that state’s health department.
Previous Updates
Investigation Details
This is an update on the number of cyclosporiasis illnesses acquired in the United States with onset on or after April 1, 2023. Cases continue to be reported.
No specific food items have been identified as the source of most of these illnesses. State and local public health officials are interviewing people with cyclosporiasis to find out what foods they ate before getting sick.
As of August 29, 2023, 40 jurisdictions, including 39 states and New York City, have reported a total of 1,957 laboratory-confirmed cases of cyclosporiasis. These individuals had not traveled outside of the United States during the 14 days before they got sick. This is an increase of 894 cases since the last update on July 27, 2023.
Sick people range in age from 2 to 96 years, with a median age of 50, and 58% are female. The median illness onset date is June 23, 2023 (range: April 1 to August 22). Of 1,932 people with information available, 153 have been hospitalized. Zero deaths have been reported.
Local, state, and federal (CDC, FDA) public health authorities are investigating multiple potential clusters of cases. The total case count (1,957) includes the clusters under investigation by the FDA. Investigations to identify potential sources are ongoing.
Where Sick People Lived
This map shows where the 1,957 people with cyclosporiasis acquired in the U.S. since April 1, 2023, lived. Cyclosporiasis cases may not be limited to these states with known cases. The true number of people sick with cyclosporiasis is likely higher than the number reported. This is because some people recover without medical care and are not tested for Cyclospora.
* These data include case data that have been reported directly to the Cyclospora surveillance program at CDC; case counts may not match exactly with what is listed in the Nationally Notifiable Diseases Surveillance System tables. New York State includes case reports from New York City. In Pennsylvania, cases are reported voluntarily. Data are preliminary and subject to change. For questions related to the number of cases reported in each state, contact that state’s health department.
Investigation Details
This is an update on the number of cyclosporiasis illnesses acquired in the United States with onset on or after April 1, 2023. Cases continue to be reported.
No specific food items have been identified as the source of most of these illnesses. State and local public health officials are interviewing people with cyclosporiasis to find out what foods they ate before getting sick.
As of July 25, 2023, a total of 1,063 laboratory-confirmed cases of cyclosporiasis in people who had not traveled outside the United States during the 14 days before they got sick have been reported from 35 jurisdictions, including 34 states and New York City. This is an increase of 482 cases since the last update on July 13, 2023.
Sick people range in age from 2 to 96 years, with a median age of 50, and 58% are female. The median illness onset date is June 8, 2023 (range: April 1 to July 17). Of 1,038 people with information available, 79 have been hospitalized. Zero deaths have been reported.
The total number of laboratory-confirmed cases reported since April 1, 2023, includes 20 cases in Georgia and Alabama linked to an outbreak associated with raw imported broccoli. Although FDA and state and local partners conducted traceback investigations, there was not enough information to identify a specific type or producer of the broccoli.
- The broccoli outbreak appears to be over. There is no indication at this time that broccoli continues to be a source of illness for other cyclosporiasis cases being reported in the United States.
Multiple potential clusters of cases are being investigated by state and local public health authorities, CDC, and FDA. No specific food(s) have yet been identified as the cause of these clusters, and investigations to identify a potential source (or sources) are ongoing.
Where Sick People Lived
This map shows where the 1,063 people with cyclosporiasis acquired in the U.S. since April 1, 2023, lived. Cyclosporiasis illnesses may not be limited to these states with known illnesses, and the true number of people sick with cyclosporiasis is likely higher than the number reported. This is because some people recover without medical care and are not tested for Cyclospora.
* These data include case data that have been reported directly to the Cyclospora surveillance program at CDC; case counts may not match exactly with what is listed in the Nationally Notifiable Diseases Surveillance System tables. New York State includes case reports from New York City. In Pennsylvania, cases are reported voluntarily. Data are preliminary and subject to change. For questions related to the number of cases reported in each state, contact that state’s health department.
Investigation Details
This is an update on the number of cyclosporiasis illnesses acquired in the United States with onset on or after April 1, 2023. Cases continue to be reported.
No specific food items have been identified as the source of most of these illnesses. State and local public health officials are interviewing people with cyclosporiasis to find out what foods they ate before getting sick.
As of July 11, 2023, a total of 581 laboratory-confirmed cases of cyclosporiasis in people who had not traveled outside the United States during the 14 days before they got sick have been reported from 32 jurisdictions, including 31 states and New York City. This is an increase of 371 cases since the last update on June 22, 2023.
Sick people range in age from 3 to 96 years, with a median age of 49, and 61% are female. The median illness onset date is May 28, 2023 (range: April 1 to July 2). Of 569 people with information available, 55 have been hospitalized. Zero deaths have been reported.
The total number of laboratory-confirmed cases reported since April 1, 2023, includes 20 cases in Georgia and Alabama linked to an outbreak associated with raw imported broccoli. Although FDA and state and local partners conducted traceback investigations, there was not enough information to identify a specific type or producer of the broccoli.
- The broccoli outbreak appears to be over. There is no indication at this time that broccoli continues to be a source of illness for other cyclosporiasis cases being reported in the United States.
Multiple potential clusters of cases are being investigated by state and local public health authorities, CDC, and FDA. No specific food(s) have yet been identified as the cause of these clusters, and investigations to identify a potential source (or sources) are ongoing.
Where Sick People Lived
This map shows where the 581 people with cyclosporiasis acquired in the U.S. since April 1, 2023, lived. Cyclosporiasis illnesses may not be limited to these states with known illnesses, and the true number of people sick with cyclosporiasis is likely higher than the number reported. This is because some people recover without medical care and are not tested for Cyclospora.
* These data include case data that have been reported directly to the Cyclospora surveillance program at CDC; case counts may not match exactly with what is listed in the Nationally Notifiable Diseases Surveillance System tables. New York State includes case reports from New York City. In Pennsylvania, cases are reported voluntarily. Data are preliminary and subject to change. For questions related to the number of cases reported in each state, contact that state’s health department.
Investigation Details
This is an update on the number of cyclosporiasis illnesses acquired in the United States with onset on or after April 1, 2023. Cases continue to be reported.
No specific food items have been identified as the source of most of these illnesses. State and local public health officials are interviewing people with cyclosporiasis to find out what foods they ate before getting sick.
As of June 20, 2023, a total of 210 laboratory-confirmed cases of cyclosporiasis in people who had not traveled outside the United States during the 14 days before they got sick have been reported from 23 jurisdictions, including 22 states and New York City.
Sick people range in age from 3 to 95 years, with a median age of 49, and 64% are female. The median illness onset date is May 5, 2023 (range: April 1 to June 9). Of 207 people with information available, 30 have been hospitalized. Zero deaths have been reported.
The total number of laboratory-confirmed cases reported since April 1, 2023, includes 20 cases in Georgia and Alabama linked to an outbreak associated with raw imported broccoli. Although FDA and state and local partners conducted traceback investigations, there was not enough information to identify a specific type or producer of the broccoli.
- As of June 20, 2023, a total of 20 people with laboratory confirmed cyclosporiasis were reported from 2 states (Georgia and Alabama). The true number of sick people in this outbreak is likely higher than the number reported, and the outbreak may not be limited to the states with known illnesses. This is because some people recover without medical care and are not tested for cyclosporiasis.
- State and local health officials collected as much information as they could by asking people or their caregivers about foods they ate before getting sick. Epidemiologic data showed that raw broccoli was a likely source for this cluster of cases in Georgia and Alabama.
- Genotyping showed that Cyclospora from sick people’s samples were likely closely related genetically, suggesting that people in this cluster got sick from the same food.
- This outbreak appears to be over. There is no indication at this time that broccoli continues to be a source of illness for other cyclosporiasis cases being reported in the United States.
Where Sick People Lived
This map shows where the 210 people with cyclosporiasis acquired in the U.S. since April 1, 2023, lived. Cyclosporiasis illnesses may not be limited to these states with known illnesses, and the true number of people sick with cyclosporiasis is likely higher than the number reported. This is because some people recover without medical care and are not tested for Cyclospora.
* These data include case data that have been reported directly to the Cyclospora surveillance program at CDC; case counts may not match exactly with what is listed in the Nationally Notifiable Diseases Surveillance System tables. New York State includes case reports from New York City. In Pennsylvania, cases are reported voluntarily. Data are preliminary and subject to change. For questions related to the number of cases reported in each state, contact that state’s health department.
Investigation Details
This is an update on the number of cyclosporiasis illnesses acquired in the United States with onset on or after April 1, 2023. Cases continue to be reported.
No specific food items have been identified as the source of these illnesses. State and local public health officials are interviewing people with cyclosporiasis to find out what foods they ate before getting sick.
As of June 6, 2023, a total of 97 laboratory-confirmed cases of cyclosporiasis in people who had not traveled outside the United States during the 14-days before they got sick have been reported from 14 states and New York City.
Sick people range in age from 16 to 92 years, with a median age of 48 and 71% are female. The median illness onset date is April 27, 2023 (range: April 1 to May 25). Of 96 people with information available, 16 have been hospitalized. No deaths have been reported.
Where Sick People Lived
This map shows where the 97 people with cyclosporiasis acquired in the U.S. since April 1, 2023, lived. Cyclosporiasis illnesses may not be limited to these states with known illnesses, and the true number of people sick with cyclosporiasis is likely higher than the number reported. This is because some people recover without medical care and are not tested for Cyclospora.
* These data include case data that have been reported directly to the Cyclospora surveillance program at CDC; case counts may not match exactly with what is listed in the Nationally Notifiable Diseases Surveillance System tables. New York State includes case reports from New York City. In Pennsylvania, cases are reported voluntarily. Data are preliminary and subject to change. For questions related to the number of cases reported in each state, contact that state’s health department.
Investigation Details
This is the first report on the number of cyclosporiasis illnesses acquired in the United States with onset on or after April 1, 2023. Cases continue to be reported.
No specific food items have been identified as the source of these illnesses. State and local public health officials are interviewing people with cyclosporiasis to find out what foods they ate before getting sick.
As of May 23, 2023, a total of 40 laboratory-confirmed cases of cyclosporiasis in people who had not traveled outside the United States during the 14-days before they got sick have been reported from 8 states.
Sick people range in age from 23 to 92, with a median age of 50 and 68% are female. The median illness onset date is April 21, 2023 (range: April 6 to May 7). Of 39 people with information available, 3 have been hospitalized. No deaths have been reported.
Where Sick People Lived
This map shows where the 40 people with cyclosporiasis acquired in the U.S. since April 1, 2023, lived. Cyclosporiasis illnesses may not be limited to these states with known illnesses, and the true number of people sick with cyclosporiasis is likely higher than the number reported. This is because some people recover without medical care and are not tested for Cyclospora.
* These data include case data that have been reported directly to the Cyclospora surveillance program at CDC; case counts may not match exactly with what is listed in the Nationally Notifiable Diseases Surveillance System tables. New York State includes case reports from New York City. In Pennsylvania, cases are reported voluntarily. Data are preliminary and subject to change. For questions related to the number of cases reported in each state, contact that state’s health department.
