We investigated the timing of diagnosis, influence of media information on testing for Cyclospora, and the method used to identify cases during eight cyclosporiasis outbreaks in California in spring of 1997. We found that Internet information, media reports, and enhanced laboratory surveillance improved detection of these outbreaks.
Cyclospora cayetanensis, a recently identified coccidian parasite of humans, causes explosive watery diarrhea that can persist for several weeks. The oocysts cannot be detected by standard ova and parasite testing; methods specific for Cyclospora include modified acid-fast or other stains, autofluorescence with ultraviolet epifluorescence microscopy, and wet mount under phase-contrast microscopy. The infection can be treated with trimethoprim-sulfamethoxazole (TMP-SMX). Eight outbreaks in California were among the 41 event-associated clusters of cyclosporiasis associated with Guatemalan raspberries identified in the United States and Canada in 1997.
We examined factors contributing to the identification of outbreaks of this emerging infectious disease. The detection of outbreaks was enhanced by Internet information that patients brought to their physicians, media reports, and enhanced laboratory-based (ELB) surveillance. ELB surveillance, part of the California Emerging Infections Program (EIP), is a cooperative agreement between the California State Health Department, the University of California Berkeley School of Public Health, selected local counties, and the Centers for Disease Control and Prevention.