Global & Disaster Medicine

People who reportedly consumed Del Monte Fresh Produce pre-packaged vegetable trays containing broccoli, cauliflower, carrots, and dill dip from Kwik Trip/Kwik Star and were infected with Cyclospora as of June 21, 2018 (n=144)

CDC

outbreak_map

Some of the elements of this figure were created based on an illustration by Ortega et al. Cyclospora cayetanensis. In: Advances in Parasitology: opportunistic protozoa in humans. San Diego: Academic Press; 1998. p. 399–418.

When freshly passed in stools, the oocyst is not infective (thus, direct fecal-oral transmission is unlikely; this differentiates Cyclospora from another important coccidian parasite, Cryptosporidium). In the environment , sporulation usually requires at least 1–2 weeks at temperatures from 22°C to 32°C, and results in division of the sporont into two sporocysts, each containing two elongated sporozoites . Fresh produce and water can serve as vehicles for transmission , and the sporulated oocysts are ingested (in contaminated food or water) . The oocysts excyst in the gastrointestinal tract, freeing the sporozoites, which invade the epithelial cells of the small intestine . Inside the cells, they undergo asexual multiplication and sexual development to mature into oocysts, which will be shed in stools .


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