DOH CONFIRMS TRAVEL-RELATED CASE OF CYCLOSPORIASIS IN HAWAI‘I VISITOR

HONOLULU – The Hawaiʻi Department of Health (DOH) has confirmed a case of cyclosporiasis in a nonresident who recently traveled to Hawaiʻi from a state that has reported recent cases of the illness.

The individual was briefly hospitalized and is recovering as an outpatient. Based on the individual’s date of the arrival in Hawaiʻi, onset of symptoms, and the known incubation period following exposure to the parasite, the investigation determined the infection was not acquired in Hawaiʻi. At this time, there is no evidence of locally acquired infection or ongoing risk to the public in Hawaiʻi.

Cyclosporiasis is an intestinal illness caused by the microscopic parasite Cyclospora cayetanensis. Eggs of the parasite shed in the feces of infected persons must mature outside the host, in the environment, to become infective for someone else. People become infected by consuming food or water contaminated with the parasite. In the United States, outbreaks have most often been linked to certain fresh produce items. The illness is not typically spread directly from person to person.

Symptoms usually begin about one week after exposure but can appear anywhere from two days to two weeks later. The most common symptom is frequent, watery diarrhea. Other symptoms may include loss of appetite, weight loss, stomach cramps or bloating, nausea, increased gas, fatigue and, less commonly, vomiting or low-grade fever. Without treatment, symptoms may last for several weeks or longer and can come and go.

“While this case was not acquired in Hawaiʻi, we want residents and visitors to be aware of the symptoms of cyclosporiasis and know when to seek medical care,” said State Epidemiologist Dr. Sarah Kemble. “There is no evidence of local transmission in Hawaiʻi, and the risk to the general public remains low.”

Residents should not be alarmed by this travel-related case. DOH routinely investigates reportable diseases to identify potential sources of infection and monitors for any signs of local transmission. At this time, there are no indications that this case poses a broader public health risk in Hawaiʻi.

People can help reduce their risk of cyclosporiasis by:

• Washing hands thoroughly with soap and water before preparing or eating food and after using the restroom.
• Washing fresh fruits and vegetables under running water before eating, cutting or cooking them.
• Following safe food handling practices when preparing meals.
• Seeking medical care if they experience prolonged or severe diarrhea, particularly after recent travel or eating fresh produce from an area associated with an outbreak.

Cyclosporiasis is treatable with prescription antibiotics. Individuals experiencing persistent diarrhea should contact their healthcare provider. Healthcare providers who suspect cyclosporiasis are encouraged to report cases to DOH and submit appropriate specimens for laboratory testing.

DOH will continue to monitor for additional cases and work closely with healthcare providers and public health partners to protect the health of Hawaiʻi residents and visitors.

For more information about cyclosporiasis, the Hawaiʻi Department of Health’s Disease Outbreak Control Division website.

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