Special Communication

Increased Cyclospora Activity and Recommended Testing

We would like to make providers aware of increased Cyclospora activity during the current transmission season. According to the CDC, 1,645 confirmed cases (5000 being investigated) domestically acquired cases have been reported across 34 states as of July 2026, and investigations are ongoing. No single source has been identified at this time. 

We have also observed an increase in Cyclospora-positive cases within our patient population, including both travel-associated but especially in locally acquired infections.

In response, Cleveland Clinic Laboratories is providing this dashboard with daily updates on CRYSPO testing volume, positive detections, and positivity rates to support clinical and public health decision-making.

Recommended testing:

For patients with suspected Cyclospora infection, particularly those with persistent or relapsing diarrhea, please order: CRYSPO – Cyclospora Modified Acid-Fast (MAF) Stain.
Please note that Cyclospora is not detected by routine Ova and Parasite (O&P) examination and requires alternative staining and test.

The Expanded Gastrointestinal Panel (STGIPI) includes a Cyclospora nucleic acid amplification target, but this is an expensive test and might not be reimbursed by insurance. CRYSPO is the preferred test for routine evaluation of suspected Cyclospora infection, as modified acid-fast staining allows direct visualization of Cyclospora oocysts within the stool specimen, providing evidence of active infection and supporting diagnosis in patients with ongoing or persistent symptoms.

Additional information:
Cyclosporiasis is a nationally notifiable disease. Cases identified through laboratory testing are automatically reported to the appropriate public health authorities in accordance with reporting requirements. Additional information is available through the CDC Cyclospora surveillance page:

CDC Cyclosporiasis Surveillance

Special Communication

New Chemistry Standard Transport Tube

New Chemistry Standard Transport Tube Implemented for All Cleveland Clinic Locations

A new standard transport tube will be implemented for all Cleveland Clinic locations and clients on March 9, 2026. This new tube will replace the existing transport tube (Sarstedt product number 62.612) for most specimens that need to be aliquoted. The existing transport tube will no longer be accepted after March 31. Please refer to the test directory or procedure catalog for test-specific requirements.

Special Communication

Test Changes – Oxidized Low-Density-Lipoprotein (OXLDL) & Lipoprotein-associated Phospholipase A2 Activity (PLAA2)

Starting March 18, 2025, Oxidized Low-Density-Lipoprotein (OXLDL) & Lipoprotein-associated Phospholipase A2 Activity (PLAA2) will be sent to a different performing reference laboratory (LabCorp).

Refer to the table below for an outline of testing changes.

Please contact Client Services with any questions or for assistance.

Test Change Overview

Special Communication

Stool Testing Universal Laboratory (STUL) Kit for Microbiology

The Stool Testing Universal Laboratory (STUL) Kit for Microbiology contains the collection and transport items necessary for most stool testing.

Place all (3) vials into the white STUL Kit bag or a large biohazard bag with Beaker labels attached externally.

All vials remain at Main Campus for add-on testing, stability permitting. Refer to the Microbiology Collection & Transport Guide: Stool Collection Devices for specific test and item information.

Special Communication

Test Update – Vasoactive Intestinal Polypeptide, Plasma (VIP)

Beginning October 8, 2024, Vasoactive Intestinal Polypeptide, Plasma (VIP) will return to the previous reference lab following the resolution of the reagent shortage.

Refer to the table below for an outline of testing changes.

Please contact Client Services with any questions or for assistance.

Test Change Overview

Vasoactive Intestinal Polypeptide, Plasma (VIP)