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