The Shadow
(VR) – The Commonwealth has confirmed its first reported cases of cyclosporiasis this summer, as health officials in the Mid-Atlantic and across the country investigate a growing surge in infections and several regional outbreaks.
The Virginia Department of Health is reporting 10 cases of cyclosporiasis so far in 2026, according to a July 7 media update. However, the agency said it is not currently investigating any local outbreaks tied to a common source.
MaryBeth DeMarco, a foodborne disease epidemiologist with VDH, said the cases are spread throughout the state rather than concentrated in one area. She added that health officials expect case numbers to continue climbing through the summer and possibly into the fall, which is typical for the illness.
State investigators are interviewing patients about their recent food histories and testing stool samples at the state public health laboratory. However, VDH said no specific food source, grower, supplier or restaurant chain has been identified in Virginia’s cases.
Neighboring Maryland has seen a larger spike, with 32 confirmed cases so far this year, including 28 reported since May 1, according to Amanda Hils, an assistant director with the Maryland Department of Health.
Virginia’s cases are part of a larger picture unfolding across the country. Cyclosporiasis is caused by a microscopic parasite called Cyclospora cayetanensis. The Centers for Disease Control and Prevention’s most recent national surveillance count, covering illness onset from May 1 through June 16, shows 145 U.S.-acquired cases across 17 states, with 20 hospitalizations and no deaths.
That count does not include more recent increases in several states. The agency has also said newly identified clusters have emerged in Alabama, Kentucky, Ohio, Pennsylvania, Tennessee and West Virginia, although interviews with patients in those clusters are still in the early stages.
By far the largest cluster is in Michigan, which typically records about 50 cases a year but has Michigan has now reported more than 1,000 cases since June 22, according to state officials cited by CNN. More than three dozen patients have been hospitalized.
Ohio has reported well over 500 cases in the affected region since the start of the year, with 171 occurring since June 20. Despite the overlapping timing of increases in multiple states, the CDC said it has found no evidence linking all the cases to a single nationwide outbreak and is treating them as several distinct regional clusters.
The parasite spreads through food or water contaminated with human feces and does not pass directly from person to person. Past U.S. outbreaks have been linked to raspberries, blackberries, basil, cilantro, snow peas, and bagged salad or mesclun lettuce mixes.
Rinsing produce reduces the risk but does not eliminate the parasite, which can cling to tiny grooves on produce surfaces. Officials recommend cooking vegetables whenever possible because heat destroys the organism.
Symptoms include frequent watery diarrhea, which can be severe or explosive, along with cramps, bloating, fatigue, body aches, loss of appetite, weight loss, nausea and a low-grade fever. Left untreated, the illness can last for weeks and may subside before returning.
Health officials say pinpointing the source of a Cyclospora outbreak is notoriously difficult—far more challenging than tracing more familiar foodborne illnesses such as salmonella or E. coli. The parasite has an incubation period of one to two weeks, and by the time a patient develops symptoms, seeks medical care, undergoes a specific parasite test and receives the results, as many as three weeks may have passed.
Recalling every raw vegetable, garnish or piece of fruit consumed three weeks earlier is a significant challenge for most patients, making it difficult for investigators to identify a common exposure.
Compounding the problem, standard stool tests often miss the infection because Cyclospora requires a specific test that most routine panels do not include. Health officials are urging anyone with prolonged or recurring diarrhea to ask their doctor specifically for a Cyclospora test.
The nation’s complex food supply chain adds another layer of difficulty. Produce is often grown in one region, packaged in another and distributed across dozens of states simultaneously, making it difficult to determine where contamination occurred.
The FDA’s Coordinated Outbreak Response and Evaluation Network is currently conducting traceback investigations involving cucumbers, cilantro, and white and green onions to determine whether regional distribution networks overlap with the clusters identified in the Mid-Atlantic. No specific food item, grower or supplier has been identified as the source in any state, and no recall has been issued.
The infection is typically treated with a 10-day course of the antibiotic commonly sold under the brand name Bactrim.
This story will be updated as Virginia and regional health officials release additional information.
