National case definition: Cyclosporiasis

Date of last revision/review: December 2023.

National notification

Only confirmed cases of disease should be notified.

Type of surveillance

Routine case-by-case notification to the federal level.

Case classification

Confirmed case

Laboratory confirmation of infection in a person with or without clinical illness from an appropriate clinical specimen (e.g., stool, intestinal fluid, small bowel biopsy), with demonstration of:

• Cyclospora spp. oocysts;
  or
• Cyclospora spp. nucleic acid (e.g., by polymerase chain reaction (PCR) or other nucleic acid test (NAT)).

Probable case

Clinical illness in a person who is epidemiologically linked to a confirmed case.

Laboratory comments

Untreated and unfixed (i.e., without formalin) clinical specimens are recommended for PCR and deoxyribonucleic acid (DNA) based methodologies including molecular diagnostic testing and downstream molecular surveillance approaches. Formalin-based fixatives used for microscopy can interfere with nucleic acid detection and sequencing.

Note: For molecular surveillance purposes, Cary Blair transport media is acceptable.

Clinical evidence

Clinical illness may be characterized by the following signs or symptoms: Watery diarrhea (most common symptom), loss of appetite, weight loss, abdominal pain, bloating and gas, nausea, fatigue (tiredness), and/or mild fever. Vomiting may also be noted. The severity of illness may vary. Relapses and asymptomatic infections may occur. Some evidence suggests that the disease may be more severe and long-lasting in immunocompromised individuals.

ICD code(s)

ICD-11 code(s):

• 1A3Y Other specified protozoal intestinal infections

ICD-10 code(s):

• A07.4 Cyclosporiasis

Comments

Probable case definitions are provided as guidelines to assist with case finding and public health management, and are not for national notification purposes.

The disease is not endemic in Canada; therefore, cases should be investigated as most likely associated with imported food or travel.

Direct person-to-person transmission is unlikely to occur.