Hawaii State Department of Health State Laboratories Division Laboratory Preparedness and Response Branch Biological Response Section Discipline A ? Analytical Track 5: Microbiology Capability/Capacity Development - Cyclospora Project Summary: Cyclosporiasis otherwise known as traveler's diarrhea is caused by a protozoan parasite, Cyclospora cayatanensis. The infection is acquired by the ingestion of infective oocysts from fecal-contaminated food or water. Cyclosporiasis in the United States has been frequently linked to consumption of imported fresh produce including leafy greens and berries. Since the mid-1990's cases have been reported in the United States usually linked to consumption of imported fresh produce. In 2013-2015, the Centers for Disease Control and Prevention (CDC) reported more than 1400 cases in a multi-state outbreak of infection due to C. cayatanensis. This multi-state outbreak was linked to fresh cilantro grown in Puebla, Mexico. From 2016- 2019, US statistics showed a dramatic increase of Cyclosporiasis linked to multi-states outbreaks and clusters of infection. According to a 2016 report prepared by the University of Hawaii ? Hilo for the Hawaii Department of Agriculture, eighty five percent of food supply in Hawaii is imported, nationally and internationally. This makes Hawaii vulnerable to food-borne illnesses. No cases of cyclosporiasis have been identified in a Hawaii resident in the past ten years. The absence of cases in Hawaii maybe due in part to absence of sensitive tests to examine stool samples for C. cayatanenesis. The objective of this proposal is to establish Cyclospora food testing capability in the HI-DOH State Laboratories Division (SLD) FERN Microbiology laboratory. It is hoped that by developing this capability, testing can be done in-state without the need to send to the nearest FDA Office which is five hours away by air. The ability to test food samples in-state will shorten Turn-Around-Time (TAT) and results can support investigations for intervention and mitigation purposes. Additionally, the ability to test food products for Cyclospora can aid in epidemiological investigations of possible cases. Having both the ability to test clinical stool samples and test potentially contaminated food products will aid in establishing an epidemiological link and aid in a more efficient tracing of cases.
