Cyclosporiasis in Children: Symptoms, Diagnosis, and Prevention During the 2026 Produce Outbreak

Cyclosporiasis is a foodborne parasitic illness that has caused a growing number of health alerts in recent years, and 2026 is no exception. As of mid-June, the CDC had confirmed at least 145 cases across 17 states linked to an active multistate outbreak, with a much larger cluster of more than 500 cases reported separately in Michigan. Investigators from the FDA continue to trace the source, with early attention on fresh cilantro, basil, white and green onions, and cucumbers.

At Hummingbird Pediatrics, we want families across Robbinsville, Hamilton, West Windsor, and Mercer County to understand this illness: what causes it, what it looks like in children, and how to protect your family while the outbreak investigation continues.

What Is Cyclospora?

Cyclospora cayetanensis is a microscopic, single-celled parasite that infects the small intestine and causes an illness called cyclosporiasis. Unlike many common childhood stomach bugs, Cyclospora does not spread easily from person to person. Instead, it is passed almost exclusively through eating food or drinking water contaminated with the parasite, most often via fresh produce that has come into contact with contaminated soil or water during growing, harvesting, or processing.

In the United States, outbreaks of cyclosporiasis are strongly associated with imported and domestic fresh produce, particularly fresh herbs and certain vegetables, and tend to occur more often in the late spring and summer months, with this parasite's peak season typically running from May through August.

Why This Matters for Pediatric Patients

Children are exposed to Cyclospora the same way adults are: by eating raw, contaminated produce. A child eating cucumber slices at home, a salad-bar lunch at school or camp, or fresh herbs and onions from a produce stand faces the same exposure risk as any adult in the household; cyclosporiasis is not an "adult food" illness. Children with weakened immune systems are at particular risk for a longer, more severe, or relapsing course of illness if infected and untreated, which makes prompt recognition and treatment especially important for medically complex pediatric patients.

Foods Linked to Outbreaks

During the current 2026 outbreak, traceback investigations have focused on:

• Fresh cilantro
• Fresh basil
• White and green onions
• Cucumbers

Past U.S. outbreaks of cyclosporiasis have also been linked to raspberries, snow peas, and bagged salad mixes. No formal recall had been issued as of this writing, but the FDA and CDC continue to investigate. Families should use extra caution with these produce categories, particularly for young children, until the source is confirmed.

An important point for parents: washing fresh produce does not reliably remove Cyclospora. The parasite can cling tightly to leaves and skins, including in small crevices on herbs like cilantro and basil. Cooking, however, kills the parasite completely, so cooked produce remains a safe option during an active outbreak.

Signs and Symptoms in Children

Cyclosporiasis has a longer incubation period than most stomach viruses; symptoms typically begin about 7 to 10 days after exposure, though the range can be anywhere from 2 days to 2 weeks. This delay often makes it difficult for families to connect the illness back to a specific meal.

Common symptoms include:

• Watery diarrhea, which can be frequent and explosive
• Loss of appetite
• Stomach cramps and bloating
• Nausea (vomiting is less common than with viral gastroenteritis)
• Fatigue and low energy
• Low-grade fever
• Weight loss, particularly with prolonged illness

One distinctive feature of cyclosporiasis is that, without treatment, symptoms can last for weeks and may fluctuate, seeming to improve before returning. This pattern is different from typical viral stomach bugs, which usually resolve within a few days. If you're trying to tell cyclosporiasis apart from a more common short-lived stomach virus, our Stomach Bug in Children guide covers vomiting, diarrhea, and dehydration warning signs for typical gastroenteritis.

How Cyclosporiasis Is Diagnosed

Cyclospora is frequently missed by standard stool culture panels, since routine testing is not designed to detect this specific parasite. If your pediatrician suspects cyclosporiasis based on your child's symptoms and recent diet, we may order a specific ova and parasite exam or a molecular (PCR-based) stool test to confirm the diagnosis.

Because standard testing can miss it, it's important to tell your pediatrician about any recent meals involving fresh herbs, onions, or other produce, as well as how long diarrhea has lasted, so we can guide testing appropriately.

Treatment

Cyclosporiasis is treated with a course of the antibiotic trimethoprim-sulfamethoxazole (commonly known by the brand names Bactrim or Septra). Most children recover fully with appropriate treatment. Children with a sulfa allergy will need an alternative treatment approach, which your pediatrician can discuss with you.

Supportive care matters throughout treatment and recovery:

• Hydration: offer fluids frequently, since prolonged watery diarrhea increases the risk of dehydration
• Diet: bland, easy-to-digest foods are usually best tolerated while symptoms are active
• Rest: fatigue is common and typically improves as treatment takes effect

When to Call Hummingbird Pediatrics

Please contact our office if your child has diarrhea lasting more than a few days, or sooner if they:

• Show signs of dehydration (no wet diapers in 8 hours, dry mouth, no tears when crying, sunken eyes)
• Have diarrhea that persists longer than 3–5 days
• Have blood in their stool
• Have a fever above 102°F
• Seem unusually lethargic or difficult to console
• Had recent exposure to any of the produce items linked to the outbreak

Go to the emergency room or call 911 if your child shows signs of severe dehydration, such as extreme lethargy, a sunken soft spot in infants, or an inability to keep fluids down.

Protecting Your Family During an Active Outbreak

• Use caution with high-risk produce: especially raw cilantro, basil, green and white onions, and cucumbers, until the outbreak source is confirmed
• Cook produce when possible: cooking kills the parasite, making cooked vegetables and herbs a safer option
• Don't rely on washing alone: rinsing raw produce under water does not reliably remove Cyclospora
• Watch for prolonged GI symptoms: especially watery diarrhea lasting more than a couple of days, which differs from a typical short-lived stomach virus
• Stay current on recalls: check the FDA's outbreak investigation page for the latest updates as the traceback continues

Prevalence and Outbreak Context

Cyclosporiasis has become an increasingly recognized cause of foodborne illness in the U.S. over the past decade, with outbreak sizes and case counts varying from year to year depending on produce sources and growing conditions. As of mid-June 2026, the CDC had confirmed 145 domestic cases across 17 states, including 20 hospitalizations and no reported deaths. Reported illness onset dates span May 1 through June 16, 2026, with patient ages ranging from 5 to 86 (median age 42) and about 61% female. Separately, Michigan has reported more than 500 cases centered on Monroe County, a cluster not yet folded into the national CDC count.

This pattern, a single contaminated produce supply chain affecting families across a wide geographic area, is consistent with prior years' outbreaks. While reported cases have spanned a broad age range, children are exposed and affected the same way adults are, and because dehydration risk from prolonged diarrhea is higher in young children, prompt recognition and treatment are especially important for families with kids.

Our Commitment to Keeping Families Informed

At Hummingbird Pediatrics, we monitor CDC and FDA outbreak communications closely and update our families as new information becomes available. If your child has had prolonged watery diarrhea, cramping, or fatigue, especially after eating fresh cilantro, basil, onions, or cucumbers, please don't hesitate to call our office. Early recognition and testing can significantly shorten the course of illness.

For our latest update on this outbreak, including current CDC case counts and foods under investigation, see our Cyclospora Outbreak 2026 Health Alert. If you have any questions about your child's symptoms or the outbreak in general, our team is here to help.