The CDC lists one to 10 domestically acquired cases in Nebraska. State health officials have received 23 reports since May, most connected to international travel.
By Hola Nebraska
Cyclospora cases have been identified in Nebraska during a sharp national increase in cyclosporiasis, an intestinal illness commonly linked to contaminated food or water.
The Centers for Disease Control and Prevention places Nebraska in the category of states with one to 10 laboratory-confirmed cases acquired within the United States since May 1.
The Nebraska Department of Health and Human Services has separately received 23 reports of cyclosporiasis since May. Most were acquired during international travel, while a small number of domestically acquired cases remain under investigation.
Nebraska has not confirmed that its cases are part of the specific multistate outbreak centered in Michigan, Ohio, West Virginia and Kentucky.
National count rises to 1,645 confirmed cases
The CDC had received reports of 1,645 laboratory-confirmed domestic cases across 34 states as of July 13. Among patients with available information, 141 were hospitalized and no deaths were reported.
More than 5,100 additional reports require further review to determine whether they meet the definition of domestically acquired cyclosporiasis.
The current total is more than six times the 249 cases reported nationally by the same point in 2025. Case counts may continue rising because several weeks can pass between the onset of illness, laboratory confirmation and reporting to the CDC.
Cyclosporiasis cases typically increase during spring and summer. The CDC considers May 1 through August 31 the annual season for the illness.
No specific food has been confirmed as the source
A large outbreak involving more than 400 people in Michigan, Ohio, West Virginia and Kentucky is among several groups of cases under investigation.
People connected to that outbreak began experiencing symptoms on or after June 22. Investigators are interviewing patients about what they ate before becoming ill, but no specific food, brand, grower or supplier has been confirmed as the source.
The Food and Drug Administration is conducting traceback investigations into several groups of Cyclospora cases involving products that have not yet been identified publicly.
Past U.S. outbreaks have been connected to fresh produce such as raspberries, basil, cilantro, snow peas and mesclun lettuce. Those earlier links do not establish the source of the current illnesses.
Symptoms can begin days after contaminated food is eaten
Cyclospora infects the small intestine and most commonly causes frequent, watery diarrhea.
Other symptoms can include loss of appetite, weight loss, stomach cramps, bloating, nausea, increased gas and prolonged fatigue. Some people also experience vomiting, body aches or a low-grade fever.
Symptoms usually begin about one week after exposure, but the interval can range from two days to two weeks or longer. Without treatment, the illness can last from several days to more than a month. Symptoms may improve and then return.
The delay between exposure and illness can make it difficult for patients to remember every restaurant meal, grocery item or produce purchase from the preceding days.
Cyclospora is unlikely to spread directly between people
People become infected after consuming food or water contaminated with the parasite.
Direct person-to-person transmission is considered unlikely because Cyclospora passed in human feces must remain in the environment for at least one to two weeks before it becomes infectious.
A person living in the same household as someone with cyclosporiasis is therefore not automatically exposed through ordinary contact.
Diagnosis requires a specific laboratory test
Cyclosporiasis is diagnosed through testing of a stool sample. Cyclospora can be difficult to detect, and patients may need to submit samples on multiple days.
The test is not always included in routine stool analysis. A health care provider who suspects cyclosporiasis may need to request testing specifically for Cyclospora.
Dr. Tim Tesmer, chief medical officer of Nebraska DHHS, said treatment is available when the parasite is identified.
The standard treatment is the antibiotic trimethoprim-sulfamethoxazole, also known as TMP-SMX and sold under brand names that include Bactrim and Septra. People with a sulfa allergy may need to discuss other options with a health care provider.
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Washing produce may not completely remove the parasite
The CDC advises washing hands with soap and water before and after preparing raw fruits and vegetables.
Produce can be washed thoroughly under running water, including items labeled as prewashed. Firm fruits and vegetables can be scrubbed with a clean produce brush, and damaged or bruised sections can be removed before preparation.
Cut, peeled or cooked produce can be refrigerated within two hours.
Washing remains part of basic food safety, but the FDA warns that rinsing food may not fully remove Cyclospora. The parasite may also resist chlorine and other routine chemical sanitizers.
The CDC advises people experiencing symptoms to contact a health care provider. Confirmed cases are reported to local public health departments as investigators work to identify clusters and possible food sources.
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