DOH CONFIRMS TWO ADDITIONAL TRAVEL-RELATED CASES OF CYCLOSPORIASIS IN HAWAIʻI RESIDENTS

HONOLULU - The Hawaiʻi Department of Health (DOH) has confirmed two additional cases of cyclosporiasis in Hawaiʻi residents who traveled together internationally and to a U.S. state that has reported a cyclosporiasis outbreak.

The two individuals are members of the same household. Based on their travel history, symptom onset and the known incubation period following exposure to the parasite, the investigation determined their infections were acquired while traveling outside of Hawaiʻi.

These cases bring the total number of confirmed cyclosporiasis cases reported in Hawaiʻi in 2026 to three. The first case involved a nonresident visitor whose infection also was acquired outside of Hawaiʻi. At this time, there is no evidence of locally acquired infection or ongoing community transmission in the state.

Cyclosporiasis is an intestinal illness caused by the microscopic parasite Cyclospora cayetanensis. Eggs of the parasite shed in the feces of infected persons must mature outside the host, in the environment, before they become infectious to another person. People become infected by consuming food or water contaminated with the parasite. In the United States, outbreaks have most often been linked to certain fresh produce items. The illness is not typically spread directly from person to person.

Symptoms usually begin about one week after exposure but can appear anywhere from two days to two weeks later. The most common symptom is frequent, watery diarrhea. Other symptoms may include loss of appetite, weight loss, stomach cramps or bloating, nausea, increased gas, fatigue and, less commonly, vomiting or low-grade fever. Without treatment, symptoms may last for several weeks or longer and can come and go.

"Although these two cases involve Hawaiʻi residents, they were exposed while traveling outside the state," said State Epidemiologist Dr. Sarah Kemble. "There is no evidence of local transmission in Hawaiʻi and the risk to the general public remains low. We encourage anyone experiencing persistent diarrhea after recent travel to seek medical care."

DOH routinely investigates reportable diseases to identify potential sources of infection and monitors for any signs of local transmission. At this time, there are no indications that these travel-related cases pose a broader public health risk in Hawaiʻi.

People can help reduce their risk of cyclosporiasis by:

• Washing hands thoroughly with soap and water before preparing or eating food and after using the restroom.
• Washing fresh fruits and vegetables under running water before eating, cutting or cooking them.
• Following safe food handling practices when preparing meals.
• Seeking medical care if they experience prolonged or severe diarrhea, particularly after recent travel or eating fresh produce from an area associated with an outbreak.

Cyclosporiasis is treatable with prescription antibiotics. Individuals experiencing persistent diarrhea should contact their healthcare provider. Healthcare providers who suspect cyclosporiasis are encouraged to report cases to DOH and submit appropriate specimens to commercial laboratories for testing.

DOH will continue to monitor for additional cases and work closely with healthcare providers and public health partners to protect the health of Hawaiʻi residents and visitors.

For more information about cyclosporiasis, the Hawaiʻi Department of Health Disease Outbreak Control Division website.

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