July 10, 2026

Michigan and other areas are experiencing an outbreak of diarrheal illness from Cyclospora infection. Here is information relevant to laboratory detection of Cyclospora (performed through our reference lab partner Quest Diagnostics):

1. Please keep in mind CDC’s warning about the much lower level shedding of oocysts in Cyclospora infection, compared to other parasites. As such, it is optimal to order Warde test CYIEL (Quest Cyclospora and Isospora examination) rather than traditional stool O&P testing. If you receive O&P orders (Warde OPCPS), consider adding Warde code CYIEL as well.
2. If Total-Fix vials are not available for stool collection, it is acceptable to submit the alternate specimen of 10% formalin. It may be prudent to prepare for an increased volume of testing from your providers, by putting together a local plan for assembling containers of 10% formalin from supplies already present in your clinical and histology laboratories.