Title: Diarrheal Disease Outbreak in the US
题目：美国流行性腹泻
Author 作者: Andrea Tenner

General Information一般资料:
As of July 30th, 2013, there have been 378 cases of Cyclospora  infection from multiple states in the US.  Cyclospora is most common in tropical and sub-tropical regions, and is spread via fecal-oral route.  While the cause of the most recent outbreak is unknown, outbreaks in the US are generally foodborne.
截至2013年7月30日，在美国的多个州已经有378例环孢子虫感染。环孢子虫最常见于热带和亚热带地区，通过粪 - 口途径传播。虽然最近的爆发原因未知，一般在美国的爆发流行都是食源性的。
Clinical Presentation 临床表现:
- Symptoms usually begin 7 days after exposure
- 症状通常在接触第7天后开始
- Watery diarrhea, cramping, bloating, nausea, fatigue, increased gas, vomiting, low grade temperature
- 水样腹泻，腹部绞痛，腹胀，恶心，疲劳，排气增加，呕吐，低烧
- Can persist several weeks to > 1 month
- 可以持续几个星期到> 1个月
Diagnosis 诊断:
- Concentrated Stool Ova and Parasites— viewed under modified acid fast or fluorescence microscopy (labs can submit photos to the CDC for “telediagnosis”)
- 浓集的粪便虫卵和寄生虫－可在改良的抗酸性或荧光显微镜下观看到（实验室可以将照片送到疾病预防控制中心做“远程诊断”）
Treatment 治疗方法:
- TMP-SMX DS one tab po bid x7-10 days
- 强效磺胺，一片，口服，一天两次，7-10天
- No effective alternate for failed treatment or sulfa allergy
- 对于治疗失败或磺胺过敏者，没有有效的替代药物
- Most will recover without treatment but S/S can persist for weeks to months
-即使不治疗，大多数人都会痊愈，但症状和体征可以持续几个星期到几个月
Bottom Line 要点:
Consider Cyclospora as a cause of prolonged diarrheal illness, treat with TMP-SMX.
对长期的腹泻性疾病，要考虑孢子虫的原因， 治疗用TMP-SMX。
References 参考文献：
www. cdc. gov/parasites/cyclosporiasis/outbreaks/investigations-2013.html
www.cdc.gov/parasites/cyclosporiasis