Cyanobacterium-Like Cyclospora Species

To the Editor: Ortega et al. (May 6 issue)¹ report the identification of organisms from the genus cyclospora that have remarkable similarities to cryptosporidia with regard to the diarrheal disease they produce in humans. In their Table 1, the authors state that only 11 of 50 cyclospora infections (22 percent) occurred in children who had diarrhea. The high ratio of asymptomatic to symptomatic infection documented among Peruvian children is remarkable. In our experience studying tourists and expatriate residents in Nepal, the presence of cyclospora was statistically associated with prolonged diarrhea, and asymptomatic carriage of the organism was extremely rare²,…