Cyclospora cayetanensis Among Expatriate and Indigenous Populations of West Java, Indonesia

Dispatches Dispatches Dispatches Dispatches DispatchesCyclospora cayetanensis is a newly recognized coccidian parasite associated with sudden onset of gastrointestinal illness and chronic diarrhea.In developing countries, cases occur sporadically, in a seasonal pattern, and primarily among western expatriates and travelers (1,2).We recently reported multiple symptomatic cases of C. cayetanensis infection among European expatriates living in Jakarta, Indonesia; C. cayetanensis and Giardia lamblia were the intestinal parasites most frequently identified (6.4%) in cases of gastroenteritis or chronic diarrhea (3).We report here the results of a longitudinal evaluation of Cyclospora infection among expatriate populations of Jakarta and the results of two recent surveys of intestinal parasite infections in Indonesian children.Three clinical diagnostic laboratories, each serving subpopulations of expatriate residents of Jakarta, Indonesia, participated in the longitudinal evaluation.The medical unit of the Embassy of the Federal Republic of Germany, a diagnostic center for an estimated 300 European expatriates, screened for ova and parasites in cases of gastrointestinal illness and diarrhea from January 1995 through July 1998.The Parasitology Department of the U.S. Naval Medical Research Unit No. 2 (NAMRU-2) provided diagnostic services for U.S. military staff and their families living in Jakarta during January 1996 to January 1998.The U.S. Embassy Medical Unit in Jakarta performed diagnostic parasitic tests for approximately 500 U.S. expatriate residents from January to December 1998.All three laboratories performed wet-mount microscopy of fresh and formalin-ethyl acetateconcentrated feces stained with dilute iodine or merthiolate-iodine-formalin solution.All specimens were from persons with self-reported cases of gastrointestinal illness and diarrhea who sought medical attention.Confirmation of Cyclospora was based primarily on size and morphologic features relative to reference slides provided by J.H. Cross, Uniformed Service University of Health Sciences, Washington, D.C., and secondarily on acid-fast staining characteristics.