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As of July 1, 2025, Idaho law requires CDH to verify the lawful presence of those applying for public benefits through our agency.

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As of July 1, 2025, Idaho law requires CDH to verify the lawful presence of those applying for public benefits through our agency.

The programs impacted by this change are:
  • Sliding fee discount for medical clinic or counseling services for those not on Medicaid
  • WIC, PAT, and NFP applicants who are not adjunctively eligible for Idaho Medicaid, SNAP, or TAFI
  • Individual permits, such as septic, food, childcare, or similar permits/licenses
    • Licenses and permits for food establishments
    • Licenses and permits for septic onsite, pumper and installer services

You can review the policy here and then complete the form below to verify your lawful presence online or you can visit one of our CDH offices to confirm in person.

Lawful Presence Online Forms: English | Spanish

WIC: English | Spanish

In Health Alert Network, News

Health Advisory: Increase in Cyclosporiasis Cases Reported in Multiple States

by on July 13, 2026

HEALTH ALERT NETWORK

 

Health District 4

 

Advisory for Healthcare Providers

 

July 13, 2026

 

 

Health Advisory: Increase in Cyclosporiasis Cases Reported in Multiple States

 

 

Key Message

 

A large multistate outbreak of cyclosporiasis is ongoing, with more than 1,500 cases reported in Michigan and increases reported in several other states. Although no Idaho cases associated with this outbreak have been identified to date, healthcare providers should consider cyclosporiasis in patients with prolonged, watery, or relapsing diarrheal illness and specifically request Cyclospora testing when clinically indicated.

 

Actions Requested

 

Healthcare providers should:

  • Consider cyclosporiasis in patients with prolonged, watery, or relapsing diarrheal illness, particularly those with recent travel to states experiencing increased cyclosporiasis activity.
  • Specifically request Cyclospora testing when submitting stool specimens, as routine gastrointestinal testing may not detect this parasite.
  • Report suspected or confirmed cases immediately to Central District Health (208-327-8625) or the Idaho Department of Health and Welfare Epidemiology Section (208-334-5939).
  • Treat confirmed cases with trimethoprim-sulfamethoxazole (TMP-SMX) when clinically appropriate.

Testing Recommendations

If cyclosporiasis is suspected:

  • Routine ova and parasite examinations may not detect Cyclospora unless special staining or laboratory procedures are performed.
  • Not all gastrointestinal PCR panels include a target for Cyclospora; providers should specifically request testing for this parasite.
  • Testing for other enteric pathogens should be considered as clinically indicated.
  • Multiple stool specimens may be required because Cyclospora oocysts may be shed intermittently and at low levels.

 

Treatment

 

Background

 

The Michigan Department of Health and Human Services announced on July 1, 2026, an investigation into a large and growing outbreak of cyclosporiasis. As of July 10, 2026, Michigan has reported 1,562 cases and 44 hospitalizations. Ohio and several other states have reported increased cyclosporiasis activity. No Idaho cases associated with this outbreak have been identified to date, but public health officials continue to monitor the situation.

 

Although fresh produce is suspected as the source of infection, investigators have not identified a specific food item, grower, supplier, or distributor responsible for the outbreak.

 

Cyclosporiasis is an intestinal illness caused by the parasite Cyclospora cayetanensis. Infection occurs through consumption of contaminated food or water. Symptoms typically begin approximately one week after exposure but can occur from 2 days to more than 2 weeks after infection. Symptoms commonly include frequent watery diarrhea, loss of appetite, abdominal cramping, nausea, weight loss, and fatigue. Illness can be prolonged or relapsing if untreated and may persist for weeks to months. Severe disease is uncommon, but dehydration can occur, particularly among young children, older adults, and immunocompromised individuals.

 

For Patients with Questions: Reduce Risk When Preparing Fresh Produce

Advise patients to follow these food safety practices when handling fresh fruits and vegetables:

  • Wash all produce thoroughly under running potable water before eating, cutting, or preparing.
  • Wash hands with soap and water before and after handling produce.
  • For leafy greens, discard outer leaves and rinse remaining leaves thoroughly under running water.
  • Wash fresh herbs (such as cilantro and basil) and green onions thoroughly before use.
  • Wash snow peas and other vegetables while gently rubbing the surface under running water.
  • Scrub firm produce, such as melons and cucumbers, with a clean produce brush before cutting.
  • Refrigerate cut, peeled, or cooked fruits and vegetables within 2 hours.
  • When possible, cooking produce can further reduce the risk of foodborne illness.

 

Additional Resources

CDC. Surveillance of Cyclosporiasis. https://www.cdc.gov/cyclosporiasis/php/surveillance/index.html

CDC. Clinical care of cyclosporiasis. https://www.cdc.gov/cyclosporiasis/hcp/clinical-care/index.html

Michigan. Cyclosporiasis Outbreak.  https://www.michigan.gov/mdhhs/keep-mi-healthy/infectious-diseases/infectious-disease-outbreaks

IDSA. 2017 Infectious Diseases Society of America Clinical Practice Guidelines for the Diagnosis and Management of Infectious Diarrhea. 2017-infectious-diseases-society-of-america-clinical-practice-guidelines-for-the-diagnosis-and-management-of-infectious-diarrhea.pdf