Cyclosporiasis

Cyclospora infection is caused by a group of protozoan parasites called Cyclospora. These parasites are found worldwide but are most common in tropic and sub-tropical regions such as Peru, Cuba, India, Mexico and the Dominican Republic. They live in the intestines of infected people. The bacteria cause gastrointestinal illness and are passed in the feces. Cyclospora parasites are one of the most common causes of traveler’s diarrhea. Outbreaks in North America have been caused by imported produce such as raspberries and lettuce contaminated with the parasite.

Diagnosis of infection is based on assessment of clinical symptoms by a health-care provider and laboratory testing of a stool sample.

Symptoms usually appear within seven to 14 days after a person becomes infected with the parasite. People who become ill may have watery diarrhea, stomach cramps, abdominal bloating and gas, loss of appetite, weight loss, fatigue, nausea and a mild fever. Symptoms may last for a few days up to a few months.

Cyclospora parasites are found in water sources contaminated with feces from infected people, and food is contaminated through use of this water on imported fresh produce such as berries or lettuce. People get sick by eating contaminated food or by drinking contaminated water.  

Some examples of how the parasite can be spread include: 

• watering crops of berries or lettuce with contaminated water
• drinking water from an unsafe source
• eating fresh uncooked fruits and vegetables when travelling

Travellers to high-risk countries who eat uncooked fruit and vegetables are at the greatest risk of exposure. Anyone exposed to the parasite can become infected. Young children, the elderly and persons with weakened immune systems are at a greater risk of developing more serious disease. Most people will recover without specific treatment.

People with diarrhea should drink plenty of liquids to avoid dehydration and practice good personal hygiene like hand washing. Consult your health-care provider for advice and treatment; prescription medicines may be used. 

Health-care providers and laboratories are required to confidentially report cases to Public Health. Public Health staff may investigate to find out how the infection occurred, identify other people who may be at risk of infection, implement control measures and provide advice as necessary.

Use good environmental management. Appropriate disposal of human waste (stool) to avoid contamination of food and water. 

Take food safety precautions when travelling to a high-risk country: Wash (using water from a safe source) or peel all raw vegetables and fruits before eating and use drinking water from a safe source. Note that washing fresh produce does not always get rid of the parasite; thoroughly cooked foods are safer to eat. 

Drink properly treated water. Avoid swallowing recreational waters from swimming pools and hot tubs. Do not drink untreated surface water from lakes or streams. Test private well drinking water regularly (once or twice per year). Boil drinking water for 10 minutes when travelling in areas where the parasite is commonly found.

For additional information, contact your health-care provider, local Public Health office or Tele-Care 811.