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Cyclospora Infections (Cyclosporiasis)

Cyclospora cayetanensis is a parasite that causes gastrointestinal illness. This parasite is not found endemically in BC. In BC, we typically see a small number of cases each year associated with travel to countries where this parasite is endemic (e.g., Central and South America) or likely through imported fresh produce such as herbs, leafy greens and berries. 

Cyclosporiasis is not usually a serious illness, but left untreated, can persist for some time. Because the parasite is resistant to chlorine and is not easily washed off produce (the "vehicle"), it poses some challenges to travelers and to consumers at home.

Information for Health Professionals

Cyclospora cayetanensis is a parasite that infects the small intestine. When a person gets sick from this infection it is called cyclosporiasis. 

Over the last number of years, B.C. has experienced an increase in the number of cyclospora infections, except for 2008 when there was a significant decrease in the number of cases: 32 cases, down from 58 in 2007. 

Most infections are linked to travel to other countries, but locally-acquired infections have increased in recent years. Outbreaks of locally-acquired disease tend to occur in the late spring/early summer and have been linked to the consumption of contaminated, imported fresh produce, especially leafy green vegetables, fresh herbs, raspberries and blackberries.

Cyclosporiasis usually causes:
  • frequent watery, often explosive, diarrhea 
  • abdominal cramps
  • nausea
  • vomiting
  • loss of appetite
  • weight loss
  • fatigue
  • and occasionally fever.

Symptoms start approximately 1 week after exposure to the parasite. A person can be infected and have no symptoms. In some cases, symptoms may continue for more than a month and can sometimes return even after you have started to feel better.

People who are immune-compromised may experience prolonged diarrhea.

Cyclospora are spread by the fecal-oral route, meaning through the consumption of food or water contaminated by human or animal feces. The parasite is not spread from person-to-person because it is not infectious when it is passed in the stools of an infected person - it must remain in the environment, outside the host, for a number of days to become infectious. 

Contaminated fruits and vegetables are the main source of cyclospora infections. Produce may become contaminated when watered with or washed in water containing the parasite, or when handled by infected workers. 

Untreated, cyclosporiasis will cause prolonged diarrhea, with relapses, especially in people whose immune systems are compromised.

Diagnosis is made by microscopic examination of one or more stool samples.

If you think you have a Cyclospora infection, see your family doctor for testing, advice and treatment.

Antibiotics are used to treat cyclospora infections. Your doctor will decide which treatment is right for you. People with cyclospora infections are usually advised to drink plenty of fluids to prevent dehydration from diarrhea.

It is important to wash fruits and vegetables as thoroughly as possible before eating them, however, washing produce will not completely remove the possibility of infection. When traveling to developing countries, avoid any fruits and vegetables that cannot be peeled or cooked. 

Do not drink untreated surface water from a spring, stream, river, lake, pond or shallow well. When traveling to a developing country make sure that you drink bottled water from a reputable supplier, or boil untreated surface water that is used for: 
  • drinking
  • making ice cubes
  • washing uncooked fruits and vegetable
  • making baby formula
  • brushing teeth and
  • washing dentures.

Boil for at least 1 minute at a rolling boil. At elevations above 2000 m (6562 ft), boil for at least 2 minutes. Cyclospora are resistant to chlorine, so boiling water is the best way to disinfect it.

Wash your hands before handling food and eating.

SOURCE: Cyclospora Infections (Cyclosporiasis) ( )
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