11 Jun 2019
Cyclospora summer travel reminderTravelHealthPro is reminding all travellers of the risk of food and water borne infections, including Cyclospora and the importance of good food and water hygiene
Since 2015, an increase in Cyclospora cases in travellers returning from Mexico has been reported every year [1, 2 and 3].
Reports of Cyclospora infections in United Kingdom (UK) travellers are being monitored by Public Health England, in collaboration with Health Protection Scotland, Public Health Wales and the Public Health Agency in Northern Ireland. As of 4 June 2019, a total of nine Cyclospora cases in returning travellers have been reported in England. Travel destinations reported include the Dominican Republic, Indonesia and Mexico .
Cyclospora is a food and water transmitted parasite. Infection may be mild, symptoms can include:
- fatigue and muscle pain
- appetite loss
- weight loss
HIV positive people and individuals who are immunosuppressed may have particularly severe, prolonged symptoms [2, 3].
Infection is commonly acquired from food or water contaminated by human faeces. There is no evidence of transmission from animals. Oocysts (a hardy form in the lifecycle of this parasite) are not infectious for around 10 days after they are passed in faeces, so person-to-person transmission does not occur. Foods involved are usually soft fruits like raspberries or salad products like coriander, basil and lettuce.
Cyclospora is common in tropical regions and most UK cases are associated with travel abroad, most commonly to South and Central America and South and South East Asia .
Advice for travellers
Cyclospora is spread by consuming food or drink contaminated with human faeces containing Cyclospora. You should ensure that you maintain good food and water hygiene at all times when abroad even if staying in high-end, all-inclusive resorts.
Choose recently prepared, thoroughly cooked food that is served piping hot.
Avoid fresh uncooked berries/unpeeled fruit and salads that have not been washed in safe water. An infographic with more specific advice is available here.
See our travellers’ diarrhoea factsheet for more information on preventing diarrhoea abroad.
After returning from your trip, if you have any symptoms, such as diarrhoea, fever, loss of appetite, nausea, fatigue, weight loss, stomach cramps/pain, bloating or increased wind, get medical attention and tell your healthcare provider about your recent travel destinations.
Advice for health professionals
If a returning traveller presents with gastrointestinal symptoms, consider protozoan parasites, including Cyclospora, as a diagnosis. Testing should be arranged through local microbiology laboratories and positive cases reported to your local health protection team.
The recommended treatment for Cyclospora is usually co-trimoxazole .
- Nichols G, Freedman J, Pollock K et al. Cyclospora infection linked to travel to Mexico, June to September 2015. Euro Surveill. 2015; 20(43):pii=30048. [Accessed 6 June 2019]
- Public Health England. Cyclospora: clinical and travel. Last updated 16 August 2016. [Accessed 6 June 2019]
- European Centre for Disease Prevention and Control. Rapid risk assessment: Cyclospora infections in European travellers returning from Mexico. 21 July 2017. [Accessed 6 June 2019]
- Public Health England. Travel Health Section, National Infection Service: personal communication. 4 June 2019