Cyclospora travel reminder

Remember - follow good food and water hygiene advice abroad to protect yourself from a parasite called Cyclospora

Cyclospora is a tiny parasite common in some tropical and sub-tropical countries worldwide. Infection can cause diarrhoea and other unpleasant symptoms. Cyclospora infection in United Kingdom (UK) travellers is often linked to summer travel abroad to South and Central America or South and South-East Asia. In the past, most UK cases were reported after visits to Mexico [1-3].

This parasite is usually spread by eating food (often soft or unpeeled fruit, lettuce, green salads and herbs like coriander or basil) or drinking water, fruit juices/drinks contaminated with human poo (faeces) [1, 2].

Direct spread between people (person-to-person) is not a risk.

Not everyone infected with cyclospora will get symptoms. For people who do develop symptoms, they usually start seven days after eating or drinking contaminated food or drinks and include:

• diarrhoea
• fever
• cramps
• loss of appetite and weight
• tiredness and muscle pain
• wind/bloating
• nausea [1].

 Cyclospora infections are usually mild and self-limiting for most people, but sometimes, symptoms can continue for over a month and can return even after the infection seems to be over. Those living with HIV or immunosuppression (weakened immune system) may become seriously ill [2].

Country-specific information can be found on our Country Information pages and Outbreak Surveillance section.

Advice for travellers

Before you travel 

Check our Country Information pages for travel health information for your destination and remember there is no vaccine or drug to prevent Cyclospora infection.

Travel with a basic first aid kit. Pack items to help reduce your risk of food and water illness, such as hand sanitiser, and over the counter medicines such as oral rehydration powders, to help you manage diarrhoea. 

Comprehensive travel insurance is recommended for all travellers.

While you are away

As Cyclospora is spread in food and drink contaminated with human faeces, make sure you follow good food and water hygiene advice at all times, even if you are staying in a luxury hotel or high end, all-inclusive resort.

• Always use bottled or treated water for drinking and brushing your teeth
• Avoid ice in drinks
• Avoid fresh uncooked berries such as raspberries, unpeeled fruit, salads, vegetables and herbs like basil or coriander, which have not been washed in safe water
• Wash your hands regularly with soap and clean water
• Only use alcohol hand gel when hand washing is not possible
• If possible, choose recently prepared, thoroughly cooked food served piping hot
• Remember - drinks may be made with raw fruit, herbs or vegetables
• Fruit you can peel (bananas and oranges) and pasteurised dairy products like yoghurts, are safer options

See Cyclospora: advice for travellers and our travellers' diarrhoea factsheet for more information.

If you are ill; drink plenty of safe fluids. Get medical help while you are away if your symptoms are severe or last for a long time.

When you return

If you have any symptoms, such as diarrhoea, fever, loss of appetite, nausea, weight loss, stomach cramps, bloating or increased wind, get medical help. Let your nurse, doctor/health professional know you travelled abroad recently and remember to tell them every country you visited. 

Advice for health professionals

In returned travellers with gastrointestinal symptoms, consider protozoan parasites (including Cyclospora) as a diagnosis, as well as other more common bacterial or viral causes of gastrointestinal infection. Testing should be arranged through local microbiology laboratories and positive cases reported to your local health protection team.

Recommended treatment for severe or prolonged Cyclospora infection is usually co-trimoxazole [1].