Cyclospora and summer travel

A reminder about Cyclospora infection and how to reduce your risk

Cyclospora is a parasite found in some tropical and subtropical countries. In the UK, infections are most commonly linked to summer travel abroad. Cyclospora has been found in Central and South America, South and Southeast Asia, and most UK travel-related cases and outbreaks have been associated with visits to Mexico [1-4].

People usually become infected by eating or drinking food or water contaminated with human faeces. Foods most commonly linked to Cyclospora include fresh produce such as soft or unpeeled fruit, lettuce, green salads and herbs like coriander or basil [1, 2]. You cannot catch Cyclospora from close contact with someone who has the infection.

Not everyone infected with Cyclospora will become ill. If you do get symptoms, they will usually start about a week after consuming contaminated food or drinks. Symptoms of Cyclospora include:

• watery diarrhoea
• fever
• stomach cramps
• loss of appetite and weight loss
• tiredness and muscle pain
• bloating and excess wind
• feeling sick [1]

Cyclospora infections are usually mild and resolve themselves. However, symptoms can sometimes last for several weeks and return even after a person seems to have recovered. People with a weakened immune system, including those living with HIV, may be at greater risk of severe illness [2].

Advice for travellers

Before you travel

Check our Country Information pages for travel health information for your destination. There is no vaccine to prevent Cyclospora infection.

Pack a basic first aid kit, including hand sanitiser and oral rehydration sachets in case you develop diarrhoea.

Comprehensive travel insurance is recommended for all travellers.

While you are away

You can reduce your risk of Cyclospora infection by following good food and water hygiene, even if you are staying in a luxury hotel or high-end all-inclusive resort:

• wash your hands regularly with soap and clean water; use alcohol hand gel only when handwashing is not possible
• where there is no clean water supply, drink only bottled or boiled tap water (this includes brushing your teeth)
• avoid ice in drinks
• avoid fresh produce that may not have been washed with bottled or boiled water, including berries, salads, vegetables and herbs like basil or coriander
• choose fruit that you can peel yourself, such as bananas and oranges
• pasteurised dairy products, like yoghurts, are generally safer choices
• eat food that has been freshly cooked and is served hot
• remember that smoothies, juices and other drinks may contain raw fruit, herbs or vegetables [1]

If you become ill abroad:

• drink plenty of 'safe' fluids, such as bottled water, or tap water that has been thoroughly boiled and cooled
• use oral rehydration solutions so that you do not become dehydrated
• get early medical advice if you have a weakened immune system or are at higher risk of complications
• seek medical help if your symptoms are severe or do not improve [5]

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

When you return

If you have symptoms, such as diarrhoea, fever, loss of appetite, nausea, weight loss, stomach cramps, bloating or increased wind, get medical help. Tell your nurse, doctor or other health professional that you have recently travelled abroad, including all the countries you visited.

Advice for health professionals

In returned travellers with gastrointestinal symptoms, consider protozoan parasites (including Cyclospora) in the differential diagnosis, as well as other more common bacterial or viral causes of gastrointestinal infection. Testing should be arranged through local microbiology laboratories. Positive tests should be reported to UKHSA through the SGSS laboratory notification system.

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