Cyclosporiasis

Cyclosporiasis is an intestinal infection caused by a parasite called Cyclospora. The infection is mainly contracted by eating or drinking contaminated food or water. For more information about foods that people at risk should avoid, see the Transmission and Prevention sections.

Cyclosporiasis is found in many regions of the world, especially in countries with poor sanitary conditions. In Canada, infections are most often linked to travel to a country where the parasite is found or to eating fresh imported produce, in particular fruits, vegetables or herbs.

Some infected people do not have any symptoms.

Others may suffer from:

• profuse, watery diarrhea (the most common symptom);
• abdominal cramps or pain;
• bloating and gas;
• nausea;
• severe fatigue;
• loss of appetite;
• mild fever.

The symptoms usually appear one week after exposure to the parasite, but the length of time can vary from 2 to 14 days. Untreated, they may last several weeks, sometimes even months. They may also go away for a few days and then return.

Some people are more likely to develop a more severe form of the infection. To find out more, go to the People at risk section.

To find out if you need to consult a health professional, go to the Gastroenteritis page.

Cyclosporiasis can be treated with antibiotics prescribed by a health professional.

In order to prevent dehydration, it is important to drink plenty of fluids and replenish mineral salts. You need to drink more fluids, such as water, or use a rehydration solution. Do not hesitate to ask your pharmacist for advice or call Info-Santé 811.

The most common complication is dehydration, which may require a medical assessment, especially for people at risk.

Left untreated, the infection can lead to prolonged diarrhea, weight loss and severe fatigue that persists after the symptoms have disappeared.

Cyclosporiasis is contracted by consuming food or water contaminated with the Cyclospora parasite.

It is unlikely for cyclosporiasis is to be transmitted directly from one person to another.

It is possible to get cyclosporiasis more than once, since a previous infection does not protect against a future infection.

The Cyclospora parasite is found in wastewater and untreated water, especially in tropical and subtropical regions where the climate is favourable to its spread:

• Latin America (especially Guatemala, Honduras, Haiti, Peru, Mexico and Brazil);
• Egypt;
• Sub Saharan Africa;
• Indian subcontinent;
• Southeast Asia.

So the Cyclospora parasite may be found in certain foods imported from countries where it is found:

• fresh fruit (raspberries, blackberries);
• aromatic herbs (basil and coriander);
• leafy greens (iceberg and romaine lettuce, watercress, mesclun, red cabbage, prepackaged salads);
• vegetables (carrots, snap peas, snow peas, etc.).

It is possible to reduce the risk of Cyclospora infection by following these recommendations:

When you are in Québec:

• rinse fruits and vegetables (even those you have to peel) under water before eating them raw, cutting them up or cooking them, especially if they come from a high risk country;
• preferably eat fresh fruits and vegetables grown in Québec or Canada;
• if possible, cook fruits or vegetables imported from countries where the Cyclospora parasite is found;
• follow the precautions to be taken when handling fruits and vegetables.

When you travel to high risk areas:

• avoid eating food that has been washed in local drinking water;
• drink bottled water;
• preferably eat cooked food or fruits that you can peel yourself.

The people most at risk of contracting cyclosporiasis are travellers to countries where the parasite is found (particularly in tropical and subtropical regions) and who:

• drink unbottled or untreated water;
• eat locally produced fruits and vegetables, especially if they are eaten raw.

Some people are more likely to develop a longer or more severe illness, such as:

• young children;
• older adults;
• immunosuppressed people.

In Canada, in recent years, several outbreaks of cyclosporiasis have been associated with imported foods, including basil, coriander, pre packaged salad mix (such as mesclun and lettuce), raspberries and blackberries.

For more details, see the food recalls on the website of the Ministère de l’Agriculture, des Pêcheries et de l’Alimentation du Québec (MAPAQ) or the website of the Canadian Food Inspection Agency (CFIA).

Cyclosporiasis has been a reportable disease in all Canadian provinces and territories since 2004. This means that health professionals and laboratories must report confirmed cases to public health authorities so that they can monitor the progress of the disease and quickly detect outbreaks. Surveillance of cyclosporiasis is carried out in Québec by the MSSS in collaboration with other partners.

Every year, a rise in cases is observed between May and August. This rise corresponds to the rainy season in some countries where the Cyclospora parasite is more common. Heavy rains can contaminate agricultural water sources, causing contamination of fresh fruits and vegetables. Foods can also be contaminated when handled by infected people.