UK Scotland – Cyclospora in travellers returning from Mexico

HPS Cyclospora_LifeCycle201

Public Health England (PHE), Public Health Wales (PHW), Health Protection Scotland (HPS) and the Health Protection Service Northern Ireland (HPSNI) are investigating an increase in cases of Cyclospora cayetanensis infection in travellers who have recently returned from Mexico. This is the fourth successive year since 2015 that cases of the infection have been reported in travellers returning from Mexico.

As of 3 August 2018, 63 laboratory-confirmed cases of Cyclospora cayetanensis have been reported in England, Scotland and Wales. Where information is available, 55 (87%) report travel outside the UK, of which 49 (89%) report recent travel to Mexico. Where information is available, cases have stayed at several different hotels in the Cancun and Riviera Maya region suggesting the source is likely to be a foodstuff that has been distributed to hotels throughout the region.

Cyclospora cayetanensis is a protozoan parasite that infects humans and other primates. Infection can cause diarrhoea, abdominal cramping, nausea, flatulence, loss of appetite, fatigue, low-grade fever and weight loss. Infection without symptoms is also reported. Infections in HIV positive people and those with other immune deficiencies can be more severe.

Infection is commonly derived from food or water contaminated by human faeces. The foods commonly involved are soft fruits such as raspberries and salad products such as coriander, basil and lettuce. The risk of infection presented by imported foods is considered to be low.

Advice for travellers on the prevention of Cyclospora is available from Health Protection Scotland: https://www.fitfortravel.nhs.uk/news/newsdetail.aspx?id=22743.

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