Public Health Environmental Health Services

www.SBCounty.gov Cyclosporiasis

What is cyclosporiasis? Cyclosporiasis is an intestinal infection caused by a parasite composed of one cell—too small to be seen without a microscope—called cayetanensis. The parasite is commonly found in tropical and subtropical regions all over the world and has been identified as one of many causes of “traveler’s ”. These spores are found in or water contaminated with feces (poop). People become infected with Cyclospora by ingesting the infective form of the parasite. An infected person sheds non-infective Cyclospora spores in the feces and, under favorable environmental conditions, the spores become infective.

How common is cyclosporiasis? How do people get infected with Cyclosporiasis occurs in many countries, but Cyclospora? it seems to be most common in tropical Cyclosporiasis occurs when food or water that and subtropical regions. In areas was contaminated with feces is consumed, where cyclosporiasis has been studied, the especially in areas where cyclosporiasis is risk for infection is seasonal. In the US, endemic (found). Since Cyclospora needs time foodborne outbreaks of cyclosporiasis since after being passed in a bowel movement to the mid-1990s have been linked to various become infectious for another person, it is types of imported fresh produce, including unlikely that Cyclospora is passed directly from raspberries, basil, snow peas, and one person to another. mesclun lettuce. According to the Centers What are the symptoms of cyclosporiasis? for Disease Control and Prevention (CDC), The time between becoming infected and three cyclosporiasis outbreaks occurred becoming sick is usually about 1 week. during July-September 2015 in the US. Results Cyclospora infects the (bowel) from outbreak investigations concluded that and usually causes watery diarrhea, with two outbreaks were linked to fresh cilantro, and frequent, sometimes explosive, bowel the other one is ongoing. A total of 546 movements. Other common symptoms include cases of cyclosporiasis were reported from loss of appetite, weight loss, stomach cramps/ 31 states. Eight percent (8%) of ill individuals pain, bloating, increased gas, nausea, and became hospitalized, and no deaths were fatigue. reported.

800-442-2283 For more information, please contact the Department of Public Health Division of Environmental Health Services www.SBCounty.gov/dph/dehs Page 1 of 2 Updated February 2017 Cyclosporiasis

Vomiting, dehydration, body  Wash cutting boards, dishes, utensils, and aches, headache, fever, and other flu-like counter tops with soap and hot water symptoms may also be noted. Symptoms may between the preparation of raw meat, seem to go away and then return one or more poultry, and seafood products and the times (relapse). If not treated, the illness may preparation of fruits and vegetables that will last for a few days to a month, or longer. Some not be cooked. people who are infected with Cyclospora may  Wash all fruits and vegetables thoroughly not have any symptoms. under running water before eating, cutting, or cooking. Fruits and vegetables that are How is Cyclospora infection diagnosed? labeled “prewashed” do not need to be Cyclospora infection is diagnosed by examining washed again. Scrub firm fruits and stool (poop) specimens. Diagnosis can be vegetables, such as melons and difficult because even persons who are cucumbers, with a clean produce brush. showing symptoms might not shed enough  Refrigerate cut, peeled, or cooked fruits and Cyclospora spores in their stool to be readily vegetables as soon as possible, or within 2 detectable by laboratory examinations. hours. Store fruits and vegetables away Therefore, patients might need to submit from raw meat, poultry, and seafood. several specimens collected on different days. When traveling out of the country:  Avoid eating or drinking beverages How can cyclosporiasis be treated? purchased from street vendors or other Most people who have healthy immune establishments where unhygienic conditions systems will recover without treatment. People are present. who have diarrhea should rest and drink plenty  Avoid eating raw or undercooked meat and of fluids. Anti-diarrheal medicine may also help seafood. reduce diarrhea, but a health care provider  Avoid eating raw fruits and vegetables should be consulted before such medicine is unless you have washed and peeled them taken. People who are in poor health or who yourself. have weakened immune systems may be at  Drink “safe beverages” like bottled higher risk for severe or prolonged illness. beverages, hot tea or coffee, or properly treated or boiled water. What can be done to prevent Cyclospora  Brush teeth with bottled, properly treated or infection? boiled water. The best way to prevent cyclosporiasis is to No for cyclosporiasis is available so avoid food or water that may have been prevention is key. contaminated with feces. Treatment with chlorine or iodine is unlikely to kill Cyclospora oocysts. The CDC encourages consumers to For more information, please contact: follow general food safety recommendations: County of San Bernardino  Wash your hands with soap for at least 20 Department of Public Health seconds. Make sure to wash your hands Communicable Disease Section after going to the bathroom, after changing www.sbcounty.gov/dph/publichealth diapers, before preparing or eating foods or (800) 722-4794 beverages, and after handling an animal or To report a possible , animal waste. contact: County of San Bernardino Department of Public Health Division of Environmental Health Services (800) 442-2283

Source: this information was taken from the Centers for Disease Control and Prevention’s website www.cdc.gov.

For more information, please contact the Department of Public Health Division of Environmental Health Services 800-442-2283 Page 2 of 2 Updated February 2017