Cyclospora Risk for Travellers to Mexico

During June and July 2016, a cluster of cases of Cyclospora infection associated with travel to Mexico was reported in the UK. In August 2016, cases of infection have continued to be reported in UK travellers returning from this popular destination.

The majority of cases have stayed in all-inclusive resorts in the Riviera Maya area on the coast of Quintana Roo state, south of Cancun. The source of infection is thought likely to be a foodstuff supplied to hotels throughout the area. Investigation into this outbreak is ongoing.

Awareness of the outbreak should be maintained and travellers to Mexico are strongly advised to maintain a high standard of food, water and personal hygiene, even if staying in high-end resorts.

Cyclospora cayetanensis is a protozoan parasite that infects humans and other primates. Infection can cause frequent, watery diarrhoea, abdominal cramping, bloating, nausea, flatulence, low-grade fever, loss of appetite and weight. HIV positive individuals and those with other immune deficiencies can be at risk of more severe infection.

Advice for Travellers

Infection is transmitted through consumption of food or water that is contaminated with human faeces containing the parasite. Foods often implicated in outbreaks include soft fruits like raspberries and salad products such as coriander, basil and lettuce. Key points:

• Iodine and chlorine do not kill Cyclospora. Drinking water must be bottled, boiled, or filtered with a special filter designed for purifying drinking water.
• Uncooked berries, unpeeled fruit and salad leaves are best avoided since these are difficult to clean.
• Food should be freshly prepared, thoroughly cooked and eaten hot whenever possible
• Further food and water advice
• Preventing and treating travellers'diarrhoea

On return from Mexico, if travellers have any symptoms such as those described above they should seek medical attention and tell their GP about their travel history.

Advice for Healthcare Professionals

Protozoan parasitic infection (including Cyclospora) should be considered as a diagnosis in travellers returning from Mexico presenting with gastrointestinal symptoms. Stool sampling and testing should be carried out in the normal way through local laboratories and confirmed cases reported to the local health protection team.

Further information on Cyclosporiasis