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On 21 July 2017 the European Centre for Disease Prevention and Control (ECDC) 
reported an increase in cases of travel-ralated cyclosporiasis. Between 1 January and 11 July 2017, 43 cases have been identified in the UK. 11 of these travelled to Mexico, 10 travelled to other overseas destinations and 4 had not been abroad. A similar increase was seen in 2015 and 2016, when most cases were also linked to travel to Mexico.
There have also been 2 cases in France, both of whom had been to Mexico. Belgium has reported four cases of cyclosporiasis in 2017, 3 of whom had travelled to Mexico.
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. HIV positive individuals and those with other immune deficiencies can be at risk of more severe infection.
Infection is transmitted through consumption of food or water that is contaminated with human faeces containing Cyclospora. Travellers to Mexico are strongly advised to maintain a high standard of food and water hygiene and personal hygiene.
On return from Mexico, if travellers have any symptoms such as watery diarrhoea, loss of appetite, weight loss, stomach cramps/pain, bloating, increased gas, nausea, fatigue and other flu-like symptoms they should seek medical attention and tell their GP about their travel history.
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 who will follow up.
