Canadian public health officials are investigating an outbreak of “locally acquired” Cyclospora infections. According to the Public Health Agency of Canada (PHAC), there are currently 51 confirmed cases in four provinces, and one person has been hospitalized.

Canadian cyclospora-epi-eng
Figure 1. Number of people infected with Cyclospora cayetanensis (Graph courtesy of the Public Health Agency of Canada)
The source of the illnesses has not yet been identified, although PHAC stated that “imported fresh produce products are currently items of interesting in the ongoing investigation.” So far, a total of 51 cases have been reported in Canada. They are in British Columbia (1), Alberta (2), Ontario (44), and Quebec (4). These individuals became ill between May and July 2016, PHAC stated. The majority of people sickened are male (51 percent), with an average age of 49. The investigation into the source of the outbreak is ongoing. To date, no multi-jurisdictional outbreaks of Cyclospora have been linked to produce grown in Canada, the agency stated. PHAC noted that officials are collaborating with provincial public health partners, the Canadian Food Inspection Agency, and Health Canada on this investigation. Previous foodborne illness outbreaks of Cyclospora infection in Canada and the U.S. have been linked to various types of imported fresh produce, such as pre-packaged salad mix, basil, cilantro, raspberries, blackberries, mesclun lettuce and snow and snap peas. PHAC reported 83 confirmed cases of Cyclospora infection in Canada in August 2015. That outbreak affected people in British Columbia (3), Alberta (1), Ontario (74), and Quebec (5). Two people were hospitalized, and no deaths were reported. On this side of the border, 384 cases of Cyclospora infection were reported last August from 26 states. Mexican cilantro was identified as the suspected source of that outbreak. lettuce-field4-featuredCyclospora is a microscopic single-celled parasite that is passed in human feces. If it comes into contact with food or water, it can infect the people who consume it. This causes an intestinal illness called cyclosporiasis. According to PHAC, Cyclospora is not common on food and is not in drinking water in Canada. The parasite is most common in some tropical and subtropical countries such as Peru, Cuba, India, Nepal, Mexico, Guatemala, Southeast Asia and Dominican Republic. In Canada, non-travel-related illnesses due to Cyclospora occur more frequently in the spring and summer months. However, PHAC noted that illnesses among travelers can happen at any time of year. People living or traveling in tropical or subtropical regions of the world who eat fresh produce or drink untreated water may be at increased risk for infection because the parasite is found in some of these regions. Most people recover fully; however, it may take several weeks before an ill person’s intestinal problems completely disappear. It can be hard to prevent cyclosporiasis. This is because washing produce does not always get rid of the Cyclospora parasite that causes the illness. You can reduce your risk by:

  • cooking produce imported from countries where Cyclospora is found, and
  • consuming fresh produce grown in countries where Cyclospora is not common such as Canada, the U.S., and European countries.

When traveling to a country where Cyclospora is found, you can reduce your risk by:

  • avoiding food that has been washed in local drinking water;
  • drinking water from a safe source, and
  • eating cooked food or fruit that you can peel yourself. infected with Cyclospora can experience a wide range of symptoms. Some do not get sick at all, while others feel as though they have a bad case of stomach flu. Few people get seriously ill. Most people develop the following symptoms within one week after being infected with Cyclospora:

  • watery diarrhea
  • abdominal bloating and gas
  • fatigue
  • stomach cramps
  • loss of appetite
  • weight loss
  • mild fever
  • nausea

When you eat or drink contaminated food or water, it may take 7 to 14 days for symptoms to appear. If left untreated, you may have the symptoms for a few days up to a few months. Most people have symptoms for 6 to 7 weeks. Sometimes symptoms may go away and then return. If you become ill, drink plenty of water or fluids to prevent dehydration from diarrhea. If you have signs of illness and have reason to believe you have cyclosporiasis, call your health care provider.

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