Public Health Notice - Outbreak of Cyclospora under investigation

    August 11, 2016

    Why you should take note?

    The Public Health Agency of Canada is collaborating with provincial public health partners, the Canadian Food Inspection Agency, and Health Canada to investigate locally-acquired Cyclospora infections in four provinces. The source of the outbreak has not been identified. Imported fresh produce products are currently items of interest in the ongoing investigation. This Notice will be updated as new information becomes available.

    Cyclospora is a microscopic single-celled parasite that is passed in people's feces. If it comes in contact with food or water, it can infect the people who consume it. This causes an intestinal illness called cyclosporiasis.

    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. Illnesses among travellers can happen at any time of year.

    Investigation Summary

    In Canada, a total of 51 cases have been reported in British Columbia (1), Alberta (2), Ontario (44), and Quebec (4). Individuals became sick between May and July 2016. The majority of cases are male (51%), with an average age of 49 years. One case was hospitalized. 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.

    Previous foodborne illness outbreaks of Cyclospora in Canada and US 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.

    Who is most at risk?

    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.

    What you should do to protect your health?

    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 United States, and European countries.
    When travelling 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.

    People 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 (tiredness)
    stomach cramps
    loss of appetite
    weight loss
    mild fever
    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.

    What the Government of Canada is doing

    The Government of Canada is committed to food safety. The Public Health Agency of Canada leads human health investigations of outbreaks and is in regular contact with its federal and provincial partners to monitor and take collaborative steps to address outbreaks.

    Health Canada provides food-related health risk assessments to determine if the presence of a certain substance or microorganism poses a health risk to consumers.

    The Canadian Food Inspection Agency (CFIA) conducts food safety investigations into the possible food source of an outbreak.

    The Government of Canada will continue to update Canadians if new information related to this investigation becomes available.

    Public Health Agency of Canada