Cyclospora and summer travel

An increase in cases has been detected in travellers returning from Mexico

• This updates the news item of 04 May 2023

The UK Health Security Agency (UKHSA) has identified an increase of Cyclospora cayetanensis in travellers returning from Mexico. Between 12 May and 14 August 2023, there have been 74 cases of cyclosporiasis reported in England, Wales and Scotland [1]. For those cases where travel information is available (52 cases), 48 cases report travel to Mexico. Detailed travel information is available for 42 of these cases, who report staying in several different hotels in the Riviera Maya and Cancún regions in Mexico, and most report eating a wide variety of different food and drink within their hotel resort as part of an all-inclusive holiday package [1].

Cyclospora is a parasite common in some tropical countries worldwide, it is spread through consumption of contaminated food or drink. Infection can cause diarrhoea and other unpleasant symptoms such as abdominal cramping, bloating, nausea, fever and loss of appetite and weight. While Cyclospora infections usually are mild and self-limiting in most people, people living with HIV or immunosuppression (weakened immune system) may have a severe, prolonged illness [3].

Cyclospora infection in United Kingdom (UK) travellers is often linked to summer travel abroad to South and Central America or South and Southeast Asia. In recent years most UK cases were reported after visits to Mexico [2-4]. Of these cases, most report travel to Riviera Maya and to Cancún, with a few sporadic cases reporting travel to other areas of Mexico.

Advice for travellers

Before you travel

Check our Country Information pages for travel health information for your destination. There is no vaccine to prevent Cyclospora infection.

Travel with a basic first aid kit. Pack items to reduce your risk of food and water illness such as hand sanitiser, and items to help you manage diarrhoea such as oral rehydration powders.

While you are away

As Cyclospora is spread by consuming food or drink contaminated with human faeces, make sure you follow good food and water hygiene at all times, even if you are staying in a high-end, all-inclusive resort.

Where possible, choose recently prepared, thoroughly cooked food that is served piping hot.

Use bottled or treated water for drinking and cleaning teeth.

Fruit that you can peel yourself (like bananas and oranges), and pasteurised dairy produce such as yoghurts, are good options, but avoid fresh uncooked berries/unpeeled fruit, salads and herbs like basil or coriander that have not been washed in safe water.

Ice in drinks should be avoided unless from a treated water source.

See Cyclospora: advice for travellers and our travellers' diarrhoea factsheet for more information.

If you are unwell, drink plenty of safe fluids. Seek medical advice if your symptoms are severe or prolonged.

When you return

If you have any symptoms, such diarrhoea, fever, loss of appetite, nausea, weight loss, stomach cramps, bloating or increased wind, get medical help. Let your nurse, doctor/health professional know you travelled abroad recently and remember to tell them every country you visited.

Advice for health professionals

In returned travellers with gastrointestinal symptoms, consider protozoan parasites (including Cyclospora) as a diagnosis, as well as other more common bacterial or viral causes of gastrointestinal infection. Testing should be arranged through local microbiology laboratories and positive cases reported to your local health protection team.

Recommended treatment for severe or prolonged Cyclospora infection is usually co-trimoxazole [2].