Canada investigating source of 83 cyclospora illnesses

The Public Health Agency of Canada (PHAC) is investigating 83 cases of cyclospora infections and said the source is unknown.

Cases have been reported in British Columbia (3), Alberta (1), Ontario (74), and Quebec (5) and two people have been hospitalized.

The majority of cases of cyclosporiasis were ill in late June and early July (first case May 9), with the last case reported illness onset being July 18.

PHAC said it is working with provincial public health partners, the Canadian Food Inspection Agency, and Health Canada to find the source.

The risk is low, but is increased for people with weakened immune systems, young children and older adults for developing complications if they get sick.

Previous foodborne illness outbreaks of cyclospora, in Canada and US have been linked to imported fresh produce, such as pre-packaged salad mix, basil, cilantro, berries, mesclun lettuce and snow peas.

PHAC said as yet no multi-jurisdictional outbreaks have been linked to produce grown in Canada.

It is unclear if it is linked to the ongoing outbreak in the US.

CDC, FDA and PHE warnings

The Centers for Disease Control and Prevention (CDC) reported 384 people had been sickened by cyclospora infection from 26 states as if August 3.

Most (59%) experienced onset of illness on or after May 1 and did not report international travel.

Clusters of illness linked to restaurants or events have been identified in Texas, Wisconsin, and Georgia, with those in Wisconsin and Texas preliminarily identifying cilantro as a suspect vehicle.

Cilantro was supplied to restaurants at which some of those who have become ill ate.

Previous US outbreaks of cyclosporiasis have been linked to imported fresh produce, including cilantro from the Puebla region of Mexico.

The Food and Drug Administration (FDA) announced import controls to detain without physical examination shipments of fresh cilantro from Puebla from April 1 to August 31.

This period aligns with the seasonality of previous cyclosporiasis outbreaks, said the agency.

The FDA and the government of Mexico’s National Agro-Alimentary Health, Safety and Quality Service (SENASICA) and Federal Commission for the Protection from Sanitary Risks (COFEPRIS) have put in place produce safety controls on both sides of the border.

Public Health England (PHE) issued a warning in late July on cyclospora infection in England and Scotland in June and July, with most associated with travel to Mexico.

24 cases had been to various resorts on the Riviera Maya coast of Mexico suggesting the source may be a food product distributed to several hotels. 

PHE recommended patients returning from Mexico with diarrhoea are tested for cyclospora.