Cyclospora Cayetanensis—Major Outbreaks from Ready to Eat Fresh Fruits and Vegetables

Abstract

Cyclospora cayetanensis is a coccidian protozoan that causes cyclosporiasis, a severe gastroenteric disease, especially for immunocompromised patients, children, and the elderly. The parasite is considered as an emerging organism and a major contributor of gastroenteritis worldwide. Although the global prevalence of cyclosporiasis morbidity and mortality has not been assessed, global concern has arisen since diarrheal illness and gastroenteritis significantly affect both developing countries and industrialized nations. In the last two decades, an increasing number of foodborne outbreaks has been associated with the consumption of fresh produce that is difficult to clean thoroughly and is consumed without processing. Investigations of these outbreaks have revealed the necessity to increase the awareness in clinicians of this infection, since this protozoan is often ignored by surveillance systems, and to establish control measures to reduce contamination of fresh produce. In this review, the major cyclosporiasis outbreaks linked to the consumption of ready to eat fresh fruits and vegetables are presented.

Seasonal Differences in Cyclospora cayetanensis Prevalence in Colombian Indigenous People

“…Although C. cayetanensis shows a worldwide distribution [ 2 ] with an estimated global average prevalence of 3.55% [ 7 ], primary areas of endemicity comprise resource-poor countries with limited or poor hygiene standards [ 2 ]. In those regions, foreigners, children, elderly, and immunocompromised individuals are particularly frequently diagnosed with cyclosporiasis, while returning travelers are affected in non-endemic areas without relevant effects of sex or age [ 2 , 12 , 13 , 14 ]. In particular, individuals with low socio-economic status are at risk of getting infected with C. cayetanensis [ 15 , 16 ] as impressively indicated by a prevalence of 22.2% in slum dwellers in South Chennai, India [ 17 ].…”

Detection of Cyclospora cayetanensis, Echinococcus multilocularis, Toxocara spp. and microsporidia in fresh produce using molecular methods: – A review

“…Fruit and vegetables are principal components of a healthy diet and have been in high demand in recent years, although eating fresh, minimally processed food is not without risk. Since 1995 until now, major outbreaks of C. cayetanensis infection from fresh produce occurred in USA, Canada and Mexico, linked to the fresh produce originated from endemic countries ( Hadjilouka and Tsaltas, 2020 ). From approximately 1100 globally reported outbreaks where etiological agent was identified, 4.5% were caused by parasites ( Ramos et al, 2013 ).…”

Single-strand conformation polymorphism-based genetic characterization of the <i>Cyclospora cayetanensis</i> strains collected from different provinces in Turkey

“…Cyclospora cayetanensis is a coccidian protozoan that causes severe gastroenteritis in both immunocompetent and immunocompromised individuals [1,2]. The oocysts of C. cayetanensis are round-oval in shape and 8-10 μm in diameter, and they are not sporulated when excreted in faeces.…”

“…The oocysts of C. cayetanensis are round-oval in shape and 8-10 μm in diameter, and they are not sporulated when excreted in faeces. As a result, infection does not spread from personto-person; rather, infection occurs through ingestion of infected oocysts and of contaminated water and food [2,3]. It has been reported that in recent years C. cayetanensis has caused foodborne outbreaks in the United States, Canada and Korea, and these outbreaks were associated with tourists and imported products [3,4,5,6].…”