Cyclosporiasis Outbreak in Germany Associated with the Consumption of Salad

Döller, P. C.; Dietrich, Karl; Filipp, Norbert; Brockmann, Stefan; Dreweck, C.; Vonthein, Reinhard; Wagner-Wiening, Christiane; Wiedenmann, Albrecht

doi:10.3201/eid0809.010517

Cited by 115 publications

(53 citation statements)

References 9 publications

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“…However, non-travel-related and waterborne cases of cyclosporiasis have been reported in several developed countries (12,450). Food-borne outbreaks have been reported in North America (189,291,450) and Germany (92). Infections in immunosuppressed patients have been reported in Turkey (350), and although symptoms may be similar to those in immunocompetent individuals, they may be prolonged (410).…”

Section: Cyclospora Cayetanensismentioning

confidence: 99%

Enteric Protozoa in the Developed World: a Public Health Perspective

et al. 2012

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SUMMARY Several enteric protozoa cause severe morbidity and mortality in both humans and animals worldwide. In developed settings, enteric protozoa are often ignored as a cause of diarrheal illness due to better hygiene conditions, and as such, very little effort is used toward laboratory diagnosis. Although these protozoa contribute to the high burden of infectious diseases, estimates of their true prevalence are sometimes affected by the lack of sensitive diagnostic techniques to detect them in clinical and environmental specimens. Despite recent advances in the epidemiology, molecular biology, and treatment of protozoan illnesses, gaps in knowledge still exist, requiring further research. There is evidence that climate-related changes will contribute to their burden due to displacement of ecosystems and human and animal populations, increases in atmospheric temperature, flooding and other environmental conditions suitable for transmission, and the need for the reuse of alternative water sources to meet growing population needs. This review discusses the common enteric protozoa from a public health perspective, highlighting their epidemiology, modes of transmission, prevention, and control. It also discusses the potential impact of climate changes on their epidemiology and the issues surrounding waterborne transmission and suggests a multidisciplinary approach to their prevention and control.

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Section: Cyclospora Cayetanensismentioning

confidence: 99%

Enteric Protozoa in the Developed World: a Public Health Perspective

et al. 2012

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“…However outbreaks of cyclosporiasis have been reported from North America (137,138,181) and Europe (76). The sources of infection in all these cases were traced to vegetables imported from areas of endemicity.…”

Section: Cyclosporamentioning

confidence: 99%

Clinical Significance of Enteric Protozoa in the Immunosuppressed Human Population

et al. 2009

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SUMMARY Globally, the number of immunosuppressed people increases each year, with the human immunodeficiency virus (HIV) pandemic continuing to spread unabated in many parts of the world. Immunosuppression may also occur in malnourished persons, patients undergoing chemotherapy for malignancy, and those receiving immunosuppressive therapy. Components of the immune system can be functionally or genetically abnormal as a result of acquired (e.g., caused by HIV infection, lymphoma, or high-dose steroids or other immunosuppressive medications) or congenital illnesses, with more than 120 congenital immunodeficiencies described to date that either affect humoral immunity or compromise T-cell function. All individuals affected by immunosuppression are at risk of infection by opportunistic parasites (such as the microsporidia) as well as those more commonly associated with gastrointestinal disease (such as Giardia). The outcome of infection by enteric protozoan parasites is dependent on absolute CD4+ cell counts, with lower counts being associated with more severe disease, more atypical disease, and a greater risk of disseminated disease. This review summarizes our current state of knowledge on the significance of enteric parasitic protozoa as a cause of disease in immunosuppressed persons and also provides guidance on recent advances in diagnosis and therapy for the control of these important parasites.

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“…Contaminated chlorinated water was believed to be the most likely source of infection. 4 Cyclosporiasis can also be acquired by the ingestion of contaminated uncooked fruits and vegetables, [5][6][7] particularly lettuce, 8 basil, 9,10 snow peas, 11 and berries. [12][13][14] Cyclospora infections have been described in tropical and subtropical areas, and are considered endemic to certain regions in developing countries, such as Peru, Guatemala, Haiti, and Nepal.…”

Section: Introductionmentioning

confidence: 99%

Cyclospora cayetanensis in a Pediatric Hospital in Morelia, México

Orozco-Mosqueda¹,

Martínez-Loya²,

Ortega³

2014

The American Society of Tropical Medicine and Hygiene

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Abstract. Cyclospora cayetanensis, a coccidian parasite, can cause gastrointestinal illness in humans and is characterized by watery and persistent diarrhea and abdominal pain. Cyclosporiasis has been associated with traveler's diarrhea. The infection is acquired through food and waterborne transmission, particularly by consumption of contaminated fresh fruits and vegetables. In the present study, stool samples from 8,877 children were examined for ova and parasites at the Pediatric Hospital of Morelia in Michoacán, Mexico, during 2000Mexico, during -2009. Sixty children (0.67%) had Cyclospora in their stools. Diarrhea (45.8%), abdominal pain (39.6%), and vomiting (18.8%) were the most frequent symptoms of cases with cyclosporiasis. Most of the cases (93.3%) were observed during June-August, the rainy season. In 45 children, Cyclospora was the only parasitic pathogen detected (75%); 15 children were co-infected with commensal, pathogenic, or both groups of parasites. Our findings suggest that C. cayetanensis is endemic to Michoacán and shows characteristically temporal patterns.

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Cyclosporiasis Outbreak in Germany Associated with the Consumption of Salad

Cited by 115 publications

References 9 publications

Enteric Protozoa in the Developed World: a Public Health Perspective

Enteric Protozoa in the Developed World: a Public Health Perspective

Clinical Significance of Enteric Protozoa in the Immunosuppressed Human Population

Cyclospora cayetanensis in a Pediatric Hospital in Morelia, México

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