British Columbians travelling to the US warned as parasitic illness outbreak spreads

British Columbians planning a trip to the United States are being urged to take extra precautions as health officials investigate several outbreaks of a parasitic intestinal illness.

The Government of Canada has added cyclosporiasis to the “Outbreak Monitoring” section of its official US travel advice.

Cyclosporiasis is caused by a microscopic parasite called Cyclospora. People can become infected after eating food or drinking water contaminated with the parasite, though it is unlikely to spread directly between people.

The warning comes during a significant increase in cases across the United States.

According to the US Centers for Disease Control and Prevention, 1,645 confirmed domestically acquired cases were reported in 34 states between May 1st and mid-July.

Another 5,100 cases were still being investigated to determine whether they were acquired within the country.

At least 141 people have been hospitalized, though no deaths have been reported.

This year’s number of cases is substantially higher than the 249 cases reported during the same period last year. 

Health officials say the actual number of illnesses is likely higher because cyclosporiasis is often underdiagnosed and underreported. The CDC and state health agencies continue to investigate several clusters and possible sources of contamination. Read the CDC health advisory here.

One of the outbreaks has been linked to shredded iceberg lettuce served at Taco Bell locations in Indiana, Kentucky, Michigan, Ohio and West Virginia.

Taylor Farms de Mexico has since recalled iceberg lettuce sourced from central Mexico, including some Marketside-brand products sold at Walmart and products distributed to restaurants and food-service customers. 

The CDC says other outbreaks currently under investigation are unrelated to the recalled lettuce.

According to health officials, the most common symptom of cyclosporiasis is frequent, watery diarrhea. Other symptoms can include loss of appetite, weight loss, stomach cramps, bloating, nausea and fatigue.

Symptoms typically begin about one week after infection but can appear anywhere from two days to two weeks later. Without treatment, symptoms can last for several weeks, sometimes disappearing and then returning. The Government of Canada says most people experience symptoms for six to seven weeks.

Travellers can reduce their risk by:

• Thoroughly washing fresh fruits and vegetables under clean, cool running water
• Washing produce even if it is labelled “pre-washed” or “ready to eat”
• Cooking produce when travelling in areas experiencing an outbreak
• Following safe food and water practices while outside Canada

Health Canada also notes that disinfectants and commercial produce washes may not completely remove Cyclospora. Cooking food can kill the parasite.

Anyone who develops severe or persistent watery diarrhea during or following a trip to the United States should seek medical attention. The CDC notes that routine stool tests do not always screen for Cyclospora, meaning patients may need to specifically request testing.

Despite the health notice, Canada has not raised its overall risk level for the United States. Travellers are still being advised to take normal security precautions.