As of early June, nine people have been sickened by the Cyclospora parasite in England this year, with the source of infection not yet known.

The sick people had traveled to several other countries, including the Dominican Republic, Indonesia and Mexico. Infection is usually acquired from food or water contaminated by human feces. Microscopic amounts of feces are enough to contaminate large amounts of food and beverages. Previous outbreaks have been traced to soft fruits like raspberries and fresh produce including cilantro, coriander, basil and lettuce.

Between 2005 and 2014, an average of 32 people fell ill with Cyclospora parasite infections in England and Wales each year.

Reports of Cyclospora infections in United Kingdom travelers are being monitored by Public Health England, Health Protection Scotland, Public Health Wales and the Public Health Agency in Northern Ireland.

Since 2015 there have been seasonal outbreaks of Cyclospora infection in UK travelers returning from Mexico. Annual case counts are:

• 2015: 79 cases
• 2016: 359 cases
• 2017: 82 cases
• 2018: 61 cases

Most patients stayed in the Riviera Maya and Cancun regions of Mexico. The source of infection was likely contaminated food supplied to hotels throughout the area, according to public health officials.

Belgium reported four cases of cyclosporiasis in 2017, three of whom had a travel history to Mexico and France had six confirmed and three probable infections in July and August 2016 in citizens returning from Mexico.

Symptoms of Cyclospora infection can include diarrhea, fever, fatigue and muscle pain, appetite loss, weight loss, cramping, gas, bloating and nausea. If it isn’t treated, the illness may last from a few days to a month or longer. Symptoms typically begin seven days after ingestion of the Cyclospora oocysts, which are the infective form of the parasite.

As of May 29, 2019, two laboratory-confirmed cases of cyclosporiasis had been reported to the U.S. Centers for Disease Control and Prevention by South Carolina and Connecticut. The two people became ill between May 1 and 29. They had no history of international travel during the 14-day period before illness onset.

In 2018, almost 2,300 lab-confirmed patients were reported to the CDC by 33 states. The people became ill from May through August. None had a history of international travel. Cyclospora parasites, which cannot be seen by the human eye, have been documented repeatedly by U.S. outbreak investigators in cilantro from Mexico.