UK Department of Health

Investigations are ongoing after an increase in cases of food and water bug, Cyclospora, associated with travellers returning from Mexico.

Public Health England (PHE) is advising people planning on travelling to the Riviera Maya coast in Mexico to be aware of the risk of infection from a food and water bug, Cyclospora.

PHE is aware of an increase in Cyclospora cases linked with travel to Mexico. There have been 204 cases reported in the UK since 1 June 2016, with 148 cases from holidaymakers who stayed in a number of different hotels and resorts on the Riviera Maya coast. Investigations into the source of infection are ongoing.

Infection can cause frequent, watery diarrhoea, abdominal cramping, bloating, nausea, flatulence, low-grade fever, loss of appetite and weight. Individuals with underlying immune deficiency can be at risk of more severe infection.

Travellers to Mexico are strongly advised to maintain a high standard of food, water and personal hygiene, even if staying in high-end resorts. There is no risk of the bug being passed from person to person.

Advice for travellers

Infection is transmitted through consumption of food or water that is contaminated by Cyclospora. Foods often implicated in outbreaks include soft fruits like raspberries and salad products such as coriander, basil and lettuce.

Travellers are advised to:

• ensure drinking water is bottled, boiled, or filtered with a special filter designed for purifying drinking water
• avoid uncooked berries, unpeeled fruit, salad leaves and fresh herbs since these are difficult to clean
• ensure food is freshly prepared, thoroughly cooked and eaten hot whenever possible

On return from Mexico, if you have any symptoms such as those described above you should seek medical attention and tell your GP about your travel history. The infection is diagnosed by testing of stool samples, and although most cases resolve on their own, antibiotics can be given to treat severe or prolonged infections.

Dr Katherine Russell, Head of Travel and Migrant Health at PHE, said:

Following the link with travel to Mexico, the UK travel industry has been informed and we are sharing information with the Mexican health authorities to support their investigations.

Get medical advice for any symptoms, either during your holiday or after you return. Symptoms can include: diarrhoea, appetite loss, stomach cramps and pain, bloating, increased wind, weight loss, nausea or tiredness. If you are ill when you get home, remember to tell your GPabout your travel history.

Dr Vanessa Field, Deputy Director of the National Travel Health Network and Centre (NaTHNaC), said:

It is very important to reinforce the need for travellers going to tropical or subtropical countries, including Mexico, to follow good food and water hygiene advice at all times on holiday, even if staying in high-end, all-inclusive resorts. Avoid buffets and choose recently prepared, thoroughly cooked food that is served piping hot. Avoid fresh uncooked berries or unpeeled fruit and any salad items not washed in safe water. Remember that drinks may also contain uncooked herbs, vegetables or fruit.

Cyclospora cayetanensis is a protozoan parasite that infects humans. Infection is acquired from food or water contaminated by the parasite. Because this organism is not infectious until approximately 10 days after they are passed in faeces, person-to-person transmission does not occur.

Read advice about food and water hygiene and specific advice for travellers to Mexico on the NaTHNaC website.

General information on Cyclospora is available on the NHS Choices website.

Clinical and travel guidance for health professionals is available on the PHEwebsite.