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Questions and Answers
What is the chief clinical symptom of Cyclospora infection?
What is the chief clinical symptom of Cyclospora infection?
What is the average duration of diarrhea in untreated cases of Cyclospora infection?
What is the average duration of diarrhea in untreated cases of Cyclospora infection?
Which diagnostic method can be used to identify Cyclospora oocysts?
Which diagnostic method can be used to identify Cyclospora oocysts?
Which of the following statements is true about asymptomatic carriers of Cyclospora?
Which of the following statements is true about asymptomatic carriers of Cyclospora?
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What preventive measure is recommended in endemic areas to avoid Cyclospora infection?
What preventive measure is recommended in endemic areas to avoid Cyclospora infection?
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What was the primary source of Cyclospora cayetanensis contamination in the wedding cake at the Philadelphia event?
What was the primary source of Cyclospora cayetanensis contamination in the wedding cake at the Philadelphia event?
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Which of the following contributory factors led to the outbreak of cyclosporiasis in 1996?
Which of the following contributory factors led to the outbreak of cyclosporiasis in 1996?
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What other foods were implicated in outbreaks of cyclospora besides raspberries?
What other foods were implicated in outbreaks of cyclospora besides raspberries?
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How were Guatemalan raspberries primarily implicated in the outbreaks in the United States?
How were Guatemalan raspberries primarily implicated in the outbreaks in the United States?
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What is the primary mode of transmission for cyclospora infection?
What is the primary mode of transmission for cyclospora infection?
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What environmental factor is suggested to contribute to the contamination of berries with Cyclospora?
What environmental factor is suggested to contribute to the contamination of berries with Cyclospora?
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What was the trend in cases of cyclosporiasis between 1996 and 2000 in North America?
What was the trend in cases of cyclosporiasis between 1996 and 2000 in North America?
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Which symptom is commonly associated with cyclospora infection?
Which symptom is commonly associated with cyclospora infection?
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Study Notes
Cyclospora
- A coccidian, spore-forming protozoan
- Oocysts are 8-10 µm in diameter
- Infection occurs through ingestion of sporulated oocysts in food or water
- Oocysts require weeks to months (1-2 weeks in optimal conditions) to sporulate outside humans and become infectious (human-to-human transmission is unlikely)
- Infectious dose of oocysts is unknown
- Asymptomatic carriers may excrete oocysts without being ill
- Natives of endemic areas may frequently be asymptomatic, but infectious
- Cyclospora is endemic in Haiti, Peru and Nepal where rainy-season outbreaks occur. Outside these areas, infections are usually travel-related
Cyclospora Background Infections
- 1996: 1,465 cases of cyclosporiasis in North America
- 20 US States, 2 Canadian Provinces
- 1997: 1,600 cases in North America
- Strawberries were implicated first before raspberries were identified as the major culprit
- Cyclospora infection was virtually unknown in North America before 1996
- In order to continue exporting products to the United States in 1996, Guatemalan farms required improvements in water quality, employee hygiene, and sanitary conditions
- Further outbreaks associated with raspberries occurred in April 1997, and the USA suspended Guatemalan raspberry importation in late May
- Outbreaks also linked to other foods, including mesclun (spring mix), fresh basil, and fresh snow peas
Cyclospora Outbreaks
- 1998: Over 300 people became ill from raspberries in Toronto, Ontano
- 1999: Several outbreaks of cyclosporiasis occurred, with Guatemalan blackberries being suspected as a source but never definitively proven in two outbreaks
- 2000: Multiple outbreaks occurred, and Guatemalan raspberries were linked as a source in two outbreaks
Cyclospora Contamination
- Contamination of berries remains unknown, but possibilities include:
- Fecal contamination of water used for fruit irrigation or pest control
- Contamination during storage or during the packing process
- Insect or bird droppings contamination prior to picking
Cyclospora Health Effects
- Clinical features include watery diarrhea (yellow or khaki-green, without blood), lasting an average of 19-43 days, often explosive diarrhea, severe fatigue, anorexia, nausea, vomiting, abdominal bloating, weight loss, stomach cramps and in a small percentage, fever, chills, and a flu-like illness
- Symptoms may occur 1-11 days after exposure (average 1 week)
- Untreated cases in immuno-competent hosts may last 1-2 months or longer
- Reactive arthritis is sometimes seen after prolonged infections
- Ocular inflammation and sterile urethritis may also be observed
Cyclospora Resistance
- Low levels are sufficient to cause disease
- Extremely resistant to chlorine
- In endemic areas, boiling water or filtration is suggested
Cyclospora Diagnosis
- Diagnosis may be through detection of eggs in stool samples or duodenal aspirates.
- Oocysts autofluoresce a bright blue color under UV light (365nm)
- Acid-fast staining and detection of parasite DNA through PCR are also possible methods.
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Description
This quiz delves into the characteristics and transmission of Cyclospora, a protozoan that causes infections through contaminated food and water. Learn about its life cycle, endemic areas, and historical outbreaks that occurred in North America. Test your knowledge on this emerging infectious disease.
