Epidemiology of Cyclospora cayetanensis Infections in Canada: 2000-2022

Cyclospora cayetanensis is a human-specific protozoan parasite that causes gastrointestinal illness, primarily through the ingestion of contaminated water or fresh produce. This study provides an epidemiological overview of cyclosporiasis in Canada from 2000 to 2022 using data from the Canadian Notifiable Disease Surveillance System, FoodNet Canada, and outbreak investigations. A total of 5337 cases were reported during this period, with the incidence increasing from 0.12 to 1.70 per 100,000 population. Seasonal peaks occurred between May and August of each year, and adults aged 30-59 years were disproportionately affected. Enhanced surveillance data identified international travel, particularly to resorts in Mexico, as a common exposure. National-level investigations occurred annually from 2013 to 2022, and various fresh produce items were identified as items of interest, but few investigations led to the identification of a source of illness. Advancements in molecular diagnostics since 2015 have likely contributed to the observed rise in case detection. This report underscores the burden of cyclosporiasis in Canada and highlights the need for continued surveillance, public health interventions targeting contaminated produce, and travel health messaging to mitigate outbreaks and reduce transmission. It also underscores the importance of real-time genetic typing to identify and differentiate clusters of closely related isolates that are more likely to share a common source.