Ciclosporiasis: distribución, prevalencia y control

Cyclospora cayetanensis is recognized as an emerging protist that causes diarrheal illness. The parasite is endemic in tropical areas but reported worldwide. Humans are the only hosts known. Cyclospora is responsible for significant morbidity in children and AIDS patients and is an important cause of foodborne outbreaks. Globalization of the food supply and increased world travel have contributed to the spread of the parasite to non-endemic areas. Most of the cases have been linked with travelers or foodborne outbreaks. Berries and leafy green vegetables have been implicated as food sources. Cyclospora has been isolated from fruits, vegetables, shellfish, drinking water, swimming pools, lakes, rivers, wastewater, sewage water, and soil. The oocysts are highly resistant to environmental conditions, pesticides, and disinfectants. Techniques for fingerprinting analysis and genotype discrimination are not available. The lack of an animal model and limited DNA sequence data have hampered efforts to develop detection methods. The complete apicoplast and mitochondrial genomes of C. cayetanensis were recently obtained which could facilitate the development of genotyping tools. Prevention and control measures include improvement of personal hygiene, efficient sanitation, and improved water quality management. Food safety training worldwide is necessary. Quantifying risk and controlling Cyclospora in the environment are complicated by the minimum infectious dose, the highly resistant oocysts, and the long sporulation and prepatent periods. This review summarizes the current status of knowledge of the parasite focusing on distribution, prevalence, and control strategies of infection. Recibido: 12-06-2017 Aceptado: 10-11-2017 alimentos, aguas y suelos contaminados. La ciclosporiasis produce manifestaciones gastrointestinales autolimitadas, especialmente diarrea, aunque también puede ser asintomática o crónica en individuos inmunosuprimidos. En áreas endémicas, los más susceptibles a la enfermedad son los niños pequeños y los individuos inmunocomprometidos y en países desarrollados, todos son propensos a sufrirla (1). INTRODUCCIÓN Cyclospora cayetanensis es un coccidio que se transmite entre humanos; hasta el presente, no se ha demostrado que existan animales reservorios del parásito. La infección tiene una distribución global; se ha observado en países en vías de desarrollo e industrializados. La transmisión puede ocurrir a través de Chacín-Bonilla y Vielma Investigación Clínica 59(1): 2018 68