Management and Therapy

 

Trimethoprim structure

* http://wwwcmc.pharm.uu.nl/edu/Drug_tri.html

 

 

Frequently, only supportive care required.  Replenishment of fluids and electrolytes with juices, water, and caffeine-free soda will help prevent dehydration from the diarrhea. However, for more severe cases, the only known treatment of Cyclospora infection is Trimethoprim/sulfamethoxazole (TMP/SMX).   Typically, adults receive TMP orally twice a day for 7 days. Children receive TMP twice a day for 7 days. Patients with AIDS may need higher doses and long-term maintenance treatment. 

 

 

There is a plethora of information about the structure and chemical properties of various medicines including Trimethoprim on the web.    For the chemically inclined, they even have IR spectroscopy!

Epidemiology

 

 

 

By and large, the epidemiology of Cyclosporiasis has yet to be determined.  Cyclosporiasis has been reported in many countries, but it is endemic only in tropical and subtropical areas (Haiti, Nepal, and Peru). The prevalence is strongly associated with the seasons, and predominates during the rainy spring or summer months. Cases also have been reported in travelers returning from Mexico, Southeast.

 Asia, Puerto Rico, Indonesia, Morocco, Pakistan, and India.  Since1990, there have been many outbreaks of cyclosporiasis in the United States and Canada which affected approximately 3600 persons. Many cases involved Guatemalan raspberries, or the consumption of food that contained fresh basil. An additional two clusters of cases in Florida were linked with eating mesclun lettuce.  It should be noted that the chances for foodborne transmission are greatly reduced by washing fruits and vegetables before consumption.  Ultimately, the prevalence of Cyclospora in North America is estimated at levels lower than .5%.

 

Public Health and Prevention

Currently, there is no vaccine available for Cyclospora infection. However, given the lack of other hosts and a reservoir, many cases of Cyclospora  in endemic areas could be prevented with proper hygiene, treatment, sanitation and filtration of water. Additionally, simply washing and rinsing fruits before serving has been shown to significantly decrease the amount of oocysts on the fruit. Also, all cases should be reported to the CDC so that the incidence of Cyclospora  infection can be properly monitored.