title: Epidemiologic studies of Cyclospora cayetanensis in Guatemala.
abstract: In 1996 and 1997, cyclosporiasis outbreaks in North America were linked to eating Guatemalan raspberries. We conducted a study in health-care facilities and among raspberry farm workers, as well as a case-control study, to assess risk factors for the disease in Guatemala. From April 6, 1997, to March 19, 1998, 126 (2.3%) of 5, 552 surveillance specimens tested positive for Cyclospora; prevalence peaked in June (6.7%). Infection was most common among children 1.5 to 9 years old and among persons with gastroenteritis. Among 182 raspberry farm workers and family members monitored from April 6 to May 29, six had Cyclospora infection. In the case-control analysis, 62 (91%) of 68 persons with Cyclospora infection reported drinking untreated water in the 2 weeks before illness, compared with 88 (73%) of 120 controls (odds ratio [OR] 3.8, 95% confidence interval [CI] 1.4, 10.8 by univariate analysis). Other risk factors included water source, type of sewage drainage, ownership of chickens or other fowl, and contact with soil (among children younger than 2 years).
authors.affiliation: National Cancer Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA.
authors.forename: C
authors.initials: C
authors.lastname: Bern
authors.forename: B
authors.initials: B
authors.lastname: Hernandez
authors.forename: M B
authors.initials: MB
authors.lastname: Lopez
authors.forename: M J
authors.initials: MJ
authors.lastname: Arrowood
authors.forename: M A
authors.initials: MA
authors.lastname: de Mejia
authors.forename: A M
authors.initials: AM
authors.lastname: de Merida
authors.forename: A W
authors.initials: AW
authors.lastname: Hightower
authors.forename: L
authors.initials: L
authors.lastname: Venczel
authors.forename: B L
authors.initials: BL
authors.lastname: Herwaldt
authors.forename: R E
authors.initials: RE
authors.lastname: Klein
mesh_terms: D000293:Adolescent; D000383:Agriculture; D000818:Animals; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D003048:Coccidiosis / Q000453:epidemiology* / Q000209:etiology; D004196:Disease Outbreaks; D016783:Eucoccidiida / Q000302:isolation & purification*; D016266:Food Parasitology; D005638:Fruit / Q000469:parasitology*; D006166:Guatemala / Q000453:epidemiology; D006801:Humans; D007223:Infant; D007411:Intestinal Diseases, Parasitic / Q000453:epidemiology* / Q000209:etiology; D011159:Population Surveillance; D015995:Prevalence; D012307:Risk Factors; D012621:Seasons; D014881:Water Supply