Epidemiologic studies of Cyclospora cayetanensis in Guatemala

In 1996 and 1997, cyclosporiasis outbreaks in North America were linked to eating Guatemalan raspberries. We conducted a study in health-care faciliti es and among raspberry farm workers, as well as a case-control study, to as sess risk factors for the disease in Guatemala. From April 6, 1997, to Marc h 19, 1998, 126 (2.3%) of 5,552 surveillance specimens tested positive for Cyclospora; prevalence peaked in June (6.7%). Infection was most common amo ng children 1.5 to 9 years old and among persons with gastroenteritis. Amon g 182 raspberry farm workers and family members monitored from April 6 to M ay 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 analy sis). Other risk factors included water source, type of sewage drainage, ow nership of chickens or other fowl, and contact with soil (among children yo unger than 2 years).