Cyclospora cayetanensis is an emerging protozoan parasite of increasing concern in Europe. Although cyclosporiasis is traditionally endemic to tropical and subtropical regions, imported cases and cases with no travel history have been documented across at least sixteen European countries. This review summarizes the current knowledge on Cyclospora in Europe, encompassing human, animal, environmental, and foodborne investigations published between 1990 and 2025. Historical reports reveal the early contribution of European parasitologists to the genus description, followed by recognition of C. cayetanensis as a human pathogen. In Europe, the infection has been detected in travellers returning from endemic areas and, sporadically, in non-travel-related outbreaks, mainly linked to contaminated fresh produce and water. Molecular studies have confirmed the parasite's occurrence in humans, non-human primates, shellfish, water, soil, and fresh produce. However, prevalence data remain fragmentary, and surveillance systems are inconsistent. Factors potentially influencing the emergence of cyclosporiasis in Europe include globalization of the food supply, travel and migration from endemic regions, inadequate wastewater management, limited diagnostic awareness among clinicians and laboratories. Although the risk of cyclosporiasis spread remains minimal, climate changes might further favour oocyst persistence and sporulation in the environment, particularly in the Mediterranean regions. Despite advances in molecular diagnostics, there is still a need for standardised protocols for environmental and food matrices. In Europe, increased awareness among clinicians and laboratories, routine inclusion of C. cayetanensis in diagnostic testing, hygiene and food safety measures and surveillance are critical. Collaboration is essential for mitigating the impact of Cyclospora and understanding its epidemiology within a changing global context.
A narrative review of Cyclospora in Europe: Unravelling the epidemiology and public health implications of cyclosporiasis
Roberto Amerigo Papini;Federica Berrilli;
2026-01-01
Abstract
Cyclospora cayetanensis is an emerging protozoan parasite of increasing concern in Europe. Although cyclosporiasis is traditionally endemic to tropical and subtropical regions, imported cases and cases with no travel history have been documented across at least sixteen European countries. This review summarizes the current knowledge on Cyclospora in Europe, encompassing human, animal, environmental, and foodborne investigations published between 1990 and 2025. Historical reports reveal the early contribution of European parasitologists to the genus description, followed by recognition of C. cayetanensis as a human pathogen. In Europe, the infection has been detected in travellers returning from endemic areas and, sporadically, in non-travel-related outbreaks, mainly linked to contaminated fresh produce and water. Molecular studies have confirmed the parasite's occurrence in humans, non-human primates, shellfish, water, soil, and fresh produce. However, prevalence data remain fragmentary, and surveillance systems are inconsistent. Factors potentially influencing the emergence of cyclosporiasis in Europe include globalization of the food supply, travel and migration from endemic regions, inadequate wastewater management, limited diagnostic awareness among clinicians and laboratories. Although the risk of cyclosporiasis spread remains minimal, climate changes might further favour oocyst persistence and sporulation in the environment, particularly in the Mediterranean regions. Despite advances in molecular diagnostics, there is still a need for standardised protocols for environmental and food matrices. In Europe, increased awareness among clinicians and laboratories, routine inclusion of C. cayetanensis in diagnostic testing, hygiene and food safety measures and surveillance are critical. Collaboration is essential for mitigating the impact of Cyclospora and understanding its epidemiology within a changing global context.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
