Sarcocystosis in Malaysia (Tioman Island) (Update)

GeoSentinel has published an update on the ongoing outbreak of sarcocystosis in travellers returned from Tioman Island.

From 27 July  to 4 November 2012, 65 cases have been identified with an acute muscular sarcocystis-like illness after recent travel to Tioman Island. All of these patients had travelled to Tioman, located off the east coast of peninsular Malaysia, mostly during July and August 2012.

Reports of cases originated from Germany (25), France (20), the Netherlands (12), Switzerland (3), Belgium (2), Spain (2), and Singapore (1). These cases appear to represent the second wave of an outbreak that began in 2011, when 35 cases were identified in travellers who had visited Tioman mostly during July and August 2011.

An epidemiologic investigation, initiated in November 2011, is ongoing.

(Via Eurosurveillance - accessed 09/11/12)

Sarcocystis is a zoonotic disease, rare in humans, so this represents a major outbreak. Humans acquire the disease by eating undercooked meat containing viable sarcocysts or by eating or drinking food or water contaminated with animal faeces.

Patients may present with fever and muscle pain while some have also experienced arthralgia, muscle weakness, headache, cough, and diarrhoea.

Advice for Travellers

• Ensure that all meat is very well cooked. Freezing meat to ≤ -5C also kills cysts.
• Strict food and water hygiene methods should be adhered to. Cysts can be destroyed by boiling.

Further information on sarcocystosis.