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The article elaborates the details of an outbreak of acute muscular sarcocystosis among travelers in Tioman Island, Malaysia during the summer of 2011. According to the article, Sarcocystis spp. can be acquired by eating undercooked beef or pork containing sarcocyst. Symptoms like fever and muscle pain are presented. The U.S. Centers for Disease Control and Prevention (CDC) posted the outbreak in Malaysia on December 6, 2011 and included some reminders on safe food and water consumption.

The article deals with cases of suspected acute muscular sarcocystosis among travelers returning home from Tioman Island in Malaysia in 2011 identified by the GeoSentinel surveillance program of the International Society of Travel Medicine and the U.S. Centers for Disease Control and Prevention (CDC). Fever and muscle pain were experienced by all patients who were from Europe, North America and Asia. The potential for human to become hosts for Sarcocystis species (spp) is explained.

Background: Through 2 international traveler-focused surveillance networks (GeoSentinel and TropNet), we identified and investigated a large outbreak of acute muscular sarcocystosis (AMS), a rarely reported zoonosis caused by a protozoan parasite of the genus Sarcocystis, associated with travel to Tioman Island, Malaysia, during 2011-2012., Methods: Clinicians reporting patients with suspected AMS to GeoSentinel submitted demographic, clinical, itinerary, and exposure data. We defined a probable case as travel to Tioman Island after 1 March 2011, eosinophilia (>5%), clinical or laboratory-supported myositis, and negative trichinellosis serology. Case confirmation required histologic observation of sarcocysts or isolation of Sarcocystis species DNA from muscle biopsy., Results: Sixty-eight patients met the case definition (62 probable and 6 confirmed). All but 2 resided in Europe; all were tourists and traveled mostly during the summer months. The most frequent symptoms reported were myalgia (100%), fatigue (91%), fever (82%), headache (59%), and arthralgia (29%); onset clustered during 2 distinct periods: "early" during the second and "late" during the sixth week after departure from the island. Blood eosinophilia and elevated serum creatinine phosphokinase (CPK) levels were observed beginning during the fifth week after departure. Sarcocystis nesbitti DNA was recovered from 1 muscle biopsy., Conclusions: Clinicians evaluating travelers returning ill from Malaysia with myalgia, with or without fever, should consider AMS, noting the apparent biphasic aspect of the disease, the later onset of elevated CPK and eosinophilia, and the possibility for relapses. The exact source of infection among travelers to Tioman Island remains unclear but needs to be determined to prevent future illnesses., (Published by Oxford University Press on behalf of the Infectious Diseases Society of America 2014. This work is written by (a) US Government employee(s) and is in the public domain in the US.)