SUBMITTED TO :

MR. PANKAJ JAIN

SUBMITTED BY: GROUP 7

MANPREET SINGH (34)
MEETPAL SINGH (35)
NITIN SHARMA (36)
CHANDNI BHANOT (37)
MUKESH VERMA (38)
KANIKA SHARMA (39)
 CONTENTS

• Overview

• What is Cryptosporidium?

• The Life Cycle of Cryptosporidium

• How is Cryptosporidium transmitted?

• How would I be exposed to Cryptosporidium?

• What are the symptoms of Cryptosporidiosis?

• How is cryptosporidiosis diagnosed and treated?

• What should I do if I become infected with

Cryptosporidium?

• How can cryptosporidiosis be prevented?

• How can Cryptosporidium be removed from water?

 OVERVIEW
In today’s time a lot of diseases are there just waiting for their one more
victim. These diseases are generally caused by the diseases causing agents
which are broken into three groups: - Bacteria, Viruses, and protozoan (word
protozoa is a Greek word means ‘little animal’). Cryptosporidium is also
one of the protozoa which cause serve water diseases. It is a troubling
disease as this disease can’t be rectified from water by the spray of chlorine
in it. Cryptosporidium during his life cycle produces a large number of small
spores which are called as cysts. These cysts have hard outer covering and
are resistant to the effect of chlorine, hence contaminate water. It can survive
for long time i9n cold and damp environment. There are mainly two types of
cryptosporidium protozoa’s which cause diseases tom human beings are: -
cryptosporidium parvum and cryptosporidium hominis.

It is an emerging protozoan diseases which was firstly reported in 1976,

before which it was not known that it cause diseases to humans. This disease
came in the eyes internationally in 1933 when an operation failure at water
treatment plant in Milwaukee, Wisconsin, led to a massive outbreak of
cryptosporidium due ton which around 403000 peoples became ill , 4400
were hospitalized and an estimated 60 people died as a result of that
outbreak. In US the proportion of water borne diseases due to protozoa has
tripled over that of last decade.

One of the major, problems associated with this is that it is difficult to test
for cryptosporidium as for testing this, it involves filtering a large volume of
water and the use of mono-clonal antibodies and immuno-fluorescent
staning. This test can’t be performed on the regularly basis, so the facial
coliforms were a good indicator of the presence or absence of
cryptosporidium, but it not works every time as a good indicator as records
shows that 49% of outbreaks doesn’t contain coliforms where protozoa were
the cause of illness. One of the interesting facts about this protozoon is that
it is not killed by the action of chlorine. This is a protozoal infection from
drinking contaminated drinking water. This particular protozoan does not
filter out during normal water purification.
There various methods for managing the cryptosporidium risks, it involve
methods such as Multi barrier method which involve Membrane filtration,
UV (ultra-violet) disinfection. These methods generally very expensive and
has not adopted widely in many countries. However membrane costs are
decreasing and membrane filtration is now very commonplace. This method
insures 99.999%-99.99999% removal of this protozoon. The next method
after filtration is disinfection which is done through UV-rays. UV-rays are
used ion place of chlorine as chlorine has no effect on cryptosporidium
protozoa.
So, this case study is mainly tells something about the causes, treatments
and it’s effects on humans.

What is Cryptosporidium?
Cryptosporidium is a parasite found in water that cause infection inside the
water that infects the small intestine of a variety of mammals, including
humans, leading to the illness Cryptosporidiosis. It belongs to the Protozoa
(Bacteria). In other words Cryptosporidium is a parasite that infects the
intestines.

When a person gets sick, it is called Cryptosporidiosis. Cryptosporidiosis

is a water-borne disease. Cryptosporidium is a common cause of diarrhea in
B.C. and the world. Cryptosporidiosis is characterized by diarrhea,
vomiting, stomach cramps and fever. In immuno suppressed patients, such
as those with AIDS and the elderly, the disease is likely to be more serious
and as yet there is no effective treatment.

The Life Cycle of Cryptosporidium

Cryptosporidium is present in aquatic environments, usually in small
numbers, and is found more commonly in surface waters than in
groundwater. It exists outside the host as oocysts and is closely associated
with livestock. Oocysts are very resistant to adverse factors and can lie
dormant for months in cool moist conditions. The life cycle begins with
ingestion of the oocyst, a tiny spore-like organism, which contains within it
the infective form the sporozoite. The entire life cycle takes place within one
host and then oocysts are shed in the faeces of the affected individual. When
ingested by another animal, a new cycle of infection begins.
How is Cryptosporidium transmitted?

Cryptosporidium can be transmitted from one infected person to another,

from contact with an infected animal or from contaminated food or water.
The bacterium which causes Legionnaire's disease is normally present at low
levels in potable water supplies. Under the right conditions (particularly
moderately hot water temperatures, from about 90 to 130 degrees
Fahrenheit, and in the presence of nutrients), its population may greatly
increase. If droplets of contaminated water get into the air and are inhaled by
a susceptible individual, he may contract the disease

Cryptosporidium is spread when feces from infected people or animals get

into the mouth by:

• Eating or drinking contaminated food or drink; or

• Contact with the feces of infected people that is not followed by
proper hand washing, such as after diaper changing, or during sexual
contact; or
• Contact with the feces of domestic or wild animals, including pets and
farm animals that is not followed by proper hand washing.

How would I be exposed to Cryptosporidium?

Cryptosporidium are very hardy organisms that survive for long periods in
the environment including in cold water. You can ingest Cryptosporidium
oocysts by:

• Drinking poorly treated surface water from sources such as streams,

rivers, lakes or shallow wells that are contaminated by human or
animal feces; or
• Swallowing contaminated water while swimming in lakes, ponds,
streams, rivers, swimming pools and hot tubs.
What are the symptoms of Cryptosporidiosis?
Cryptosporidiosis may cause frequent watery diarrhea, stomach cramps,
nausea, vomiting, mild fever and dehydration. Young children and the
elderly may be at risk of getting dehydrated

Symptoms start two to 10 days after exposure to the parasite, with an

average of seven days. Symptoms usually last for one to two weeks in
people who are otherwise healthy. The infection may last longer in people
with a weakened immune system. People with AIDS, those who have had an
organ or bone marrow transplant, and those who have had cancer treatment
are examples of people who may get serious infections.

Often a person can be infected and have no symptoms. In some cases,

symptoms can return after you have started to get better.

How is Cryptosporidiosis diagnosed and treated?

If you think you have cryptosporidiosis, or any persistent diarrhea see your
family doctor for testing, advice and follow-up. You will be asked to submit
a stool sample for testing. Your doctor will give you treatment advice to suit
your particular needs, which may include medications to stop the diarrhea.
People with cryptosporidiosis should drink fluids to prevent dehydration.

What should I do if I become infected with Cryptosporidium?

Cryptosporidium is passed in the feces; therefore people with diarrhea who
cannot control their bowel movements should not go to work or school.

If you have a Cryptosporidium infection do not swim in lakes, ponds,

streams, rivers, swimming pools and hot tubs while you have diarrhea and
until at least 48 hours after the diarrhea has stopped. Avoiding this activity
will help to ensure that other swimmers do not become infected.

If you are a food handler or health care worker it is possible for you to
transmit Cryptosporidium to others. Do not work while you have diarrhea or
vomiting and do not return to work until 48 hours after your last loose stool
or episode of vomiting. Wash your hands well and often, which will help
you to recover and lessen the chance of spreading the infection to others.

Children in daycare who have diarrhea can be cared for in a supervised area
away from other children until picked up by their parents. Children cannot
return to daycare until 48 hours after their last loose stool or episode of
vomiting. Children in daycares should be supervised by an adult when
washing their hands.

When you recover you may excrete Cryptosporidium in your stools for
several weeks and possibly infect others. After using the toilet and before
eating or preparing foods, wash your hands well with liquid soap and water.

How can Cryptosporidiosis be prevented?

• If your local Medical Health Officer has issued a Boil Water Advisory
or notice for your community water system, take the advice seriously.
• If you have a weakened immune system, you should discuss your risk
of Cryptosporidiosis with your doctor. This includes people with
HIV/AIDS, cancer and transplant patients taking immunosuppressive
drugs. People who wish to take extra precautions can boil their
drinking water, as outlined below.
• Do not drink untreated surface water from a spring, stream, river, lake,
pond or shallow well. It is likely contaminated with animal feces.
When camping do not relieve yourself within 100 feet of a water
source.
• Do not drink unpasteurized milk or juices.
• Avoid uncooked food or drinks prepared with untreated water,
especially during international travel.
• Wash your hands before eating and handling food, and after using
the toilet, changing diapers, or after touching animals.
 • Make sure children, especially those who handle pets, wash their
hands carefully before eating and on a regular basis.
• Avoid contact with feces during sexual activity.

How can Cryptosporidium be removed from water?

There are some suggestions Cryptosporidium from water:

1. Boiling: Boil or filter water from sources that are used for drinking,
making ice cubes, washing uncooked fruits and vegetables, making
baby formula, brushing teeth or rinsing dentures. Bring water to a
rolling boil for at least one minute and then allow it to cool. At
elevations over 2,000 meters (6,562 feet) you should boil water for at
least two minutes to disinfect. Boiling will not purify water that is
heavily polluted or chemically contaminated.
2. Membrane Filtration: It should be noted that conventional filtration
techniques, sand filtration for example, are actually very effective in
providing significant reductions in Cryptosporidium. A well-operated
sand filter can achieve in excess of 99% removal of Cryptosporidium
cysts. To remove Cryptosporidium oocysts, filters must have an
absolute pore size of one micron or be certified by an organization
accredited by the National Standards Foundation (NSF) for oocyst
removal. Jug-type water filters will not remove Cryptosporidium.
Some built-in water filtration systems will remove Cryptosporidium,
but they need regular and thorough maintenance to work well.
3. Ultraviolet light (UV) Disinfection Ultraviolet light is an emerging
disinfection technology which is gaining more widespread acceptance
in recent years, particularly in the context of providing protection
against Cryptosporidium.
4. Chlorine This is a key point. For the past one hundred years chlorine
has proved to be a reliable and effective disinfectant. In fact, the
introduction of filtration and chlorination of drinking water has been
the single biggest factor in reducing mortality rates and increasing
longevity in the developed world in the 20th century