CRYPTOSPORIDIUM

CRYPTOSPORIDIUM
 Common name: Crypto
 initially described in mice in 1907 but it was not until 1976
that it was reported in humans
 an intestinal spore-forming protozoa that mainly causes
diarrheal illness
 transmitted via contaminated food or water
 CRYPTOSPORIDIUM
 In healthy individual, typically causes watery or mucoid
diarrhea w/ abdominal pain lasting for several days or
occassionaly weeks that is self -limites even without
treatment.
 It causes more serious disease in immuno compromised
individual, with no effective treatment for those with AIDS
 CRYPTOSPORIDIUM
• C. parvum
– the most commonly identified species considered pathogenic
for man
Genotypes :
1. Human anthroponotic genotype 1 - found almost
exclusively in humans
2. Bovine or zoonotic genotype 2 - found in both ruminants
and human.
*However, studies revealing molecular diversity among human
Cryptosporidium isolates suggest that multiple sub genotypes
or more thatn one sepecies may be implicated in human
disease.
 CRYPTOSPORIDIUM
• All species of Cryptosporidium that have been studied
are obligate intracellular parasites, however, unlike other
coccidians, their developmental stage do not occur deep
within the host cells but are confined to an
extracytoplasmic location.
• Cryptosporidium differs from the other coccidians in its
ability to undergo complete development within a single
host
 Cryptosporidium oocysts
• Resistant to most disinfectants and are difficult to filter
due to their small size, thus enabling them to persist and
spread in the environment.
*Alcohol-based hand sanitizers do not effectively kill
Cryptosporidium
*Swimming pool disinfection with 3 to 5 mg/L of chlorine does not
kill the oocysts
Cryptosporidium spp. oocysts are rounded and measure 4.2 to 5.4
µm in diameter. Sporozoites are sometimes visible inside the
oocysts, indicating that sporulation has occurred.
Cryptosporidium sp. oocysts stained with
modified acid-fast.
Cryptosporidium sp. oocysts unstained on a
slide stained with modified acid-fast.
Cryptosporidium sp. oocysts stained with
Ziehl-Neelsen modified acid-fast.
Cryptosporidium parvum oocysts stained with
the fluorescent stain auramine-rhodamine.
Oocysts of C. parvum and cysts of Giardia
duodenalis labeled with immunofluorescent
antibodies.
 Mode of Transmission
• Zoonotic and person to person
– Direct Transmission
– Indirect Transmission

• Autoinfection
 Pathogenesis and Clinical Manifestation
 Symptoms of cryptosporidiosis generally begin 2 to 10 days
(average 7 days) after becoming infected with the parasite. The
most common symptom of cryptosporidiosis is watery diarrhea.
Symptoms include:
• Watery diarrhea
• Stomach cramps or pain
• Dehydration
• Nausea
• Vomiting
• Fever
• Weight loss
 Pathogenesis and Clinical Manifestation
People who are in poor health or who have weakened
immune systems are at higher risk for more severe and
prolonged illness.
Young children and pregnant women may be more
susceptible to dehydration resulting from diarrhea and
should drink plenty of fluids while ill.
Rapid loss of fluids from diarrhea may be especially life
threatening to babies.
 Pathogenesis and Clinical Manifestation
• While the small intestine is the site most commonly affected, in
immunocompromised persons Cryptosporidium infections could possibly
affect other areas of the digestive tract or the respiratory tract.
• People with weakened immune systems may develop serious, chronic, and
sometimes fatal illness. Examples of people with weakened immune systems
include:
people with AIDS;
those with inherited diseases that affect the immune system; and
cancer and transplant patients who are taking certain
immunosuppressive drugs.
The risk of developing severe disease may differ depending
on each person's degree of immune suppression.
 Diagnosis
 Most often, stool specimens are examined microscopically using
different techniques (e.g., acid-fast staining, direct fluorescent
antibody [DFA] , and/or enzyme immunoassays for detection of
Cryptosporidium sp. antigens).
 Immunoassay procedures for the direct detection of
Cryptosporidium antigen or oocysts in fecal specimen have
proven to be much more sensitive than the routine acid fast
stains.
 Molecular methods (e.g., polymerase chain reaction – PCR) are
increasingly used in reference diagnostic labs, since they can be
used to identify Cryptosporidium at the species level.
 Treatment
 Most people who have healthy immune systems will recover
without treatment. Diarrhea can be managed by drinking plenty of
fluids to prevent dehydration.
 Nitazoxanide has been FDA-approved for treatment of diarrhea
caused by Cryptosporidium in people with healthy immune
systems and is available by prescription.
 For those persons with AIDS, anti-retroviral therapy that improves
the immune status will also decrease or eliminate symptoms of
cryptosporidiosis. However, even if symptoms disappear,
cryptosporidiosis is often not curable and the symptoms may
return if the immune status worsens.
 Epidemiology
• Most common cause of waterborne disease in the United
Kingdom
• In the United States, the Milwaukee cryptosporidiosis
outbreak in 1993 was the largest outbreak of waterborne
disease ever reported in the united States due to Lake
Michigan water contaminated with Cryptosporidium
oocysts
• Prevalence in the Philippines has been reported to be low
at 2.6%
 Prevention and Control
 Practice Good Hygiene
 Avoid Water That Might Be Contaminated
 Prevent Contact and Contamination With Feces During
Sex
 Practice Extra Caution While Traveling