Giardia & Cryptosporidium: Protozoan Parasites. FISH/MICROM 490 Spring 2007. Anne Mataia Vanessa Lowe Lisa Crosson Kelsey Davies. Giardia and Cryptosporidium. What disease do these microorganisms cause? What factors aid in transmission? How are these microorganisms related?
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Giardia & Cryptosporidium: Protozoan Parasites
Giardia cysts and Cryptosporidium oocysts
Zoonotic agents are a special class of pathogens that co-evolve with the reservoir host, not with humans. They have a tendency to cause severe disease in humans.
Among children aged 1-5 years with diarrhea, Cryptosporidium parvum may be the most frequently found pathogen.
Spring, 1993- Milwaukee. An outbreak sickened an estimated 400,000 people and contributed to the deaths of more than 50 AIDS and chemotherapy patients. Spring rains and runoff from surrounding farmland had drained into Lake Michigan and overburdened the water supply system. Dairy cattle were the most likely source of this outbreak.
*Over 200,000 people in the US become infected with Giardia every year from contaminated food.
Food borne outbreaks are the result of contamination of food by infected workers or household members
*Giardia lamblia was implicated in 4 of the 15 recent drinking water infectious disease outbreaks in the US.
Major route of transmission: fecal–oral transfer of Giardia cysts, and most occur in child day-care and nurseries.
1998,An outbreak occurred on an USA Naval vessel, infecting hundreds of US sailors. Contaminated water was bunkered at a port in Indonesia. Chlorine residuals were reported as trace. No additional treatment of the ship’s tanks had been performed.
Giardia cysts can survive in low amounts of chlorine
"Diarrhea, which is spread easily in an environment of poor hygiene and inadequate sanitation, kills about 2.2 million people each year, most of them children under five” UNICEF
Water supply, distribution of unserved populations
of unserved population
Asia shows the highest number of people unserved by either water supply or sanitation; yet it is important to note that proportionally, this group is bigger in Africa because of the difference of population size between the two continents.
Source: WHO/UNICEF Joint Monitoring Programme, (2002)
Specificity to host
Ability to persist
Access to water
Sanitary bathroom habits
Access to toilet paper
Proximity to livestock
Microbial Rosetta Stone Database: relates microorganism names, taxonomic classifications, diseases, specific detection and treatment protocols, and relevant literature.
Food and Waterborne Pathogens
Unicellular flagellated Protists
Manifest in 7-10 days
Lasts 2- 6 weeks
May lead to
than Giardia infected children in 2 tests
Partovi et al., 2007
2 trophozoites released per cyst
Multiply by binary fission every 12 h
Sucking disc used for attachment
Cyst forms in transit to colon
carbon dioxide, ethanol, and acetate
composition of lipids in cysts are similar
Jarroll et al, 1989
H.D.A. Lindquist, U.S. EPA
Small (2-5µm) single-celled parasitic protist
Invade and grow intracellularly in mucosal epithelial cells of the stomach and intestine
1895 Clarke first to view Cryptosporidium
1910 Tyzzer named and described Cryptosporidium muris in mice
Recognized as disease agent in 1976
1987 Carrollton,Georgia ~13,000 people ill
1993 Milwaukee, Wisconsin ~400,000 people ill
C. Baileyi, C. canis, C. felis, C. hominis, C meleagridis, C. muris, and C. parvum
C. hominis invasion
Thick-walled oocyst of C. parvum (Scanning Electron Micrograph)
Occurs naturally in a variety of animals
Most common-watery diarrhea
Others include:Abdominal crampsNauseaLow-grade feverDehydrationWeight loss
or no symptoms at all
Schematic representation of Cryptosporidium pathogenesis. Many factors may be involved in the diarrhea associated with cryptosporidiosis. (Modified from Clark and Sears, Parasitology Today 12:221, 1996.)
Images courtesy of the San Francisco PUC
Image courtesy of CDC. Oocysts can be detected with fluorescent antibodies.
Image courtesy of CDC. Diagnostics can involve PCR detection of C. parvum in stool specimen
Treatment with agmatine inhibits Cryptosporidium parvum infection in infant mice
(Moore et al. 2001)
The cell biology of endosymbiosis - how parasites build, divide and segregate the apicoplast
(Vaishnava & Striepen 2006)
51% of waterborne disease outbreaks were preceded by precipitation events above the 90th percentile.
-of these 13% were attributed specifically to Giardia
Curriero et al., 2001
Centers for Disease Control and Prevention: Division of Parasitic Diseases. “Cryptosporidiosis Control and Prevention.” Available online at: http://www.cdc.gov/ncidod/dpd/parasites/cryptosporidiosis/crypto_control_prevent.htm.
Centers for Disease Control and Prevention: Division of Parasitic Diseases. Giardiasis. Available online at: http://www.cdc.gov/Ncidod/dpd/parasites/giardiasis/default.htm
Curriero, F.C., J.A. Patz, J.B. Rose, and S. Lele. 2001. The association between extreme precipitation events and waterborne disease outbreaks in the United States, 1948-1994. American Journal of Public Health 91: 1194-1199.
Danielle Moore, W. Ray Waters, Michael J. Wannemuehler, James A. Harp. Treatment with Agmatine Inhibits Cryptosporidium parvum Infection in Infant Mice.The Journal of Parasitology, Vol. 87, No. 1 (Feb., 2001), pp. 211-213
Ecker DJ, Sampath R, Willett P, Samant V, Massire C, Hall TA, Hari K, McNeil JA, Buchen-Osmond C, Budowle B. The Microbial Rosetta Stone Database: A common structure for microbial biosecurity threat agents. Journal of Forensic Science. 2005;in press
Fayer, R. Cryptosporidium: a water-borne zoonotic parasite. Veterinary Parasitology. (2004) 126:37-56.
Goldstein, S.T., D.D. Juranek, O. Ravenholt, A.W. Hightower, D.G. Martin, J.L. Mesnik, S.D. Griffiths, A.J. Bryant, R.R. Reich, and B.L. Herwaldt. 1996. Cryptosporidiosis: An Outbreak associated with drinking water despite state-of-the-are water treatment. Annals of Internal Medicine 124: 459-468.
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Murray, CJL.; Lopez, AD. The Global Burden of Disease: A Comprehensive Assessment of Mortality and Disability from Diseases, Injuries, and Risk Factors in 1990 and Projected to 2020 (Global Burden of Disease and Injury, Vol. 1). Murray CJL and Lopez PD. , editor. Vol. 1. Boston, WHO; 1996. p. 906.
Partovi, F., G. Khalili, A. Kariminia, H. Mahmaudzadeh-Niknam. 2007. Effect of Giardia lamblia infection on the cognitive function of school children. Iranian Journal of Public Health, 36 (1), pp.73-78.
Patz, J.A., T.K. Graczyk, N. Gellar, and A.Y. Vittor. 2000. Effects of environmental change on emerging parasitic diseases. International Journal of Parasitology 1-11.
Roubin, M.-R. de, J.-S. Pharamond, F. Zanelli, F. Poty, S. Houdart, F. Laurent, J.-L. Drocourt, S. Van Poucke. 2002. Application of laser scanning cytometry folled by epifluorescent and differential interference contrast microscopy for the detection and enumeration of Cryptosporidium and Giardia in raw and potable waters. Journal of Applied Microbiology, 93, pp. 599-607.
San Francisco Department of Public Health - Environmental Health Section. Cryptosporidium Surveillance Project. Available online at: www.dph.sf.ca.us/ ehs/phes/water/crypto.htm
San Francisco Public Utilities Commission."Cryptosporidium White Sheet" Available online at: http://sfwater.org/detail.cfm/MC_ID/10/MSC_ID/51/MTO_ID/71/C_ID/446
Smith, HD, and Corcoran, GD. New drugs and treatment for cryptosporidiosis. Cur Opin Infec Dis. (2004) 6:557-564.
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