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Cryptosporidiosis. Infectious Agent. Protozoan Cryptosporidium parvum. Humans Cattle Other domestic animals. Reservoir. Life Cycle. Life Cycle. Mode of Transmission. Fecal-oral Person to person esp. child care settings Waterborne RWI’s, both natural and swimming pools

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infectious agent
Infectious Agent
  • Protozoan
  • Cryptosporidium parvum
reservoir
Humans

Cattle

Other domestic animals

Reservoir
mode of transmission
Mode of Transmission
  • Fecal-oral
  • Person to person
    • esp. child care settings
  • Waterborne
    • RWI’s, both natural and swimming pools
    • Drinking water
  • Foodborne
susceptible individuals
Susceptible Individuals
  • Immunocompromised
  • Young children
  • Pregnant women
  • AIDS patients
symptoms
Symptoms
  • Diarrhea
    • Weight loss
    • Dehydration
  • Stomach cramps
  • Fever
  • Nausea
  • Vomiting
important considerations
Important Considerations
  • Incubation-1 to 12 days
  • Oocysts survive extreme conditions
  • Oocysts infective for 2-6 months in environment
  • Oocysts are 4-5 microns
  • Infection may result from 10 oocysts
important considerations1
Important Considerations
  • Oocysts in stool appear with symptom onset
  • Oocysts are immediately infectious
  • Oocysts shed for several weeks after symptoms resolve
  • Asymptomatic infections appear to be common
treatment
Treatment
  • Self-limiting in healthy individuals
  • Drink fluids to prevent dehydration
  • A new drug, nitazoxanide, has been approved for treatment of diarrhea
milwaukee 1993
Milwaukee 1993
  • Largest documented waterborne outbreak in U.S. history
  • 403,000 cases
  • 111 deaths
causes of milwaukee incident
Causes of Milwaukee Incident
  • Livestock runoff from record rainfalls entered Milwaukee River
  • Poor design-Drinking water influent too close to wastewater effluent
  • Human errors in drinking water plant
milwaukee illness
Milwaukee Illness
  • Watery diarrhea (93%)
  • Median stools/day=12 (range 1 to 90)
  • Abdominal cramps (84%)
  • Fever (57%)
  • Vomiting (48%)
recreational water illness
Recreational Water Illness
  • 10 documented outbreaks since 1988
  • Contamination by AFRs
  • Highly resistant to chlorination
foodborne outbreaks
Foodborne Outbreaks
  • 1993-Unpasteurized apple cider---apples fell in cow pasture
  • 1995-Chicken salad-contamination by food worker operating home day care
  • 1996-Commercially produced unpasterurized apple cider-contamination by washing with well water having fecal contamination
general prevention
General Prevention
  • Do not swallow recreational water
  • Do not drink untreated water
    • Lakes, rivers, streams, untested wells
    • Travelers and hikers
    • Boil water for 1 minute or use NSF filter rated for “cyst removal.” Don’t rely on chemical treatments
  • Do not swim with GI infection
foodborne prevention
Foodborne Prevention
  • Thoroughly wash all produce
  • No bare hand contact of ready-to-eat foods
  • No food workers with GI illness
    • Until 2 weeks after end of diarrhea
  • Handwashing-handwashing-handwashing