Cryptosporidiosis
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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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Cryptosporidiosis

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Cryptosporidiosis

Cryptosporidiosis


Infectious agent

Infectious Agent

  • Protozoan

  • Cryptosporidium parvum


Reservoir

Humans

Cattle

Other domestic animals

Reservoir


Life cycle

Life Cycle


Life cycle1

Life Cycle


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


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