Cryptosporidium

Cryptosporidium is a protozoan that is often associated with diarrhea in humans.

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General characteristics

Cryptosporidium is a protozoan pathogen of the Phylum Apicomplexa and causes a diarrheal illness called cryptosporidiosis. Other apicomplexan pathogens include the malaria parasite Plasmodium, and Toxoplasma, the causative agent of toxoplasmosis. Unlike Plasmodium, which transmits via a mosquito vector, Cryptosporidium does not utilize an insect vector and is capable of completing its life cycle within a single host, resulting in cyst stages which are excreted in feces and are capable of transmission to a new host.

A number of species of Cryptosporidium infect mammals. In humans, the main causes of disease are C. parvum and C. hominis (previously C. parvum genotype 1). C. canis, C. felis, C. meleagridis, and C. muris can also cause disease in humans. In recent years, cryptosporidiosis has plagued many commercial Leopard gecko breeders. Several species of the Cryptosporidium family (C. serpentes and others) are involved, and outside of geckos it has been found in monitor lizards, iguanas, tortoises as well as several snake species.

Cryptosporidiosis is typically an acute short-term infection but can become severe and non-resolving in children and immunocompromised individuals such as AIDS patients. The parasite is transmitted by environmentally hardy cysts (oocysts) that, once ingested, excyst in the small intestine and result in an infection of intestinal epithelial tissue.

The genome of Cryptosporidium parvum was sequenced in 2004 and was found to be unusual amongst Eukaryotes in that the mitochondria seem not to contain DNA ^[1]. A closely-related species, C. hominis, also has its genome sequence available ^[2]. CryptoDB.org is a NIH-funded database that provides access to the Cryptosporidium genomics data sets.

Life cycle

Cryptosporidium has a spore phase (oocyst) and in this state can survive for lengthy periods outside a host and also can resist many common disinfectants, notably chlorine based disinfectants.^[3]

Because of this resistance, water purification to eliminate Cryptosporidium generally relies upon coagulation followed by filtration or boiling.

Recently, it has been discovered that Cryptosporidium is sensitive to ultraviolet light and ozonation, and water treatments based on these sterilization methods are being developed.^[4][5]

Treatment of drinking water

Most treatment plants that take raw water from rivers, lakes, and reservoirs for public drinking water production use conventional filtration technologies. This involves a series of processes including coagulation, flocculation, sedimentation, and filtration. Direct filtration, which is typically used to treat water with low particulate levels, includes coagulation and filtration but not sedimentation. Other common filtration processes are slow sand, diatomaceous earth filter, membranes, and bag and cartridge filters. Conventional, direct, slow sand and diatomaceous earth technologies will remove 99% of Cryptosporidium.^[6] Membranes and bag and cartridge filters remove Cryptosporidium on a product-specific basis. With the proper concentrations and contact time, Cryptosporidium inactivation will occur with chlorine dioxide and ozone treatment. Additionally, ultraviolet light treatment at relatively low doses will inactivate Cryptosporidium.

People with risk of exposure to waterborn spores of cryptosporidium

• People exposed to contaminated drinking water.
• Hikers and campers who drink untreated, unfiltered water.
• Swimmers who swallow water from pools, lakes and rivers.
• Those who drink from shallow, open wells.
• Travelers to Third World countries.

People with risk of exposure to cryptosporidium from sources other than water

• Children who attend child-care centers, especially where diaper-changing is done.
• Parents of infected children.
• Child-care workers.
• Animal handlers.
• People who have oral-to-anal sex.

Cases of cryptosporidiosis can occur in a city that does not have a contaminated water supply. In a city with clean water, it may be that cases of cryptosporidiosis have different origins. Testing of water, as well as epidemiological study, are necessary to determine the sources of specific infections. Note that cryptosporidium typically does not cause serious illness in healthy people. It may chronically sicken some children, as well as adults who are exposed and immunocompromised. A subset of the immunocompromised population is people with AIDS. A subset of people with AIDS, especially some sex workers and some gay men, engages in behaviors that can transmit the parasite directly.

Outbreaks in Western USA and Norway, 2007

On September 21, 2007, Cryptosporidium outbreak attacked the Western United States: 230 Idaho residents, with hundreds across the Rocky Mountain area; in the Boise and Meridian areas; Utah, 1,600 illnesses; Colorado and other Western states - Montana, decrease.^[7]

There is also an on-going (October 2007) alleged outbreak in Oslo (but doubts remain about confirmation).

See also

• Cryptosporidiosis
• Milwaukee Cryptosporidium outbreak
• Cryptosporidium in Galway
• 2002 Glasgow floods

References

1. ^ Complete Genome Sequence of the Apicomplexan, Cryptosporidium parvum. Science/AAAS. Retrieved on 2007-05-06.
2. ^ The genome of Cryptosporidium hominis.
3. ^ Chlorine Disinfection of Recreational Water for Cryptosporidium parvum. CDC. Retrieved on 2007-05-06.
4. ^ Irreversible UV inactivation of Cryptosporidium spp. despite the presence of UV repair genes.. NCBI PubMed. Retrieved on 2007-05-06.
5. ^ Ultraviolet Disinfection and Treatment. AWWARF.org. Retrieved on 2007-05-06.
6. ^ The Interim Enhanced Surface Water Treatment Rule – What Does it Mean to You? (pdf). USEPA. Retrieved on 2007-05-06.
7. ^ Yahoo.com, Cryptosporidium outbreak hits the West

• White, A. Clinton, Jr. "Cryptosporidiosis". In Mandell, G et al, eds., Principles and Practice of Infectious Diseases, 6th edition; Elsevier, 2005, pp 3215-28.
• Upton, Steve J. (2003-09-12). Basic Biology of Cryptosporidium (Website). Kansas State University: Parasitology Laboratory.
• The Taxonomicon & Systema Naturae (Website database). Taxon: Genus Cryptosporidium. Universal Taxonomic Services, Amsterdam, The Netherlands (2000).