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Cryptosporidium

What is Cryptosporidium? Cryptosporidium is a five micrometer microscopic intracellular protozoal parasite that was first associated with human gastro-intestinal disease in 1976. With the advent of the acquired immunodeficiency syndrome (AIDS) epidemic, Cryptosporidium infections became increasingly recognized as a cause of diarrheal illness.

Today, Cryptosporidium is known as a ubiquitous parasite (meaning this thing is everywhere!), able to infect many different species of animals including mammals, birds, and reptiles to cause symptoms in persons who don’t have strong immune systems. Your doctor can see the little cysts in the feces, especially when they are treated with acid fast staining techniques.

The pictures are from scanning electron microscopic studies—something that  doesn't routinely get done routinely at your doctor’s office.

Cryptosporidium (Cysts and the protozoa inside the intestine). The picture on the right is a specially stained fecal sample. 

Common Sources of Infection—This highly infectious organism is passed through direct oral contact via food, infected feces and contaminated water.

Symptoms of Cryptosporidium: Fever, right upper-quadrant pain, jaundice, nausea, and vomiting but not necessarily with concomitant diarrhea. Nonspecific respiratory symptoms, including shortness of breath, wheezing, cough, hoarseness, and croup, may be a manifestation of infection in the respiratory tree. Watery diarrhea, which may also contain mucus, and dehydration are the most common signs that are related to GI cryptosporidiosis.

Humans can have daily losses of up to 15-20 liters of fluids with severe infection which is enough to kill. Dehydration like this puts a big strain on the heart and the result can be heart failure (Parvo—a viral infection—in the dog and cat kill in this manner which is why intravenous fluids are SO important with many kinds of infections that cause diarrhea.)  Secondary malabsorption of fat, D-xylose, and vitamin B-12 has been noted in some cases. Other signs that are related to GI illness include right upper quadrant or upper stomach tenderness, icterus (also called jaundice), and, rarely, ascites related to pancreatic involvement. Ascites is a build up of fluid in the abdominal area.

Also seen is reactive arthritis that affects the hands, knees, ankles, and feet. It is thought that the parasite releases toxins (these are called endotoxins in the medical world) and these toxins are responsible for the pain.

While on our large animal block in veterinary school a few of my classmates were exposed to crypto via some of the calves who had diarrhea. Let me tell you first-hand. This is bad stuff.

Life Cycle of Cryptosporidium: Transmission is from farm livestock to humans or from person to person. Outbreaks in childcare centers are not rare. Extensive waterborne outbreaks have occurred from contamination of municipal water and swimming pools. Although less common, transmission through certain sexual practices involving oro-anal contact has been documented.

Treatment of Cryptosporidium: Rehydration, discontinue immunosuppressive drugs (like chemotherapy and steroids). Although not that effective, some people have been helped with the antibiotics spiramycin, furazolidone or alpha-difluoromethylornithing (DFMO). My opinion? There are certain homeopathics that work wonderfully for this disease when nothing else seems to help (with fewer side-effects).

Prevention of Cryptosporidium Prevention methods include the installation of more advanced in-home water filtration systems, constant testing of water supply, and educating populations about the signs of the disease and ways to prevent it. The distribution of Cryptosporidium is worldwide, but outbreaks are especially common in developing countries. This one really spreads easily. Sterile technique is essential for prevention of spread. (See our water section for these systems.)

References:

·        http://www.nsf.gov/news/speeches/colwell/rc02abelwolman/sld033.htm

·        http://www.emedicine.com/ped/topic516.htm

·        http://www.waterfilterreview.com 

·        Sterile Technique Information: http://cabellsociety.20m.com/custom2.html

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