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Cryptosporidiosis

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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  1. Cryptosporidiosis

  2. Infectious Agent • Protozoan • Cryptosporidium parvum

  3. Humans Cattle Other domestic animals Reservoir

  4. Life Cycle

  5. Life Cycle

  6. Mode of Transmission • Fecal-oral • Person to person • esp. child care settings • Waterborne • RWI’s, both natural and swimming pools • Drinking water • Foodborne

  7. Susceptible Individuals • Immunocompromised • Young children • Pregnant women • AIDS patients

  8. Symptoms • Diarrhea • Weight loss • Dehydration • Stomach cramps • Fever • Nausea • Vomiting

  9. 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

  10. 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

  11. Treatment • Self-limiting in healthy individuals • Drink fluids to prevent dehydration • A new drug, nitazoxanide, has been approved for treatment of diarrhea

  12. Milwaukee 1993 • Largest documented waterborne outbreak in U.S. history • 403,000 cases • 111 deaths

  13. 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

  14. Milwaukee Illness • Watery diarrhea (93%) • Median stools/day=12 (range 1 to 90) • Abdominal cramps (84%) • Fever (57%) • Vomiting (48%)

  15. Recreational Water Illness • 10 documented outbreaks since 1988 • Contamination by AFRs • Highly resistant to chlorination

  16. 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

  17. 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

  18. 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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