Cryptosporidiosis is a parasitic disease of the gastrointestinal tract which has only been recognised as a disease of humans since 1976. There have been large outbreaks of the disease in many parts of the world including over 400,000 people in Milwaukee (USA) in 1993 and many hundreds of cases occur in western Europe including ones in England and also some in Ireland.
Transmission of Cryptosporidiosis
Cryptosporidiosis is transmitted through the ingestion of contaminated food or water. This contamination may have occurred from contact with the infected stool of either an animal or from another human. Frequently this is by drinking contaminated water (even brushing your teeth in infected tap water may be sufficient). Eating undercooked or raw food (typically cold vegetables etc.) may also be a source of infection.
Symptoms of Cryptosporidiosis
In humans the first evidence that there may be an infection may not occur for up to two weeks after exposure. Many patients will experience an abdominal complaint within 48 hours.
The spectrum of the disease in humans can be divided into three levels; mild, moderate and severe.
Mild; In many patients the disease may not be evident to any great extent and it is then only diagnosed on careful examination of the stool specimen. These patients may spread the disease to others despite the fact that they are not suffering any particular ill effects themselves.
Moderate; In others the disease may present with waves of tiredness, lethargy, headaches, loose bowel motions, nausea and vomiting. These patients may also have a low grade fever and notice weight loss over a period of time. Frequently the signs and symptoms of the disease in these patients lessen with the passage of time (often a few weeks) and then the patients own defences work to eradicate the disease from the body.
Severe; Under most circumstances the disease process does not develop into the severe stage. Nevertheless in patients with an underlying deficiency of their immune system (following transplantation, those with AIDS or on Steroids etc.) a very severe state can occur. These patients can present with profuse diarrhoea and significant crampy abdominal pain. Fever and headache may also be prominent features of cryptosporidiosis infection and even death can follow in those severely affected.
The diagnosis of this disease is more complicated than the normal routine examination of the stool sample which is carried out for the diagnosis of standard ova and parasites. Special stains are required and the possibility of this condition must be considered by the doctor to ensure that the laboratory are informed of this possible diagnosis.
Treatment for Cryptosporidiosis
At this point in time there is no clear effective treatment to ensure eradication of the parasite from the body. Patients treated with Metronidazole (Flagyl) frequently improve clinically though the parasite may still be present in their stool sample.
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