In 2002, the French Food Safety Agency drew attention to the lack of information on the prevalence of human cryptosporidiosis in the country. Two years later, the ANOFEL Cryptosporidium National Network (ACNN) was set up to provide public health authorities with data on the incidence and epidemiology of human cryptosporidiosis in France. Constituted on a voluntary basis, ACNN includes 38 hospital parasitology laboratories (mainly in university hospitals). Each laboratory is engaged to notify new cases of confirmed human cryptosporidiosis, store specimens (e.g. stools, duodenal aspirates or biopsies) and related clinical and epidemiological data, using datasheet forms. From January 2006 to December 2009, 407 cryptosporidiosis cases were notified in France and 364 specimens were collected. Of the notified cases, 74 were children under four years of age, accounting for 18.2%. HIV-infected and immunocompetent patients represented 38.6% (n=157) and 28% (n=114) of cases, respectively. A marked seasonal pattern was observed each year, with increased number of cases in mid to late summer and the beginning of autumn. Genotyping of 345 isolates from 310 patients identified C. parvum in 168 (54.2%) cases, C. hominis in 113 (36.4%) and other species in 29 (9.4%), including C. felis (n=15), C. meleagridis (n=4), C. canis (n=4), Cryptosporidium chipmunk genotype (n=1), Cryptosporidium rabbit genotype (n=1) and new Cryptosporidium genotypes (n=4). These data represent the first multisite report of laboratory-confirmed cases of cryptosporidiosis in France.
Heavy Trichuris trichiura infestation is rare in developed countries, and complications requiring surgical intervention have been described rarely in human trichuriasis. A case of colonic obstruction and perforation related to heavy whipworm infection is described in an 84 year old woman. The woman was admitted to hospital because of a chest infection. Two days after admission she suffered nausea and vomiting followed a day later by bowel stoppage. Laparotomy indicated intestinal obstruction by a tumour. A partial right sided ileocolectomy was performed. Pathological examination of the resected bowel revealed heavy infestation with T trichiura causing a pseudotumour following a proliferative inflammatory response. (7 Clin Pathol 1997;50:615-616)
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