1049 An outbreak of cryptosporidiosis in a day care center

Alpert, Gershon; Bell, Iain; Kirkpatrick, Carl E.; Budnick, Lawrence D.; Campos, Joseph M.; Friedman, Harvey M.; Plotkin, S. A.

doi:10.1203/00006450-198504000-01079

Cited by 35 publications

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“…The TRAP-C2 gene sequence analysis of oocyst specimens from several North American outbreaks, including an isolate from the Cranbrook outbreak, demonstrated that these two major genotypes could be associated with two different cycles of transmission, i.e., either zoonotic transmission, which has been mainly bovine-to-human, 4,5 or person-to-person transmission. 9,10 The analysis of patient isolates from the Cranbrook and Maine outbreaks using more than one polymorphic gene locus confirmed that the parasite genotype was an animal genotype. This showed that transmission was associated with exposure of these patients to cryptosporidiosis-infected animals.…”

Section: Discussionmentioning

confidence: 99%

“…In urban areas, the transmission of cryptosporidiosis from person to person has been documented. [9][10][11] Molecular epidemiology has been used recently to characterize the genotype of C. parvum isolates from 5 North American cryptosporidiosis outbreaks and to associate parasite genotype with disease transmission cycles. 12 Several polymorphic gene loci such as the thrombospondin-related adhesion protein (TRAP-C2) gene, 12 the internal transcribed spacer 1 (ITS1), 13 the 18S rRNA gene, 14 the 190-kD oocyst wall protein gene, 15 the dihydrofolate reductase-thymidylate synthase gene, 16 an anonymous non-telomeric repetitive gene, 17 and a threonine-rich open reading frame (ORF) 18 have been amplified by the polymerase chain reaction (PCR) and identified by sequencing as well as restriction mapping.…”

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confidence: 99%

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Molecular epidemiology of cryptosporidiosis outbreaks and transmission in British Columbia, Canada.

Ong¹,

Eisler²,

Goh³

et al. 1999

The American Journal of Tropical Medicine and Hygiene

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Abstract.Isolates from 25 (13 sporadic and 12 outbreak) cryptosporidiosis cases, 24 of which were from British Columbia, Canada, were characterized using nested polymerase chain reaction amplification of the polymorphic internal transcribed spacer 1 locus. Two predominant Cryptosporidium parvum genotypes were found. Twelve (8 sporadic and 4 outbreak) isolates amplified with the cry7/cry21 primer pair and 12 (5 sporadic and 7 outbreak) isolates amplified with the cry7/cryITS1 primer pair. Multi-locus gene analysis using sequence polymorphisms on 3 other loci, i.e., the thrombospondin-related adhesion protein gene, the dihydrofolate reductase gene, and the 18S rRNA gene on 8 (4 outbreak and 4 sporadic) isolates showed non-random association among the human and animal alleles of the 4 different C. parvum gene loci. Associations between these 2 parasite genotypes and different routes of cryptosporidiosis transmission such as zoonotic, anthroponotic, and waterborne transmission were studied using municipal population and agricultural information, as well as detection of C. parvum oocysts in municipal drinking water specimens of the residential communities of sporadic and outbreak cases.Within the last 10 years, several waterborne cryptosporidiosis outbreaks have occurred in North America.

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Section: Discussionmentioning

confidence: 99%

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confidence: 99%

Molecular epidemiology of cryptosporidiosis outbreaks and transmission in British Columbia, Canada.

Ong¹,

Eisler²,

Goh³

et al. 1999

The American Journal of Tropical Medicine and Hygiene

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“…O criptosporídio tem sido relatado em todas as partes do mundo com uma prevalência, entre as crianças diarréi-cas, de 1,9 a 19% dos casos 1,5,6,9,14,18 e, no Brasil, entre 0,5 a 21,3% 2,10,12,16,20 . Os percentuais mais elevados têm sido observados entre crianças procedentes de famílias de baixas condições sócio-econômicas, nas quais a contaminação ambiental é elevada.…”

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“…Cerca de 10% dos episódios diarréi-cos agudos na infância estão relacionados com os protozoários e, dentre estes, o Cryptosporidium sp, ocupa lugar de destaque 7,11,12,18 . Descrito inicialmente como agente etiológico importante entre indivíduos imunodeprimidos, posteriormente se constatou que se relacionava com quadros diarréicos agudos em pacientes imunocompetentes de todas as idades, de modo particular na criança 4,8,9,14,18,19,21 .O criptosporídio tem sido relatado em todas as partes do mundo com uma prevalência, entre as crianças diarréi-cas, de 1,9 a 19% dos casos 1,5,6,9,14,18 e, no Brasil, entre 0,5 a 21,3% 2,10,12,16,20 . Os percentuais mais elevados têm sido observados entre crianças procedentes de famílias de baixas condições sócio-econômicas, nas quais a contaminação ambiental é elevada.…”

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“…Os percentuais mais elevados têm sido observados entre crianças procedentes de famílias de baixas condições sócio-econômicas, nas quais a contaminação ambiental é elevada. Nos países desenvolvidos, ele é descrito com maior freqüência entre pacientes institucionalizados 1,17 .O quadro diarréico é autolimitado na maioria das crianças infectadas, mas pode apresentar um curso prolongado, principalmente entre crianças desnutridas 13 .A maioria dos estudos realizados no Brasil 2,12,20 refere-se apenas aos percentuais de identificação do protozoário nas fezes de crianças diarréicas e assintomáticas. É nosso objetivo descrever as características e o curso clínico da diarréia Cryptosporidium-positiva em um grupo de lactentes na cidade do Recife.…”

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Acute infant diarrhea associated to cryptosporidium sp., in the city of Recife

Ga¹,

Magalhães²,

Oliveira³

et al. 1994

J Pediatr (Rio J)

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IntroduçãoA diarréia aguda é, na quase totalidade dos casos, de etiologia infecciosa. Cerca de 10% dos episódios diarréi-cos agudos na infância estão relacionados com os protozoários e, dentre estes, o Cryptosporidium sp, ocupa lugar de destaque 7,11,12,18 . Descrito inicialmente como agente etiológico importante entre indivíduos imunodeprimidos, posteriormente se constatou que se relacionava com quadros diarréicos agudos em pacientes imunocompetentes de todas as idades, de modo particular na criança 4,8,9,14,18,19,21 .O criptosporídio tem sido relatado em todas as partes do mundo com uma prevalência, entre as crianças diarréi-cas, de 1,9 a 19% dos casos 1,5,6,9,14,18 e, no Brasil, entre 0,5 a 21,3% 2,10,12,16,20 . Os percentuais mais elevados têm sido observados entre crianças procedentes de famílias de baixas condições sócio-econômicas, nas quais a contaminação ambiental é elevada. Nos países desenvolvidos, ele é descrito com maior freqüência entre pacientes institucionalizados 1,17 .O quadro diarréico é autolimitado na maioria das crianças infectadas, mas pode apresentar um curso prolongado, principalmente entre crianças desnutridas 13 .A maioria dos estudos realizados no Brasil 2,12,20 refere-se apenas aos percentuais de identificação do protozoário nas fezes de crianças diarréicas e assintomáticas. É nosso objetivo descrever as características e o curso clínico da diarréia Cryptosporidium-positiva em um grupo de lactentes na cidade do Recife. Casuística e métodosForam estudados 156 lactentes com quadro diarréico (caracterizado pelo início abrupto, presença de três ou mais evacuações de fezes não-formadas ao dia e com duração máxima de cinco dias) e 80 lactentes assintomá-ticos (grupo-controle). No grupo diarréico a mediana de ARTIGO ORIGINAL Diarréia aguda do lactente associada ao Cryptosporidium sp., na cidade de Recife Acute infant diarrhea associated to cryptosporidium sp., in the city of Recife

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Protozoal infections in the acquired immunodeficiency syndrome

Sun

Teichberg

1988

J. Elec. Microsc. Tech.

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Several protozoa have emerged as the major opportunistic infections and cause of death in patients with acquired immunodeficiency syndrome (AIDS). Pneumocystis carinii pneumonia is the leading cause of death in AIDS patients. Electron microscopy (EM) usually shows numerous trophozoites and cysts of Pneumocystis filling up the entire alveolar space, while only cysts are seen under the light microscope. The focal thickening of cyst wall of Pneumocystis, as demonstrated by EM and manifested as a "parentheses" shaped structure with silver stain, serves as a diagnostic marker for Pneumocystis. Freeze-fracture EM has demonstrated the intimate contact between Pneumocystis trophozoites and the type I pneumocytes, which may contribute to the alveolar-capillary block, leading to severe respiratory distress. However, EM is seldom needed for the diagnosis of this infection. Toxoplasma encephalitis, which is an unusual clinical manifestation in cases of toxoplasmosis reported previously, has become a common complication and one of the major causes of death in patients with AIDS. Because subclinical infection by Toxoplasma is common, serologic tests usually offer no definite answers as to whether the infection is acute or chronic, active or past. The small size and its non-specificity in both morphology and tissue affinity make light microscopic diagnosis of toxoplasmosis difficult. Only immunologic staining, such as immunoperoxidase and immunofluorescence, can help to achieve a definite positive identification of the organism. When special antibodies or facility for such staining is not available, EM is the final resort for identifying Toxoplasma by showing the apical complex with the characteristic sausage-shaped rhoptries. Cryptosporidiosis, practically unknown before the AIDS outbreak, has become one of the most common intestinal protozoa in both immunocompromised and immunocompetent patients. The protracted and sometimes fatal course of cryptosporidiosis in immunocompromised patients can be explained by the presence of autoinfective oocysts (thin-walled oocysts), as detected by EM, and by recycling of first-generation schizonts observed experimentally. While diagnosis of cryptosporidiosis can be made by detection of oocysts in stools in most cases, EM is still the last resort for a definitive identification of Cryptosporidium species. While the incidence of isosporiasis is still low, it has been found more frequently in patients with AIDS than in the general population. The parasite, Isospora belli, being a coccidian as is the Cryptosporidium species, is similar to the latter in its life cycle and clinical manifestations.(ABSTRACT TRUNCATED AT 400 WORDS)

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1049 An outbreak of cryptosporidiosis in a day care center

Cited by 35 publications

References 0 publications

Molecular epidemiology of cryptosporidiosis outbreaks and transmission in British Columbia, Canada.

Molecular epidemiology of cryptosporidiosis outbreaks and transmission in British Columbia, Canada.

Acute infant diarrhea associated to cryptosporidium sp., in the city of Recife

Protozoal infections in the acquired immunodeficiency syndrome

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