Laboratory-based surveillance for Cryptosporidium in France, 2006–2009

Abstract

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.

Public health significance of zoonotic Cryptosporidium species in wildlife: Critical insights into better drinking water management

“…( Tamias sp. ), Eastern grey squirrel ( Sciurus carolinensis ), Deer mice ( Peromyscus maniculatus )Emerging human pathogenXIVaA18G2T1, XIVaA18G2T2Jiang et al., 2005, Feltus et al., 2006, Feng et al., 2007, ANOFEL Cryptosporidium National Network, 2010, Insulander et al., 2013, Lebbad et al., 2013, Guo et al., 2015Chipmunk genotype IIEastern chipmunk ( Ramias striatus )No reports in humans to date–Feng et al., 2007, Stenger et al., 2015aChipmunk genotype IIISiberian chipmunk ( Tamias sibiricus )No reports in humans to date–Lv et al., 2009Deer mouse genotype IDeer mouse ( Peromyscus )No reports in humans to date–Xiao et al., 2002b, Feng et al., 2007, Feng et al., 2011bDeer mouse genotype IIDeer mouse ( Peromyscus )No reports in humans to date–Xiao et al., 2002b, Feng et al., 2007Deer mouse genotype IIIDeer mouse ( Peromyscus )No reports in humans to date–Feng et al., 2007, Stenger et al., 2015bDeer mouse genotype IVDeer mouse ( Peromyscus )No reports in humans to date–Feng et al., 2007Ferret genotypeFerret ( Mustelidae ), Siberian chipmunk ( Tamias sibiricus ), River otters (Lontra canadensis), Black-footed ferret ( Mustela nigripes ), Red squirrel ( Sciurus vulgaris )No reports in humans to dateVIIIaA5G2Xiao et al., 2002a; Abe and Iseki, 2003, Gaydos et al, 2007; Kváč et al., 2008, Lv et al., 2009, Feng et al., 2011bGiant panda genotypeGiant panda ( Ailuropoda melanoleuca )No reports in humans to date–Liu et al., 2013Squirrel genotypes I–IIIGolden-mantled ground squirrels ( Callospermophilus lateralis ), Belding's ground squirrels ( Urocitellus beldingi ), California ground squirrels ( Otospermophilus beecheyi ), Black-tailed prairie dog ( Cynomys ludovicianus )No reports in humans to date–Atwill et al., 2004, Pereira et al., 2010, Stenger et al., 2015b…”

Multicentric Evaluation of a New Real-Time PCR Assay for Quantification of Cryptosporidium spp. and Identification of Cryptosporidium parvum and Cryptosporidium hominis

“…In humans, Cryptosporidium parvum and Cryptosporidium hominis are the most frequently detected species, accounting for almost 90% of cases of diagnosed cryptosporidiosis but displaying different prevalence rates in different areas. The two species are almost equally represented in Europe and the United States (3)(4)(5)(6)(7)(8), whereas C. hominis is predominant in tropical regions, reaching a prevalence of up to 88% of identified cases in some countries (9)(10)(11)(12). Several other species also have emerged as causes of cryptosporidiosis in immunocompromised and immunocompetent patients, but at much lower prevalence rates than C. parvum or C. hominis (5,10,11).…”

Subtyping Novel Zoonotic Pathogen Cryptosporidium Chipmunk Genotype I

“…Although most Cryptosporidium spp. from wildlife are host adapted in nature and chipmunk genotype I was initially found in rodents (chipmunks, squirrels, and deer mice) and watershed runoff in New York (3,4), it has been subsequently reported in sporadic cases in humans in the United States and Europe (5)(6)(7)(8). The extent to which human infections with Cryptosporidium chipmunk genotype I are zoonotically transmitted is currently unclear, as there are no subtyping tools for tracking this emerging parasite.…”