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| {{DiseaseDisorder infobox | | | {{DiseaseDisorder infobox | |
| Name = {{PAGENAME}} | | | Name = {{PAGENAME}} | |
| ICD10 = {{ICD10|A|07|2|a|00}} |
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| ICD9 = {{ICD9|007.4}} |
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| ICDO = |
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| Image = Cryptosporidium muris.jpg | | | Image = Cryptosporidium muris.jpg | |
| Caption = Cryptosporidium muris | | | Caption = Cryptosporidium muris | |
| OMIM = |
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| OMIM_mult = |
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| MedlinePlus = |
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| eMedicineSubj = med |
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| eMedicineTopic = 484 |
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| DiseasesDB = 3221 |
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| }} | | }} |
| {{Cryptosporidiosis}} | | {{Cryptosporidiosis}} |
| | {{About1|Cryptosporidium parvum}} |
| | {{CMG}} {{AE}} {{KD}} |
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| ==[[Cryptosporidiosis overview|Overview]]== | | ==[[Cryptosporidiosis overview|Overview]]== |
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| ==[[Cryptosporidiosis pathophysiology|Pathophysiology]]== | | ==[[Cryptosporidiosis pathophysiology|Pathophysiology]]== |
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| ==[[Cryptosporidiosis epidemiology and demographics|Epidemiology & Demographics]]== | | ==[[Cryptosporidiosis epidemiology and demographics|Epidemiology and Demographics]]== |
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| ==[[Cryptosporidiosis risk factors|Risk Factors]]== | | ==[[Cryptosporidiosis risk factors|Risk Factors]]== |
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| ==[[Cryptosporidiosis screening|Screening]]==
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| ==[[Cryptosporidiosis causes|Causes]]== | | ==[[Cryptosporidiosis causes|Causes]]== |
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| ==[[Cryptosporidiosis differential diagnosis|Differentiating Cryptosporidiosis]]== | | ==[[Cryptosporidiosis differential diagnosis|Differentiating Cryptosporidiosis]]== |
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| ==[[Cryptosporidiosis natural history|Complications & Prognosis]]== | | ==[[Cryptosporidiosis natural history|Complications and Prognosis]]== |
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| ==Diagnosis== | | ==Diagnosis== |
| [[Cryptosporidiosis history and symptoms|History and Symptoms]] | [[Cryptosporidiosis physical examination|Physical Examination]] | [[Cryptosporidiosis staging|Staging]] | [[Cryptosporidiosis laboratory tests|Laboratory tests]] | [[Cryptosporidiosis electrocardiogram|Electrocardiogram]] | [[Cryptosporidiosis x ray|X Rays]] | [[Cryptosporidiosis CT|CT]] | [[Cryptosporidiosis MRI|MRI]] [[Cryptosporidiosis echocardiography or ultrasound|Echocardiography or Ultrasound]] | [[Cryptosporidiosis other imaging findings|Other images]] | [[Cryptosporidiosis other diagnostic studies|Alternative diagnostics]] | | [[Cryptosporidiosis history and symptoms|History and Symptoms]] | [[Cryptosporidiosis physical examination|Physical Examination]] | [[Cryptosporidiosis laboratory tests|Laboratory Findings]] |
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| ==Treatment==
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| [[Cryptosporidiosis medical therapy|Medical therapy]] | [[Cryptosporidiosis surgery|Surgical options]] | [[Cryptosporidiosis primary prevention|Primary prevention]] | [[Cryptosporidiosis secondary prevention|Secondary prevention]] | [[Cryptosporidiosis cost-effectiveness of therapy|Financial costs]] | [[Cryptosporidiosis future or investigational therapies|Future therapies]]
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| '''Cryptosporidiosis''' is a [[parasitic disease]] affecting the [[intestine]]s of [[mammal]]s that is caused by ''[[Cryptosporidium]]'', a [[protozoa]]n [[parasite]] in the phylum [[Apicomplexa]]. It is a disease spread through the [[fecal-oral route]]; the main symptom is self-limiting [[diarrhea]] in people with intact immune system. In immunocompromised individuals, such as [[AIDS]] patients, infection can cause permanent & life-threatening diarrhea. Despite not being identified until 1976 it is one of the most common waterborne diseases and is found worldwide.
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| ==Transmission==
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| [[Infection]] is through contaminated material such as earth, [[water]], uncooked or cross-contaminated [[food]] that has been in contact with the [[feces]] of an infected individual or animal. Contact must then be transferred to the [[mouth]] and swallowed. It is especially prevalent amongst those in regular contact with bodies of fresh water whether through work or recreation.The source can be recreational water like swimming pools, contaminated water supplies, or contaminated food. The high resistance of ''Cryptosporidium'' [[oocyst]]s to [[disinfectant]]s like [[chlorine]] [[bleach]] facilitates transmission of the disease.<ref name=Carpenter_1999>{{cite journal | author = Carpenter C, Fayer R, Trout J, Beach M | title = Chlorine disinfection of recreational water for Cryptosporidium parvum. | journal = Emerg Infect Dis | volume = 5 | issue = 4 | pages = 579-84 | year = 1999 | id = PMID 10458969}}</ref> Some outbreaks have happened in day care related to diaper changes.
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| ==Symptoms==
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| [[Symptom]]s appear from two to ten days after infection and last for up to two weeks or so. As well as watery diarrhea there is often [[stomach]] pains or [[cramp]]s and a low [[fever]]. Some individuals are [[asymptomatic]] (have no symptoms) but are still infective and thus can pass on the infection to others. Even after symptoms have finally subsided that individual is still infective for some weeks.
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| Severe disease, including [[pancreatitis]], can occur.<ref>{{cite journal | author = Hawkins S, Thomas R, Teasdale C | title = Acute pancreatitis: a new finding in cryptosporidium enteritis. | journal = Br Med J (Clin Res Ed) | volume = 294 | issue = 6570 | pages = 483-4 | year = 1987 | id = PMID 3103738}}</ref>
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| Treatment is primarily supportive. Fluids need to be replaced with oral rehydration. A lactose free diet should be taken as tolerated. In rare situations, intravenous fluids may be required. Antibiotics are not usually helpful, and are primarily reserved for persons with severe disease and a weak immune system. Sometimes relapses happen.
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| Prevention is through washing hands carefully after going to the bathroom or contacting stool, and before eating. If the water supply is in question, the water can be boiled or carefully filtered before drinking.
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| ==Treatment== | | ==Treatment== |
| The majority of immuno-competent individuals suffer a short (less than 2 weeks) self limiting course that requires supportive care with re-hydration and occasionally anti-diarrhoeal medication. In immuno-incompetent individuals (including some with [[HIV]]/[[AIDS]]) anti-retroviral therapy has been associated with improved outcomes. Several drug trials with high dose [[azithromycin]] look promising.
| | [[Cryptosporidiosis medical therapy|Medical therapy]] | [[Cryptosporidiosis primary prevention|Primary Prevention]] |
| | | ==Case Studies== |
| ==Infectious agents== | | [[Cryptosporidiosis case study one|Case #1]] |
| A number of species of ''Cryptosporidium'' infect mammals. In humans the main causes of disease are ''[[Cryptosporidium parvum|C. parvum]]'' and ''C. hominis'' (previously ''C. parvum'' genotype 1). ''C. canis'', ''C. felis'', ''C. meleagridis'', and ''C. muris'' can also cause disease in humans.
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| ==Notable cases==
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| * In 1993 a waterborne cryptosporidiosis outbreak occurred in Milwaukee, Wisconsin. An estimated 403,000 people became ill, including 4,400 people hospitalized.<ref name=Corso_2003>{{cite journal | author = Corso P, Kramer M, Blair K, Addiss D, Davis J, Haddix A | title = Cost of illness in the 1993 waterborne Cryptosporidium outbreak, Milwaukee, Wisconsin. | journal = Emerg Infect Dis | volume = 9 | issue = 4 | pages = 426-31 | year = 2003 | id = PMID 12702221}}</ref>
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| * In the summer of 2005, after numerous reports by patrons of gastrointestinal upset, a water park at Seneca Lake State Park, in the Finger Lakes region of upstate New York, was found to have two water storage tanks infected with ''Cryptosporidium''. By early September of 2005, over 3,800 people reported symptoms of a ''Cryptosporidium'' infection.<ref>{{cite web | title=State Health Department Issues Update on Seneca Lake State Park Gastrointestinal Outbreak | work=New York State Health Dept | url=http://www.health.state.ny.us/press/releases/2005/2005-09-01_school_precautions_seneca_lake_release.htm | accessdate=2006-09-29}}</ref> The "Sprayground" was ordered closed for the season on August 15.
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| * In October 2005 Gwynedd and Anglesey areas of North Wales (UK) suffered an outbreak of Cryptosporidiosis. The outbreak may be linked to the drinking water supply from Llyn Cwellyn but this is yet to be confirmed. This has resulted in over 200 people falling ill and the company Welsh Water (Dwr Cymru) advising 61000 people to boil their water before use.
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| *The UK's biggest outbreak occurred in Torbay in Devon in 1995 when 575 people fell ill.
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| * In March 2007, a suspected outbreak occurred in Galway, Ireland, after the source of water for much of the county, Lough Corrib, was suspected to be contaminated with the parasite. A large population (90,000 people) including areas of both Galway City and County were advised to boil water for drinking, food preparation and for brushing teeth. On 21 March 2007, it was confirmed that the city and county's water supply was contaminated with the parasite. The area's water supply was finally given the all-clear on 20 August, 2007; five months after it was first detected. Around 240 people contracted the disease, however experts say the true figure could be anything up to 5,000. <ref>[http://www.rte.ie/news/2007/0820/galway.html RTÉ News - ''Galway water now safer than ever - HSE'']</ref>
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| * As of June 20, 2007, Anglian Water Services prepared an alert confirming the possibility that cryptosporidium might have entered the drinking water supply in North Walsham, Anglia, England.<ref>{{cite web | title=Anglian Water Services: alert | work=Anglian Water Services, June 20, 2007 | url=http://www.anglianwater.co.uk/index.php?sectionid=135&contentid=879&parentid=0 | accessdate=2007-06-20}}</ref>. Customers in North Walsham and in the North Walsham Road area of Felmingham are being advised to boil their tap water before drinking it or using it in cooking.
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| * As of August 9 2007, there is an outbreak of Crypto in Montgomery County, PA. There are 20 confirmed cases, and the Health Department is keeping close watch on local swimming pools. The Spring Valley YMCA has been under closest watch as all 20 of the cases have been to it. They have been closing the pools for extra disinfection after accidents. Other local pools have been affected and most are taking the same steps to assure safety, whether they have crypto or not.
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| * Hundreds of public pools in 20 Utah counties were closed to young children in 2007, as children under 5 are most likely to spread the disease, especially children wearing diapers. As of September 10, 2007 the Utah State health department had reported [http://health.utah.gov/uthealthnews/2007/20070911-Restrictions.htm 1302 cases] of cryptosporidiosis in the year; a more usual number would be 30. On September 25, the pools were re-opened to those not requiring diapers, but hyperchlorination requirements were not lifted.
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| ==References==
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| <references />
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| ==External links==
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| *[http://www.monroecounty.gov/org1.asp?storyID=6051 Monroe County Health Dept. Fact Sheet]
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| *[http://www.health.state.ny.us/nysdoh/communicable_diseases/en/crypto.htm NYSDOH Crypto Fact Sheet]
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| *[http://www.health.state.ny.us/press/releases/2005/2005-08-26_seneca_release.htm NYS Dept. of State Parks Update, 8/26/05]
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| *[http://www.aidsmeds.com/OIs/Crypto3.htm Treatment of Cryptosporidiosis from the AidsMeds site]
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| *[http://www.atdn.org/access/drugs/azit.html Azithromycin information]
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| *[http://www.hivpositive.com/f-Oi/OppInfections/4-Protozoal/4-Pro-Crypto.html#TREATMENT%20RESULTS Summary of treatment results with Azithromycin]
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| *[http://www.galwaycity.ie/PublicNotices/MainBody,3558,en.html Galway City Council notice]
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| {{Protozoal diseases}} | | {{Protozoal diseases}} |
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| [[zh:隐孢子虫病]] | | [[zh:隐孢子虫病]] |
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| [[Category:Apicomplexa]]
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| [[Category:Parasitic diseases]] | | [[Category:Parasitic diseases]] |
| [[Category:Infectious disease]]
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| [[Category:Overview complete]]
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| {{SIB}}
| | [[Category:Disease]] |
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| {{WikiDoc Help Menu}} | | {{WikiDoc Help Menu}} |
| {{WikiDoc Sources}} | | {{WikiDoc Sources}} |