Cryptosporidium - Information for Clinicians
Type of infection
Cryptosporidium is an intracellular protozoal parasite.
Sources of infection
- Cryptosporidia are pathogens for many species of animals. Cryptosporidium hominis is mainly a human pathogen and C. parvum infects many species, particularly cattle.
- Cryptosporidium is spread by the fecal oral route. The infectious dose is very low. It survives in water even in the presence of moderate amounts of chlorine.
- Many outbreaks and sporadic cases results from waterborne transmission in swimming pools, lakes, and water parks.
- Contaminated water and food can spread Cryptosporidium.
- Person to person transmission can occur.
- Travel is a risk factor.
Usual symptoms
- Incubation period is 7-10 days.
- Nausea, fatigue, diarrhea, and abdominal pain or cramps.
- Diarrhea is usually watery and frequent.
Duration of illness
- In immunocompetent persons the median duration is 10-14 days without treatment.
Complications
- Dehydration or persistent diarrhea can occur.
- Very prolonged diarrhea and cholangitis, cholecystitis, hepatitis, pancreatitis occur in immunocompromised patients with Cryptosporidium.
Treatment
- Prevent and treat dehydration and electrolyte abnormalities.
- Nitazoxanide reduced the duration of diarrhea in immunocompetent patients in a randomized clinical trial and is the preferred drug if treatment is needed. It was not associated with sustained benefit in HIV-infected patients. Paromomycin and azithromycin have some activity and have been used in combination in some immunocompromised patients.
Comments
- Careful hand hygiene.
- Wash hands after contact with cows or calves.
- Do not drink untreated water from rivers, streams, or ponds.
- Do not swallow water in swimming pools or water parks.
- Take children out of the pool for regular bathroom breaks.
- Children with diarrhea should not swim or use water parks.