Serum immunoglobulin G, M and A response to Cryptosporidium parvum in Cryptosporidium-HIV co-infected patients

Cryptosporidium parvum, the protozoan parasite, causes a significant enteric disease in immunocompromised hosts such as HIV patients. The present study was aimed to compare serum IgG, IgM and IgA responses to crude soluble antigen of C. parvum in HIV seropositive and seronegative patients co-infected with Cryptosporidium and to correlate the responses with symptomatology.

Methods: Cryptosporidium parvum specific serum antibody (IgG, IgM and IgA) responses were assessed by ELISA in 11 HIV seropositive Cryptosporidium positive (Group I), 20 HIV seropositive Cryptosporidium negative (Group II), 10 HIV seronegative Cryptosporidium positive (Group III), 20 HIV seronegative Cryptosporidium negative healthy individuals (Group IV) and 25 patients with other parasitic diseases (Group V).

Results: A positive IgG and IgA antibody response was observed in significantly higher number of Cryptosporidium infected individuals (Gp I and III) compared to Cryptosporidium un-infected individuals (Gp II, IV and V) irrespective of HIV/immune status. Sensitivity of IgG ELISA in our study was found to be higher as compared to IgM and IgA ELISA.

The number of patients with positive IgG, IgM and IgA response was not significantly different in HIV seropositive Cryptosporidium positive patients with diarrhoea when compared to patients without diarrhoea and in patients with CD4 counts <200 when compared to patients with CD4 counts >200 cells/ul.

Conclusions: The study showed specific serum IgG and IgA production in patients infected with Cryptosporidium, both HIV seropositive and seronegative as compared to uninfected subjects suggesting induction of Cryptosporidium specific humoral immune response in infected subjects. However, there was no difference in number of patients with positive response in HIV seropositive or seronegative groups indicating that HIV status may not be playing significant role in modulation of Cryptosporidium specific antibody responses.

The number of patients with positive IgG, IgM and IgA response was not significantly different in patients with or without history of diarrhoea thereby indicating that Cryptosporidium specific antibody responses may not be necessarily associated with protection from symptomatology.

Author: Kirti KaushikSumeeta KhuranaAjay WanchuNancy Malla
Credits/Source: BMC Infectious Diseases 2009, 9:179

Spinacia oleracea L. leaf stomata harboring Cryptosporidium parvum oocysts: A potential threat for food safety

American Society for Microbiology
Dumitru Macarisin, Gary Bauchan, and Ronald Fayer

Abstract

Cryptosporidium parvum is a cosmopolitan microscopic protozoan parasite that causes severe diarrheal disease (cryptosporidiosis) in mammals, including humans and livestock. There is growing evidence of Cryptosporidium persistence in fresh produce that may result in foodborne infection, including sporadic cases as well as outbreaks. However, drinking or recreational waters are still considered the major source of cryptosporidiosis infection in humans, thereby prioritizing studies of parasite etiology in aquatic environments, while the mechanisms of transmission and parasite persistence on edible plants remain poorly understood. Using laser scanning confocal microscopy together with fluorescein-labeled monoclonal antibodies Cryptosporidium parvum oocysts were found to strongly adhere to spinach plants after contact with contaminated water, to infiltrate through the stomatal openings into spinach leaves, and to persist at the mesophyll level. These findings and the fact that this pathogenic parasite resists washing and disinfection raise concerns regarding food safety.

Settlement in the works in cryptosporidia sprayground class action

Craig Fox of the Finger Lake Times reported today that attorneys are ready to begin negotiating an out-of-court settlement in a lawsuit that claims about 2,000 people became sick with a waterborne intestinal illness after visiting the sprayground at Seneca Lake State Park four years ago.

The suit filed with the state Attorney General’s office is against the state Department of Parks, Recreation and Historic Preservation and seeks compensation for damages, including pain and suffering, medical expenses and lost wages. The class action suit involves an outbreak related to the waterborne microscopic parasite cryptosporidia — which is spread through feces — between June 1 and Aug. 17, 2005. The plaintiffs allege that the outbreak was the result of contaminated water at the spraypark, and that the parks department was negligent..

The sprayground was closed from mid-August 2005 until May 2006, until new equipment was installed to stop the water from being recycled through its many stations and to prevent another outbreak from occurring.

New York Spray Park Class Action Cryptosoridium Update

UPDATE: The discovery process which is the formal means of getting information to support claims in a lawsuit is now complete. We have taken depositions of the key players in the spraypark outbreak and have developed our experts’ testimony. The State has taken the depositions of a select group of claimants to better understand the nature of the damages suffered as a result of a Cryptosporidium infection. We have just filed our request for a trial date. This is a key step as it will force the case to a conclusion. Because it is a claim against the State of New York, any trial will be before a judge in the Court of Claims. We have been assigned a judge from the beginning who has been involved in the process of the case to this point and who would hear the case if it goes to trial.

In any effort to resolve the claims and avoid a trial however, we have also agreed to mediate these claims. The State has also agreed and the judge has ordered both sides to request a mediation with one of the other Court of Claims judges. A mediation is a voluntary settlement effort in which representatives of both sides meet with a neutral mediator who tried to get the sides to reach common ground. We hope the mediation will occur before the end of the year, and certainly before the end of January. To explain what class claimants have been through we will have both a great deal of documentary information as well as class representatives to explain to the mediator what a cryptosporidiosis infection is like. All issues, including legal responsibility for the outbreak, will be discussed at the mediation. The mediator does not have the power to compel either side to take action, but he can certainly provide insight given that the case would be heard by a fellow Court of Claims judge. We know that the State will contest its legal responsibility for the outbreak as well as damages we will claim on behalf of class members. But the mediation is intended to provide an opportunity for compromise that provide benefits to both sides.

We expect that if the State is willing to entertain a monetary settlement of claims, we will group similar claimants together in terms of the extent and severity of illness in order to treat similar claims in a like manner. Of course, each person’s experience is different, but a class action works because it addresses large numbers of claimants whose experiences are similar. We expect that there may be several levels of monetary settlement depending on the injuries suffered. Any outcome that provides for compensation to class members will result in a written notice about the proposed settlement to individual class members.

We believe we are now in the final stages of the class action. If we cannot resolve the claims at mediation, we are prepared to try the case. This will not require the involvement at trial of class members as comprehensive information about the claims will provided to the judge. We will have further updates as we near mediation.

South Wales Pool Makes 30 Sick With Crypto; Eight Being Held In Isolation

The British call them the "wet activities," which apparently refers to just about anything that can be done in a swimming pool.

In the South Wales town of Merthyr Tydfil the town has a deck level competition size swimming pool complete with electronic score boards for keeping track of those in-water competitive events.

There's both an adjoining learning pool and a leisure pool that comes with  flume , spa bath, & water features.   Oh, and did we tell you that all the pools are combatting the outbreak of the parasite cryptosporidium?

Eight swimmers who used the Merthyr Tydfil pool are now being kept in isolation after being struck by the crypto parasite.

Health officials traced the outbreak to a pool party at the town’s leisure centre two weeks ago, but were quick to reassure residents the pool is now clear of the disease.

More than 30 of the 46 people who attended the party complained of illness after swimming in the pool.

Dr Gwen Lowe, consultant in communicable disease control, at the National Public Health Service Wales, said: “A likely source of this outbreak of illness is a faecal accident.

“Our advice is that anyone who has vomiting or diarrhoea from any cause should not swim for two weeks after their symptoms have settled.”

Washington University in St. Louis Provides Tell All On Cryptosporidium

The School of Medicine at Washington University in St. Louis is the publisher for the "Hospital Medicine Virtual Journal."  It just published "up to date review of the biology, biochemistry and host parasite relationships of Cryptosporidium."

The complete summary is found below and one may visit the HMVJ for more.

Cryptosporidium is one of the most common enteric protozoan parasites of vertebrates with a wide host range that includes humans and domestic animals. It is a significant cause of diarrhoeal disease and an ubiquitous contaminant of water which serves as an excellent vehicle for transmission. A better understanding of the development and life cycle of Cryptosporidium, and new insights into its phylogenetic relationships, have illustrated the need to re-evaluate many aspects of the biology of Cryptosporidium. This has been reinforced by information obtained from the recent successful Cryptosporidium genome sequencing project, which has emphasised the uniqueness of this organism in terms of its parasite life style and evolutionary biology. This chapter provides an up to date review of the biology, biochemistry and host parasite relationships of Cryptosporidium.

CDC Advise For Dallas Back Yard Pool Owners Might Be Good For Other Hotspots

The Center for Disease Control (CDC) has released a bulletin encouraging pool cleaning of Dallas pools on a weekly basis to prevent recreational water illnesses (RWI's). The announcement comes after a study concluded that the number of outbreaks of RWI's has been increasing each year for the past decade. Regular pool cleaning and maintenance are the most effective way known to prevent them.

The CDC issues similar warnings every year for public pools, but this is the first time they are focusing on homeowners and asking them to be aware of the dangers. RWI's include gastrointestinal, skin, ear, respiratory, eye, neurological and wound infections. The most commonly reported RWI is diarrhea and it is often caused when children swallow contaminated or dirty water while swimming.

It is recommended as part of the weekly process that you test the water quality, add chemicals to achieve the proper PH balance, and brush and vacuum your pool thoroughly. Checking the operation of filtering and cleaning devices is also recommended. If you don't have the time or knowledge to do all of this yourself it is recommended that you hire a Dallas pool cleaning service to do it for you.

Dallas wasn't the only city mentioned in the CDC announcement. They are actually recommending that all homeowners be more vigilant in the upkeep and maintenance of their swimming pools. Cities in warmer climates were said to be at higher risk due to the elevated growth pace of dangerous bacteria such as Cryptosporidium, Giardia, Shigella, norovirus and E. coli O157:H7.

If you are a Dallas homeowner with a swimming pool and one of your children is ill, contact your family doctor right away. RWI's are generally not fatal but can be extremely uncomfortable if not treated with the proper antibiotics and medications. To prevent them, keep your pool clean and have a regular Dallas pool cleaning service or maintenance company come over on a regular schedule to make sure all of your equipment is working properly.

Wisconsin City Closes And Then Re-Opens Popular Fountain That Is Not Treated and Sanitized To Public With Lot's of Warning Signs

 City officials in Neenah, WS this week restarted a popular fountain in Shattuck Park, but at the same time imposed tougher rules to prohibit kids from playing in it.

According to the local Post-Crescent newspaper, here's what happened:

The city posted signs July 22 warning people to stay out of the Shattuck fountain for health and safety reasons and then shut down the fountain indefinitely later that day after park visitors defiantly ignored the signs.

The water in the fountain is not treated and sanitized to the same degree as drinking water or swimming pool water, and officials are concerned with the risks associated with waterborne pathogens like cryptosporidium and giardia.

Eileen McCoy, director of parks and recreation, said additional warning signs were posted Tuesday to emphasize the change in policy.

"It is going to be more in your face," McCoy said of the additional signs. "We will see if that is more effective."

Neenah officials billed the fountain as an interactive water feature when it was built in 2005.

The sudden turnabout stemmed from a better understanding of how people were using the fountain and of how waterborne illnesses can spread.

Neenah is putting $45,000 in its 2010 budget for ultraviolet lighting systems for fountains at both Shattuck and Riverside parks.

The city is taking the steps to maintain its recreational immunity under Wisconsin law.

Fear By Beer-makers About EPA Forced Change To Portland's Bull Run Waters

Portland's brewmasters say its wrong for the federal Environmental Protection Agency to apply one standard to all open drinking water systems across the entire United States.

But forcing all open public water operations  to install filtration systems by 2014 is EPA's answer to the the spring 1993 cryptosporidium outbreak in Milwaukee, Wisconsin.   EPA does not want to make any exceptions to its one-size-fits-all mandate.

Station KGW captured reaction to the coming deadline to filter water from Portland's pristine  Bull Run Watershed this past weekend at the city's 22nd annual beer festivill. 

"We have wonderful composition water -- the way it comes to us is perfect," said Kurt Widmer, co-founder of Widmer Brothers Brewing. He wonders why on earth anyone would want to tamper with perfection.

Brewmaster Karl Ockert with Bridgeport Ales wonders how a change will affect flavor. "It might jeopardize the delivery and the performance of the water," Ockert speculated.

Even the environmental group Oregon Wild questions the need for filtering the Bull Run waters.  It says:

The Bull Run Watershed enjoys unique federal legislative protections. The Bull Run is a forested and undeveloped watershed on federal land, with restrictions on logging and entry of human and domestic animals (sources of viruses, bacteria and protozoa). These stringent watershed protections, some in place for over one hundred years and some legislated as recently as 2001, have increasingly been recognized by the EPA and the drinking water industry as the most cost effective strategy for protection of superb water quality. There have never been any demonstrated outbreaks of cryptosporidium associated with Bull Run water. LT2 (the filtration rule)  completely disregards the effectiveness of a closed, pristine, water source like Bull Run in preventing disease outbreaks.

It somewhat ironic to note that the Milwaukee outbreak was caused by cryptosporidium oocysts that passed through the filtration system of one of the city's water-treatment plant. More than 400,000 were stricken by the crypto parasite.

Virginia's Rye Valley Water Authority Mum For 11 Months About Water Gone Bad

In Virginia, the Rye Valley Water Authority is being accused of going almost a year before telling the public that its water had gone bad. The Bristol Herald Courier reports on how that's got the whole community of Sugar Grove up in arms.

Michael Ward stood up at a community meeting to declare he had diarrhea eight times last year – a peculiar public announcement, but one met with gratitude by dozens of his neighbors, who had squeezed into a muggy gymnasium for the June gathering. Ward was expressing their commonly held fear – that their drinking water had been making them sick for months.

That angry community meeting came after a June 11th notice by the Rye Valley Water Authority telling people that coliform bacteria was in their water.  In the "boil water" warning, the district said the danger could extend for the next 18 months advised that “In July 2008 Rye Valley Water Authority began noticing changes in our untreated or raw water testing results.”

The newspaper explained the danger this way:

Found naturally in the intestines of warm-blooded animals, coliform is used as a standard measure of fecal-matter pollutants in drinking water. Its presence in the Rye Valley system indicates that surface water might have infiltrated the water source, which is an underground spring, and quite possibly brought along other parasites such as giardia lamblia and cryptosporidium. Those parasites can cause diarrhea, headaches, even death in the most severe cases.

The boil water order caused some local restaurants to close.  The Bristol Herald Courier has more on the controversy.