Cryptosporidium Lawyer & Attorney : Marler Clark : Cryptosporidium Blog

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

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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.

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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.

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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.

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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.

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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.

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New York has a new water safety regulation. It’s found in Section 6-3.11 and says: “Ultraviolet light disinfection is required in addition to approved Chemical disinfectant.”

A company in Northwest England ---atg UV Technology—tells how that new NY regulation came about:

Following major outbreaks in Northampton, Galway, Utah and New York, Cryptosporidium has become a major concern for the leisure industry. Commonly found in lakes and rivers, waterborne pathogen Cryptosporidium, has a thick outer shell, making it highly resistant to traditional methods of chemical disinfection such as chlorine, vastly increasing the risk of infection and illness, that can often prove fatal in the young, elderly and the immunocompromised.

Due to the resistant nature of Cryptosporidium and the scale of health problems caused, the need for increased protection is now at the top of the agenda. With traditional methods failing to provide adequate protection, atg UVs' range of technologically advanced water treatment systems are the obvious choice for water treatment engineers committed to resolving this threat.

So large was the scale of the problem in New York, approximately 4,000 patrons of an aquatic facility became infected with Cryptosporidium and consequently took out legal action. The New York Department of Health was forced to re-think their entire water treatment strategy. Calling upon their experience in the drinking water industry to find a solution to the growing threat, they concluded that the risk of an outbreak could be greatly reduced by the use of “Ultraviolet treatment systems.”

Working closely with atg UV, the New York Department of Health invested in a range of state-of-the-art UV treatment systems to safeguard public health. Additionally, atg UV biodose tested a number of UV systems, gaining regulatory approval for their effectiveness against Cryptosporidium and other waterborne pathogens. Ultimately the inclusion of UV treatment systems is now firmly entrenched within New York’s water safety legislation for a range of leisure facilities.

And that's how UV treatment came to America!

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In an editorial that went along way toward explaining to the public what's really going on at Olympia, Washington's Heritage Park Fountain, the Daily Olympian still fell too short of providing the public with a real education about the dangers of "swimming" in such facilities.

Here's the crux of what the Olympian said:

"No one ever thought that the fountain, made with green granite from New York, would accommodate up to 300 youngsters at a time.

And those youngsters bring an assortment of dirt, grime and other grit with them when they splash in the water.

City workers cannot use chlorine to disinfect the water because it would corrode the brass piping of the fountain. Instead they use bromine, which kills germs and bacteria just like chlorine, but does not harm the piping.

But the quality of water, which recirculates through an underground, 5,000-gallon tank, deteriorates quickly. The sun evaporates the bromine, which is also broken down by sunscreen and carried off on the bodies of the bathers. That’s why the fountain must be shut down during the hottest part of the day to recharge bromine levels.

“Why not shut it down in the middle of the night?” ask critics.

Simple answer. In the middle of the night no one is using the fountain, the sun is not evaporating the bromine and the levels of disinfectant stay constant, actually building as the water recirculates."

Washington's Capitol City newspaper then goes into a lot of history of the 47 nozzle pools with jets shooting 40 into there air.  No where do they provide the information they should have told swimmers and parents of toddlers who do.  From the Centers on Disease Control and Prevention, we will fill in that huge gap:

 Three Steps for All Swimmers

Keep germs from causing recreational water illnesses (RWIs)

• Please don't swim when you have diarrhea. You can spread germs in the water and make other people sick.
• Please don't swallow the pool water. Avoid getting water in your mouth.
• Please practice good hygiene. Shower with soap before swimming and wash your hands after using the toilet or changing diapers. Germs on your body end up in the water.

 Three Steps for Parents of Young Kids

Keep germs out of the pool: 

• Please take your kids on bathroom breaks or check diapers often. Waiting to hear "I have to go" may mean that it's too late.
• Please change diapers in a bathroom or a diaper-changing area and not at poolside. Germs can spread in and around the pool.
• Please wash your child thoroughly (especially the rear end) with soap and water before they go swimming. Invisible amounts of fecal matter can end up in the pool.

Next time, Olympian, just tell people not to poop in the fountain nor let their toddlers do so!

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The 2007 closure of the splash park in Meridian, Idaho's popular Settler's Park after the  chlorine-resistant parasite Cryptosporidium began making people sick gets an autopsy in the Morbidity and Mortality Weekly Report (MMWR) for June 12, 2009.

MMWR, published by the Centers For Disease Control and Prevention (CDC), say Meridian "reopened the splash park in 2008 after installation of an ultraviolet treatment system, improvement of hygiene facilities, hiring of attendants to monitor for nonhygienic behaviors by visitors, and posting of educational signs instructing visitors not to drink the splash-feature water."

Health officials first learned of the problem at the Idaho splash poark when they learned of the complaints of "several ill persons with watery diarrhea consistent with cryptosporidiosis after attendance at a municipal splash park on July 26."

MMWR reports that: "The initial investigation by CDHD and IDHW began on August 7 with interviews of 20 persons who attended a party at the splash park on July 26. Among those 20 persons, 12 reported gastrointestinal illness that began August 1--6 (6--11 days after exposure), including eight persons who reported watery diarrhea. All 12 ill persons reported exposure to splash-feature water, and six reported exposure to water from a nearby drinking fountain. No food items at the party were implicated as the source of the outbreak. Investigators hypothesized that swallowing contaminated splash park water was the source of illness."

Additional investigation found that while there were no deaths nor over-night hospital stays, at least 45 people were ill from the crypto.  As to the cause: "During an initial site inspection, young children were observed to be the predominant users of the splash park, and diapered children frequently sat on top of splash features. Soap was not available in nearby restrooms, nor were showers. Public health education signs were not posted at the park. The splash park did not have any standing water; investigators noted that water drained from a concrete deck, passed through a high-flow sand filter, and was chlorinated before recirculation through several splash features."

See the complete report in MMWR.

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The City of Arvada, the 100,000 plus suburb that fills in much of the space between Denver and Boulder counties in Colorado, boasts an "Olde Town" dating back to 1870.  Its been the subject of an intense urban renewal focus in recent years that has brought office, retail, and housing investment to the area.

The Olde Town Plaza includes a new water fountain in a space adjacent to a new Jefferson County Public Library.  On its website, the city recently announced that fountain "will remain off until further notice. We apologize for any inconvenience."

However, in the letter to Olde Town's merchants, the city explained the situation.  "Public health officials have increased standards for "interactive fountains," which unfortunately, the Old Town fountain does not meet."   The letter said that with a holding tank of only 1,500 gallons and the extensive human contact with the fountain, it "has become a de facto swimming pool" with risk to public health and safety.  Risk from E. coli and Cryptosporidium were specifically mentioned as "potentially fatal" water borne diseases that concern the city.

In the letter, Arvada said other Colorado cities were having similar concerns for their water features.

Arvada is estimating it might cost $700,000 to add a proper filtration system, showers and rest rooms to the outdoor public space.  The Colorado Department of Health regulations Arvada is applying can be found here.

It is worth noting, the regulations are not new, but there application is.  It is just another example of how health department in the West are looking for ways to fight Crypto before it again overcomes them.

 

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Swim diapers do not prevent the spread of Cryptosporidium (Crypto) in swimming pools and water parks, according to a new University of North Carolina (UNC) - Charlotte study  

 

Researchers found swim diapers may slow the release of disease-causing germs, but the benefits are short-lived.

Crypto is spread when swimmers ingest some water that has been contaminated by diarrhea from infected people or mammals.  To prevent the spread of Crypto, the UNC-Charlotte reseachers advise that people should not get in the water if they have diarrhea.

During the last couple of summers, Crypto outbreaks have closed swimming pools and water parks throughout the Midwest and West, especially in Utah, Arizona, and Texas.   A common follow up to such outbreaks has been the banning of diaper-wearing, but usually permitting so-called swim diapers.  According to UNC-Charlotte:

The researchers measured the amount of microspheres that released from swim diapers worn by children. The microspheres have a similar size (five microns) to that of Crypto. Normal swim trunks, common disposable diapers and reusable diapers with and without vinyl diaper covers were tested. Swimming trunks without a swim diaper of any kind had the poorest performance - almost 90 percent of the microspheres were released into the water within one minute.

Swim diapers released about 50 percent of the microspheres within one minute. A vinyl diaper cover placed over a disposable swim diaper slightly improved performance. Still, over 25 percent were released into the water within two minutes. "When a fecal accident contains about a billion disease-causing Crypto oocysts, hundreds of millions of oocysts get into the water within minutes," explains Dr. James Amburgey, the lead scientist in the study. "Swimmers only need to ingest about ten Crypto oocysts to become infected."

Crypto is a parasite that causes severe diarrhea and dehydration.   More about the study and where it will be next discussed can be found here.

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Joplin, MO just got itself a twofer.  A new water treatment facility will add an extra five million gallons of clean water a day for economic development AND it will inactivate the cryptosporidium bacteria with ultra violet light.

Joplin celebrated the new water treatment plant Thursday with a ribbon cutting.  Joplin's water is provided by St. Louis-based Missouri American Water, which provides utility services in 19 states and has invested $1.5 billion in new facilities in the past three years.

Christie Barnhart of Missouri American Water says this plant is also using new ultaviolet light technology.

"Specifically, the ultra violet light is the only form of treatment that inactivates a bacteria known as cryptosporidium and the use of UV treatment for surface water plants is an upcoming EPA regulation," says Barnhart. "So this is something that definitely does enhance water quality."

The new facility also improves Joplin's disinfection and filter systems.  The community decided to hold the ribbon cutting now in honor of National Drinking Water Week.  Joplin is located in southwest Missouri, not far from the borders of Kansas, Oklahoma, and Arkansas.

 

 

 

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 We always go for a "man bites dog" story.

Consider this: President George W. Bush's Environmental Protection Agency (EPA) in 2006 issued a STRONGER rule involving water quality for municipal water systems.   Now, the Portland City Council, which usually can be found a couple of clicks left of Hanoi on the dial, is fighting for a WEAKER standard.

 At issue is what the rule-makers call the LT2.  The Portland Water Bureau explains it thusly:

According to the EPA, "The purpose of the LT2 rule is to reduce illness linked with the contaminant Cryptosporidium and other disease-causing microorganisms in drinking water." Cryptosporidium is a micro-organism (protozoan) naturally present in bodies of surface water throughout the world. Surface water supplies are particularly vulnerable if, unlike the city's Bull Run supply, they regularly receive runoff or pollution from human or animal wastes.

Compliance with the LT2 rule would have impacts on two separate parts of Portland's water system. First, the rule requires the city to provide additional treatment to its Bull Run supply to either remove or inactivate Cryptosporidium. The treatment options available to the city for this include filtration (either traditional or newer micro-membrane technology to remove the parasites), ozonation (the introduction of ozone to water to destroy the Cryptosporidium oocysts) chlorine dioxide (a chemical disinfectant) or ultraviolet radiation (ultraviolet lights irradiate the Cryptosporidium oocysts to prevent them from reproducing which is commonly referred to as inactivation).

Secondly, the rule would require changes to how open finished drinking water reservoirs are managed and operated. The rule requires that water systems with uncovered finished water reservoirs, like those at Portland's Mt.Tabor and Washington Parks, either cover the reservoirs or provide treatment at the outlets of the reservoirs to either remove or inactive Cryptosporidium and other viruses.

Portland's Willamette Week puts it this way:

Portland's source water, from Bull Run watershed, is far removed from human activity, including cattle. The city, which monitors the water on a monthly basis, hasn't detected Cryptosporidium since 2002. Because of this, the city has been challenging the LT2 rule, compliance with which would require the city to institute additional treatment facilities AND cover the open watershed—both very expensive and, the Water Bureau argues, unnecessary.

For a city that does many a silly thing in the name of the environment, this is an interesting issue.

For more from the Portland Water Bureau, go here. 

Catch the Willamette Week story here.

 

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Shoshone County, Idaho was the home of Lana Turner (1921-1995). One of the 20th Century's biggest movie stars was discovered, according to the story, at Schwab's Drug Store by the publisher of the Hollywood Reporter. The railroad and mining town of Wallace, Idaho, however was also known for its whorehouses, some of which remained opened throughout much of the 20th Century.

So its no surprise that what appears on the surface might not be the entire story in this large county with fewer than 13,000 people.

For over 14 years, the Idaho Department of Environmental Quality has been trying to get the Central Shoshone County Water District to address what might be below the surface--giardia and cryptosporidium.

According to Steve Tanner, IDEQ engineering manager for North Idaho, CSCWD is the last large surface water-influenced water district in the state that remains unfiltered.

After failing to pass tax increases before, last August voters in Shoshone County did approve new taxes to pay for a new filtration plant.

Bids for the $12.5 million project, designed to provide the district with thousands of gallons per day of treated, potable water will be accepted on Feb. 25th.

Clean water free of giardia and cryptosporidium contamination will cost Shoshone rate-payers about $5 a month to start.

See the story on this in the Shoshone News Press here.

 

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We've seen some cities move very quickly when they confirm that their splash, swimming or wave pools are contaminated by Cryptosporidium. Now comes a quicker test to detect the bug, one that moves the typical time for results up to a mere three hours, from today's fifteen hours.

Wendy Laursen, writing for TCE Today, the website of the Institution of Chemical Engineers, says:

"The new rapid screening tool uses fluorescent in situ hybridisation technology. The reliability of the new technology was tested against one of the standard methods applied in the water industry in collaboration with the Cryptosporidium Reference Laboratory in the UK. A strong correlation (0.994) between the two methods confirmed that the species identification method was as reliable as currently-used methods."

For more on the rapid screen tool, go here.

 

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The Environmental Protection Agency (EPA) has brought certain California small towns and rural water systems into compliance for testing of  E. coli, which can indicate the presence of cryptosporidium, a pathogen than can caused intestinal illness.

The company town of Scotia's water system is one such place.  

According to the Times-Standard published in Eureka:

Scotia was one of 10 California towns and agencies which hadn't yet complied with a new federal regulation to test the source of its public drinking water system. It was supposed to begin monitoring for E. coli on Oct. 1. When it didn't, the EPA ordered it to start the program or face up to $32,500 a day for each violation.

”Since we issued the order they did come into compliance,” said EPA spokeswoman Mary Simms.

Scotia dates back to 1863.  It was created as a "company town" by Pacific Lumber, known by the locals as PL, around the world's largest redwood mill.  Go here for more.

 

 

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The Utah Department of Health (UDOH) received 1,902 case reports of laboratory-confirmed cryptosporidiosis during June-December 2007, compared with an annual median of 16 reports of laboratory-confirmed cases (range: six to 20) during 2002-2006. All 1,902 cases met the outbreak-related case definition.

Clearly, this was an outbreak made for eventual analysis for specific publication in the Journal of the American Medical Association (JAMA).   That document has now been published and can be found here.

Below are the recommendations for health professionals in dealing with Crypto.

 

Continue Reading...

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Health authorities in Texas now say there is a dangerous oversight in state health codes.

They have concluded that this summer's outbreak of the cryptosporidium parasite from Burger's Lake spread to sprayparks.

Unlike larger public swimming pools, stand-alone fun fountains are not inspected and treated.  WFAA-TV reports that:

More than 1,000 cases of the parasite cryptosporidium have been confirmed in counties across North Texas.

Only a handful of those were people who swam in Burger's Lake, the source of this summer's outbreak.

"We were under the assumption that the sprayparks were considered or had guidance under the health and safety code. And under our review, we discovered that they are not regulated under the health and safety code," said Zachary Thompson, from the Dallas County Health Department.

Health officials  believe  the smaller sprayparks helped spread the cryto parasite across Texas,  They will seek legislation to close the loophole before next summer's swimming and splashing season begins anew.

 

 

 

 

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Cryptosporidium parvum (also known as "Crypto") is a parasite that is too small to be seen with the naked eye. It is found in water and food sources contaminated with the feces of infected humans, cattle, and other mammals. The infectious form of the parasite, known as an ìoocyst, it is highly resistant to the levels of chlorine normally found in drinking water and swimming pools.

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Cryptosporidium parvum (also known as "Crypto") is a parasite that is too small to be seen with the naked eye. It is found in water and food sources contaminated with the feces of infected humans, cattle, and other mammals. The infectious form of the parasite, known as an ìoocyst,î is highly resistant to the levels of chlorine normally found in drinking water and swimming pools.

Symptoms of Cryptosporidium

Cryptosporidiosis, the infection caused by ingestion of the Cryptosporidium parasite, causes painful abdominal cramping and profuse, watery diarrhea. In addition to diarrhea, symptoms of infection are fatigue, fever, nausea, vomiting, and loss of appetite.

Symptoms of Cryptosporidiosis appear an average of seven days after oocysts are swallowed, and normally last for two weeks or less in healthy adults. People with compromised immune systems (those with diabetes, receiving cancer treatments, who have received organ transplants, or are infected with HIV/AIDS), the elderly, pregnant women, and small children are more likely to become infected, and will suffer more severe illnesses than healthy adults. In some cases, Cryptosporidiosis can be life-threatening, especially when those infected become dehydrated.

Detection and Treatment of Cryptosporidium

Infection with Cryptosporidium parvum typically occurs after a person swallows contaminated water, eats contaminated food, or comes into direct contact with contaminated feces. Since 1988, health departments have documented more than ten outbreaks traced to contaminated water sources, including water parks and swimming pools in the U.S. Thousands have become ill.

The number of Cryptosporidium oocysts needed to cause human infection is relatively low ñ ingestion of as few as two to ten oocysts can cause illness. When infectious, a person can pass millions of oocysts per day in his or her stool; even after symptoms resolve, a person can remain infectious for a number of weeks. Therefore, it is important that individuals experiencing symptoms of diarrheal illness do not participate in activities that could lead to the contamination of water (i.e. swimming in pools, playing in spray-or waterparks).

Cryptosporidium may remain infectious for 2-6 months in moist environments outside the body.

Prevention of Cryptosporidium

Reported outbreaks of Cryptosporidium are small in number, but it is believed that as physicians and other health care providers increase their testing of patients with diarrheal illness for crypto that reported incidence will increase. Once a pool is contaminated by fecal accident or by rinsing a diaper in the water, it can remain a source of infection for significant periods of time since Cryptosporidium is resistant to treatment with Chlorine.
In addition to its resistance to treatment with Chlorine, Cryptosporidium is difficult to filter out of water sources because the oocysts are microscopic in size. Oocysts can pass through pool sand filters and most cartridge filters relatively easily; however, a diatomaceous earth filter can capture most oocysts.

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1. Division of Parasitic Diseases - Cryptosporidium Infection
This pamphlet was prepared by the inter-agency Working Group on Waterborne Cryptosporidiosis.
www.cdc.gov/Ncidod/dpd/parasites/cryptosporidiosis/default.htm

2. US FDA/CFSAN - Bad Bug Book - Cryptosporidium parvum
Provides basic facts about cryptosporidium parvum.
www.cfsan.fda.gov/~mow/chap24.html

3. EPA Ground Water & Drinking Water > Safe Drinking Water – Guidance. Cryptosporidium is a parasite commonly found in lakes and rivers.
www.epa.gov/safewater/crypto.html

4. Parasitology at KSU - Basic biology of Cryptosporidium: Coccidia of the World (KSU site).
www.k-state.edu/parasitology

5. Cryptosporidium - Wikipedia
Cryptosporidium is a protozoan pathogen of the Phylum Apicomplexa and causes a diarrheal illness.
www.wikipedia.org/wiki/Cryptosporidium

6. Cryptosporidium: A Waterborne Pathogen. USDA Water Quality Program Cornell Cooperative Extension. This fact sheet has been revised (August 2004).
www.nal.usda.gov/wqic/cornell.html

7. Cryptosporidium is a coccidian protozoan parasite that has gained much attention in the last 20 years as a clinically important human pathogen.
www.biology.kenyon.edu/slonc/bio38/hannahs/crypto.htm

8. MedlinePlus - Medical Encyclopedia: Cryptosporidium enteritis
Cryptosporidium enteritis is an infection of the small intestine. www.nlm.nih.gov/medlineplus/ency/article/000617.htm

9. Cryptosporidium Lawyer & Attorney: Marler Clark: Cryptosporidium
www.cryptosporidiumblog.com

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Cryptosporidium parvum (also known as "Crypto") is a parasite that is too small to be seen with the naked eye. It is found in water and food sources contaminated with the feces of infected humans, cattle, and other mammals. The infectious form of the parasite, known as an "oocyst," is highly resistant to the levels of chlorine normally found in drinking water and swimming pools.

Symptoms of Cryptosporidium

Cryptosporidiosis, the infection caused by ingestion of the Cryptosporidium parasite, causes painful abdominal cramping and profuse, watery diarrhea. In addition to diarrhea, symptoms of infection are fatigue, fever, nausea, vomiting, and loss of appetite.

Symptoms of Cryptosporidiosis appear an average of seven days after oocysts are swallowed, and normally last for two weeks or less in healthy adults. People with compromised immune systems (those with diabetes, receiving cancer treatments, who have received organ transplants, or are infected with HIV/AIDS), the elderly, pregnant women, and small children are more likely to become infected, and will suffer more severe illnesses than healthy adults. In some cases, Cryptosporidiosis can be life-threatening, especially when those infected become dehydrated.

Detection and Treatment of Cryptosporidium

Infection with Cryptosporidium parvum typically occurs after a person swallows contaminated water, eats contaminated food, or comes into direct contact with contaminated feces. Since 1988, health departments have documented more than ten outbreaks traced to contaminated water sources, including water parks and swimming pools in the U.S. Thousands have become ill.

The number of Cryptosporidium oocysts needed to cause human infection is relatively low -- ingestion of as few as two to ten oocysts can cause illness. When infectious, a person can pass millions of oocysts per day in his or her stool; even after symptoms resolve, a person can remain infectious for a number of weeks. Therefore, it is important that individuals experiencing symptoms of diarrheal illness do not participate in activities that could lead to the contamination of water (i.e. swimming in pools, playing in spray-or waterparks).

Cryptosporidium may remain infectious for 2-6 months in moist environments outside the body.

Prevention of Cryptosporidium

Reported outbreaks of Cryptosporidium are small in number, but it is believed that as physicians and other health care providers increase their testing of patients with diarrheal illness for crypto that reported incidence will increase. Once a pool is contaminated by fecal accident or by rinsing a diaper in the water, it can remain a source of infection for significant periods of time since Cryptosporidium is resistant to treatment with Chlorine.
In addition to its resistance to treatment with Chlorine, Cryptosporidium is difficult to filter out of water sources because the oocysts are microscopic in size. Oocysts can pass through pool sand filters and most cartridge filters relatively easily; however, a diatomaceous earth filter can capture most oocysts.

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