What is Cryptosporidiosis

Cryptosporidiosis is a diarrheal disease caused by microscopic parasites of the genus Cryptosporidium. Once an animal or person is infected, the parasite lives in the intestine and passes in the stool.

The parasite is protected by an outer shell that allows it to survive outside the body for long periods of time and makes it very resistant to chlorine- based disinfectants. Both the disease and the parasite are commonly known as “crypto.”

During the past two decades, crypto has become recognized as one of the most common causes of waterborne disease within humans in the United States. The parasite may be found in drinking water and recreational water in every region of the United States and throughout the world.

How is cryptosporidiosis spread?

Cryptosporidium lives in the intestine of infected humans or animals. Millions of crypto germs can be released in a bowel movement from an infected human or animal.

Consequently, Cryptosporidium is found in soil, food, water, or surfaces that have been contaminated with infected human or animal feces. If a person swallows the parasite they become infected. You cannot become infected through contact with blood. The parasite can be spread by

      * Accidentally putting something into your mouth or swallowing something that has come into contact with feces of a person or animal infected with Cryptosporidium.

 

      * Swallowing recreational water contaminated with Cryptosporidium (Recreational water includes water in swimming pools, hot tubs, jacuzzis, fountains, lakes, rivers, springs, ponds, or streams that can be contaminated with sewage or feces from humans or animals.) Note: Cryptosporidium can survive for days in swimming pools with adequate chlorine levels.

 

      * Eating uncooked food contaminated with Cryptosporidium. Thoroughly wash with clean, safe water all vegetables and fruits you plan to eat raw. See below for information on making water safe.
    * Accidentally swallowing Cryptosporidium picked up from surfaces (such as bathroom fixtures, changing tables, diaper pails, or toys) contaminated with feces from an infected person.

Symptoms of Cryptosporidiosis

The most common symptom of cryptosporidiosis is watery diarrhea. Other symptoms include:

* Dehydration
* Weight loss
* Stomach cramps or pain
* Fever
* Nausea
* Vomiting

Some people with crypto will have no symptoms at all. While the small intestine is the site most commonly affected , Cryptosporidium infections could possibly affect other areas of the digestive or the respiratory tract.

Symptoms of cryptosporidiosis generally begin 2 to 10 days (average 7 days) after becoming infected with the parasite.

In persons with healthy immune systems, symptoms usually last about 1 to 2 weeks. The symptoms may go in cycles in which you may seem to get better for a few days, then feel worse again before the illness ends.

Who is most at risk for cryptosporidiosis?

People who are most likely to become infected with Cryptosporidium include:

* Children who attend day care centers, including diaper-aged children
* Child care workers
* Parents of infected children
* International travelers
* Backpackers, hikers, and campers who drink unfiltered, untreated water
* Swimmers who swallow water while swimming in swimming pools, lakes, rivers, ponds, and streams
* People who drink from shallow, unprotected wells
* People who swallow water from contaminated sources

Contaminated water includes water that has not been boiled or filtered. Several community-wide outbreaks of cryptosporidiosis have been linked to drinking municipal water or recreational water contaminated with Cryptosporidium.

How is a cryptosporidiosis diagnosed?

Your health care provider will ask you to submit stool samples to see if you are infected. Because testing for Crypto can be difficult, you may be asked to submit several stool specimens over several days. Tests for Crypto are not routinely done in most laboratories; therefore, your health care provider should specifically request testing for the parasite.

Treatment for Cryptosporidiosis

A new drug, nitazoxanide, has been approved for treatment of diarrhea caused by Cryptosporidium in people with healthy immune systems. Consult with your health care provider for more information. Most people who have a healthy immune system will recover without treatment. The symptoms of diarrhea can be treated.

If you have diarrhea, drink plenty of fluids to prevent dehydration. Rapid loss of fluids from diarrhea may be especially life threatening to babies; therefore, parents should talk to their health care provider about fluid replacement therapy options for infants.

Anti-diarrheal medicine may help slow down diarrhea, but talk to your health care provider before taking it.

People who are in poor health or who have a weakened immune system are at higher risk for more severe and more prolonged illness. The effectiveness of nitazoxanide in immunosuppressed individuals is unclear.

For persons with AIDS, anti-retroviral therapy that improves immune status will also decrease or eliminate symptoms of Crypto. However, even if symptoms disappear, cryptosporidiosis is usually not curable and the symptoms may return if the immune status worsens. See your health care provider to discuss anti-retroviral therapy used to improve your immune status.

If I have been diagnosed with Cryptosporidium , should I worry about spreading the infection to others?

Yes, Cryptosporidium can be very contagious. Follow these guidelines to avoid spreading the disease to others:

1. Wash your hands with soap and water after using the toilet, changing diapers, and before eating or preparing food.
2. Do not swim in recreational water (pools, hot tubs, lakes or rivers, the ocean, etc.) if you have cryptosporidiosis and for at least 2 weeks after diarrhea stops. You can pass Cryptosporidium in your stool and contaminate water for several weeks after your symptoms have ended. This has resulted in outbreaks of cryptosporidiosis among recreational water users.

Note: Cryptosporidium can be spread in a chlorinated pool because it is resistant to chlorine and, therefore, can live for days in chlorine-treated swimming pools.
3. Avoid fecal exposure during sexual activity.

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