What is Cryptosporidiosis?
Cryptosporidium is a significant cause of serious diarrhea in children under two years old and a leading cause of death worldwide. This disease is often spread during waterborne outbreaks and affects those with weaker immune systems most severely. It’s worth noting that Cryptosporidium infections may go unnoticed and undiagnosed. Furthermore, current treatments aren’t fully effective, and there are no solid preventive measures against it. Luckily, healthy individuals with strong immune systems typically overcome these infections naturally. However, in patients who are at higher risk, the infection can lead to lasting symptoms, poor nutrition, and other complications.
What Causes Cryptosporidiosis?
Cryptosporidium is a type of microscopic parasite known as protozoa, and it’s part of a group known as coccidia, which also includes parasites like Isospora and Cyclospora. Striking about these coccidian parasites is their ability to reproduce both asexually and sexually. However, it’s notable that Cryptosporidium infects only the surface layer of the intestinal lining, unlike other coccidian parasites which can infect deeper tissues.
There have been reports of human infections caused by over 15 species of Cryptosporidium. The primary two types that cause illness in humans are Cryptosporidium hominis and Cryptosporidium parvum. Cryptosporidium parvum is typically seen more in rural areas because it is linked to cattle and other animals. Cryptosporidium hominis, on the other hand, is found more often in urban areas.
There are some less common species also linked to human disease; these include Cryptosporidium felis, Cryptosporidium meleagridis, Cryptosporidium canis, and Cryptosporidium muris.
Risk Factors and Frequency for Cryptosporidiosis
The spread of Cryptosporidium, a type of parasite, often comes from tainted water sources or when tiny particles of feces are unknowingly swallowed (fecal-oral transmission). Recent data from the Centers for Disease Control and Prevention (CDC) reveals that Cryptosporidium outbreaks have been rising in the United States. Many of these outbreaks can be traced back to contaminated recreational and municipal water supplies. Places like daycare centers have also experienced outbreaks, likely due to the ease of fecal-oral transmission in these settings. Surprisingly, it can also be passed on during anal intercourse.
Other factors known to be related to this illness include seasonal changes and malnutrition. Some research has found a connection between warmer temperatures and more rainfall with an increased risk of catching cryptosporidiosis, the disease caused by Cryptosporidium. The rise in reported cases recently might be due to greater awareness and testing of the disease in the medical field.
- The disease is more prevalent in places with limited resources, with 5% to 10% of people who have healthy immune systems getting rid of the parasite in their feces in these countries. In contrast, this figure is about 1% in wealthier countries.
- Exposure to animals, especially cats and cattle, can also raise the likelihood of infection.
- Children and the elderly are often the ones diagnosed with cryptosporidiosis.
- People with weakened immune systems – either because of a condition they were born with (like IgA deficiency) or one they acquired (like HIV, chemotherapy side effects, or immunosuppressive medications) – are the most at risk of catching the disease and having it severely or for a long time.
Signs and Symptoms of Cryptosporidiosis
Cryptosporidiosis is an infection that causes intense, watery diarrhea and weight loss as a result of malabsorption, where the body struggles to absorb nutrients from food. It’s common to see these symptoms come and go over a period of one to two weeks. Generally, the diarrhea tends to go away on its own within seven to 14 days. But, symptoms such as fever, nausea, vomiting and stomach ache may show up, specifically in babies.
In people with weakened immune systems, especially those with HIV, the diarrhea can become chronic and last for months to years if their underlying health issue is not addressed. These patients are also at risk of severe complications including malnutrition, slow growth, problems in understanding or learning new things, and symptoms related to the respiratory system, and bile ducts that carry digestive fluids.
It’s important to recognize that Cryptosporidiosis often leads to more long-term symptoms and has a higher death rate in comparison to other diarrhea-causing illnesses, notably in children. The infection can prove to be fatal in the early stages for people with weak immune systems. What’s also alarming is that this infection can occur without any symptoms and still lead to malnutrition. Studies have found that Zero to 6 percent of children living in high-risk areas carry the infection without showing any signs of being sick.
Testing for Cryptosporidiosis
Cryptosporidium, a parasite that can cause disease, can be spotted in several ways. These include looking for it in stool samples with special dyes, using tests that identify its presence based on its antigen (a part of it that triggers an immune response), or using a method called polymerase chain reaction (PCR). In PCR, the parasite’s genetic material is duplicated to make it easier to identify.
Using a staining technique on stool samples is an affordable method to find the parasite, but it requires technical know-how to do it right. Methods like PCR and antigen detection have improved our ability to diagnose diseases caused by Cryptosporidium because they can even distinguish between different species of the parasite.
Serologic assays, or blood tests that look for antibodies, are also used. They help us understand how widespread Cryptosporidium infection is in a population, including in people who don’t have symptoms.
Treatment Options for Cryptosporidiosis
Nitazoxanide is a medication approved by the FDA to treat a certain illness called cryptosporidiosis, and it is generally the first option used for patients with healthy immune systems. However, it doesn’t always successfully relieve symptoms. Other medications like Paromomycin or Azithromycin might also be used.
For patients with weakened immune systems, however, these treatments might not work unless the immune system can strengthen or “reconstitute” itself. This is because the body’s own cellular immunity (which is a key part of the immune system) is crucial for relieving the symptoms of this disease.
Scientists are studying other potential ways to treat cryptosporidiosis by targeting certain functions in the body – like microtubule function and calcium-dependent protein kinases – as well as other metabolic pathways that are critical for the growth and development of the disease.
What else can Cryptosporidiosis be?
Doctors and healthcare professionals might suspect different types of illnesses when patients come in with stomach issues. Here are some possibilities:
- Infections caused by Campylobacter bacteria
- Infections caused by a microscopic parasite called Cyclospora
- A parasitic infection known as Cystoisosporiasis
- Infections caused by E Coli, a common bacteria that may lead to serious illness
- Giardiasis, an infection in your small intestine caused by a tiny parasite
- Diseases caused by a group of parasites known as Microsporidia
- Salmonella infection, commonly caused by contaminated food or water
- Shigellosis, a bacterial infection that can cause severe diarrhea
- Viral gastroenteritis, often called the stomach flu
It’s always crucial to see a healthcare professional if you experience abdominal discomfort that lasts longer than typical or is accompanied by other concerning symptoms, because numerous serious conditions might present with stomach-related issues.
