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Cryptosporidiosis, also known as “crypto,” is a highly contagious intestinal infection that typically results in acute, self-limiting diarrhea. However, in immunocompromised patients—who contract it more often—cryptosporidiosis causes chronic, severe, life-threatening symptoms. Those at greatest risk for cryptosporidial infection include patients with hypogammaglobulinemia, patients receiving immunosuppressants for cancer therapy or organ transplantation, and malnourished children. Cryptosporidiosis is especially prevalent in patients with acquired immunodeficiency syndrome.
In addition to immunocompromised patients, travelers to foreign countries, medical personnel caring for patients with the disease, and children are at particular risk. Cryptosporidiosis is spread easily in day-care facilities and among household contacts and medical providers. Backpackers, hikers, and campers who drink unfiltered or untreated water are also at increased risk. Contaminated water, such as in a swimming pool or contaminated stream, is a frequent source of infection. This disease occurs worldwide. (See Preventing cryptosporidiosis.)
Cryptosporidiosis is caused by the protozoan Cryptosporidium. These small spherules inhabit the microvillus border of the intestinal epithelium. There, the protozoa shed infected oocysts into the intestinal lumen, where they pass into the stool. Millions of these parasites can be released in a single bowel movement from an infected human or animal. Cryptosporidium oocysts are particularly hardy, resisting destruction by routine water chlorination. This increases the risk of infection through contact with contaminated water. Cryptosporidiosis may also be found in soil or on surfaces that have been contaminated with the feces from infected humans or animals. The disease can also be transmitted via contaminated food and person-to-person contact.
At present, there is no vaccine available for cryptosporidiosis. In order to prevent infection, strict food preparation guidelines should be followed. Water should not be swallowed when swimming, and exposure to fecal matter should be avoided. In addition, proper handwashing should be observed. Cryptosporidium is poorly treated with chlorine or iodine; therefore, water suspected of contamination should be treated by boiling or filtration with an absolute 1-micron filter prior to ingesting.
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