Moist heat inactivation of Cryptosporidium sp

Eugenol: effective complementary treatment for cryptosporidiosis in experimentally infected mice

Cryptosporidiosis is an opportunistic, globally distributed parasitic disease. Whereas Cryptosporidium causes asymptomatic infection and diarrhea in healthy people, it may lead to severe illness in immunocompromised individuals. Limited, effective therapeutic alternatives are available against cryptosporidiosis in those categories of patients. So, we are in urgent need of better drugs for the treatment of cryptosporidiosis. Fifty male Swiss albino mice were used. Mice were grouped into five groups of ten mice each. Group I was left uninfected, and four groups were infected with 1000 oocysts of cryptosporidium. The first infected group was left untreated. The remaining three-infected groups received nitazoxanide (NTZ), eugenol, and eugenol + NTZ, respectively, on the 6th day post infection (dpi) for five days. Mice were sacrificed on the 30th dpi. The efficacy of treatment was evaluated using parasitological, biochemical, and histopathological parameters. Combination therapy of eugenol with NTZ caused a significant reduction of the number of oocysts secreted in stool and improved cryptosporidiosis-induced liver injury manifested by the restoration of normal levels of liver enzymes (ALT and AST). Treatment with eugenol-NTZ combination maintained a well-balanced antioxidant status, as evidenced by a reduced level of nitric oxide (NO) and increased antioxidant Superoxide dismutase (SOD) enzyme activity. Moreover, the combination of eugenol with NTZ resulted in the restoration of the normal morphology of intestinal villi, crypts, and muscularis mucosa. Based on the findings extracted from the present work, we can conclude that eugenol is a complementary therapeutic when used with NTZ in the treatment of cryptosporidiosis. The addition of eugenol to NTZ in the treatment of cryptosporidiosis synergized the effect of NTZ, causing a greater reduction of the number of shedded oocysts, improving liver enzyme levels, and restoring normal intestinal pathology. Therefore, we presume that eugenol's antioxidant capacity accounts for the protective effect seen in the current study. We suggest eugenol as a supplemental chemotherapeutic agent with good therapeutic potential and high levels of safety in the treatment of cryptosporidiosis based on the findings of the current study.

Wilderness Medical Society Clinical Practice Guidelines on Water Treatment for Wilderness, International Travel, and Austere Situations: 2024 Update

To provide guidance to medical providers, wilderness users, and travelers, the Wilderness Medical Society convened an expert panel to develop evidence-based guidelines for treating water in situations where the potability of available water is not assured, including wilderness and international travel, areas impacted by disaster, and other areas without adequate sanitation. The guidelines present the available methods for reducing or eliminating microbiological contamination of water for individuals, groups, or households; evaluation of their effectiveness; and practical considerations. The evidence base includes both laboratory and clinical publications. The panel graded the recommendations based on the quality of supporting evidence and the balance between benefits and risks/burdens according to the criteria published by the American College of Chest Physicians.

In vitro and in vivo anti-Cryptosporidium and anti-inflammatory effects of Aloe vera gel in dexamethasone immunosuppressed mice

Cryptosporidiosis has been considered as a serious diarrheal disease, especially in immunodeficient patients, where they failed to clear the infection leading to several consequences of infection (i.e death). The role of cell mediated immunity in clearing the infection was demonstrated by the increased susceptibility of HIV/AIDS patients to infection. To date, no specific treatment has been proven for cryptosporidiosis in immunodeficient patients. The study aimed to evaluate the efficacy of Aloe vera gel for the treatment of cryptosporidiosis in immunocompetent and dexamethasone immunosuppressed mice in comparison to that of nitazoxanide. Mice were orally administrated with Aloe vera gel, in a daily dose of 250 mg/L in drinking water, for 14 consecutive days post infection. Parasitological, molecular and immunological measurements were recorded on the 7th, 14th, 21st and 32nd days post infection. Our in vitro results showed that 250 mg/L of prepared gel achieved the highest parasitic reduction. The body weights of Aloe vera treated mice on the 21st and 32nd day post infection, either in immunocompetent or immunosuppressed groups, were nearly the same as those of their corresponding control groups. Aloe vera gel succeeded in clearing cryptosporidiosis with a percent reduction of 100% in immunocompetent mice and 99.67% in immunosuppressed mice. The anti-inflammatory effect of Aloe vera reduced the levels of IFN-γ, IL-4, -6 and -17. The success of Aloe vera gel, in clearing cryptosporidiosis in immunosuppressed mice, was obvious either from the reduction of Cryptosporidium DNA or the oocysts in stool samples; and from the improvement of histopathological sections.

Giardia and Cryptosporidium in Neo-Tropical Rodents and Marsupials: Is There Any Zoonotic Potential?

Cryptosporidiosis and giardiasis have been identified as emerging diseases in both developed and developing countries. Wildlife has been highlighted to play a major role in the spread of these diseases to humans. This review aims to highlight the research findings that relate to Cryptosporidium spp. and Giardia spp., with a focus on (1) parasitism of neo-tropical hystricomorphic rodents and marsupials from the genus Didelphis and (2) prevention and treatment strategies for humans and animals for the neo-tropical region. It was found that there are few studies conducted on neo-tropical rodent and marsupial species, but studies that were found illustrated the potential role these animals may play as zoonotic carriers of these two parasites for the neo-tropical region. Thus, it is recommended that further studies be done to assess the threat of protozoan parasites in neo-tropical wildlife to humans and domestic animals, and to further determine the most effective prophylaxis adapted for the unique conditions of the region.

Cryptosporidium Oocyst Purification Using Discontinuous Gradient Centrifugation

Many laboratory studies in cryptosporidial research require a source of purified oocysts. Sources can include experimentally infected laboratory animals or from samples collected from naturally infected animals and from clinical cases of human cryptosporidiosis. Purification of oocysts can be accomplished with readily available laboratory equipment including tabletop centrifuges and microcentrifuges. Following purification, oocysts can be stored in antibiotic-supplemented buffers or in 2.5% aqueous potassium dichromate for over 6 months. Ultimately, oocyst viability and infectivity decline to less than 10% after 1 year, so if isolates are expected to be maintained, serial passage in a suitable host at ≤6-month intervals is recommended. Oocysts purified as described in this chapter are suitable for animal infection studies, cell culture studies, and a wide range of molecular biological studies, environmental studies, drug testing, and disinfection studies.

Wilderness Medical Society Clinical Practice Guidelines for Water Disinfection for Wilderness, International Travel, and Austere Situations

To provide guidance to clinicians, the Wilderness Medical Society convened experts to develop evidence-based guidelines for water disinfection in situations where the potability of available water is not ensured, including wilderness and international travel, areas affected by disaster, and other areas without adequate sanitation. The guidelines present the available methods for reducing or eliminating microbiologic contamination of water for individuals, groups, or households; evaluation of their effectiveness; and practical considerations. The evidence evaluation includes both laboratory and clinical publications. The panel graded the recommendations based on the quality of supporting evidence and the balance between benefits and risks or burdens, according to the criteria published by the American College of Chest Physicians.

Elevation and vegetation determine Cryptosporidium oocyst shedding by yellow-bellied marmots (Marmota flaviventris) in the Sierra Nevada Mountains

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Yellow-bellied marmots of Sierra Nevada Mountain shed Cryptosporidium oocysts.

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Oocysts loads are low compared to other mammals in California.

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Shedding of oocysts is associated with altitude and vegetation type.

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Cryptosporidium oocysts were 99.9%–100% match to Cryptosporidium parvum.

Wildlife are increasingly recognized as important biological reservoirs of zoonotic species of Cryptosporidium that might contaminate water and cause human exposure to this protozoal parasite. The habitat range of the yellow-bellied marmot (Marmota flaviventris) overlaps extensively with the watershed boundaries of municipal water supplies for California communities along the foothills of the Sierra Nevada. We conducted a cross-sectional epidemiological study to estimate the fecal shedding of Cryptosporidium oocysts by yellow-bellied marmots and to quantify the environmental loading rate and determine risk factors for Cryptosporidium fecal shedding in this montane wildlife species. The observed proportion of Cryptosporidium positive fecal samples was 14.7% (33/224, positive number relative to total number samples) and the environmental loading rate was estimated to be 10,693 oocysts animal^-1 day^-1. Fecal shedding was associated with the elevation and vegetation status of their habitat. Based on a portion of the 18s rRNA gene sequence of 2 isolates, the Cryptosporidium found in Marmota flaviventris were 99.88%–100% match to multiple isolates of C. parvum in the GenBank.

Inactivation of protozoan parasites in food, water, and environmental systems

Protozoan parasites can survive under ambient and refrigerated storage conditions when associated with a range of substrates. Consequently, various treatments have been used to inactivate protozoan parasites (Giardia, Cryptosporidium, and Cyclospora) in food, water, and environmental systems. Physical treatments that affect survival or removal of protozoan parasites include freezing, heating, filtration, sedimentation, UV light, irradiation, high pressure, and ultrasound. Ozone is a more effective chemical disinfectant than chlorine or chlorine dioxide for inactivation of protozoan parasites in water systems. However, sequential inactivation treatments can optimize existing treatments through synergistic effects. Careful selection of methods to evaluate inactivation treatments is needed because many studies that have employed vital dye stains and in vitro excystation have produced underestimations of the effectiveness of these treatments.

Viability staining and animal infectivity of Cryptosporidium andersoni oocysts after long-term storage

Preservation of biological properties of oocysts during the storage is critical for experimental work. Stomach species of cryptosporidia are less resistant against external influences, and their infectivity decreases rapidly in comparison with intestinal cryptosporidia. Cryptosporidium andersoni oocysts lost their infectivity for gerbil (Meriones unguiculatus) after 7 months storage in deionised water (DW) or in 2.5% potassium dichromate solution (PDS). Evaluation of oocyst viability by flow cytometry indicates higher percentage of viable oocysts stored in PDS than in DW, particularly after 6 months of storage. However, direct counting using fluorescent microscope revealed that these results are false and are influenced by the change of staining properties during the storage in PDS. Moreover, the examination of oocyst integrity by flow cytometry revealed that oocysts preserved in PDS kept their wall integrity longer than those stored in DW, and this fact should be taken into consideration during quantification of oocyst survival.

The effect of thermal treatments on the viability and infectivity of Cryptosporidium parvum on beef surfaces

AIMS

The aim of this research was to examine the effect of thermal treatments on the viability and infectivity of Cryptosporidium parvum oocysts attached to a beef surface.

METHODS AND RESULTS

This study examined the effects of heat treatment (60 or 75 degrees C) on the viability of C. parvum oocysts inoculated onto the surface of beef muscle estimated by vital dye assay. The infectivity of the oocysts was assessed against monolayers of HCT-8 cells. At 60 degrees C viability of the oocysts decreased from 100% at T0 to 64.2% at T60. At 75 degrees C the viability of the oocysts decreased from 100% at T0 to 53.7% at T15 and finally to 11.2% at T60. Oocysts were rendered noninfective against monolayers of HCT-8 cells following treatments of 60 degrees C/45 s and 75 degrees C/20 s.

CONCLUSION

The washing of carcasses with hot water and standard thermal treatments is sufficient to kill C. parvum on beef.

SIGNIFICANCE AND IMPACT OF THE STUDY

This study found that relatively mild heat, currently used to decontaminate and heat treat beef carcasses and to cook meat products, is capable of inactivating C. parvum.

Cryptosporidiosis: epidemiology and impact

Cryptosporidium was first recognized in humans in 1976 and came to prominence in the 1980s and 1990s as a cause of severe diarrheal illness in patients with AIDS. Its hardy, chlorine-resistant oocysts, tiny size, low infectious dose, fully infectious development when shed and zoonotic potential make it a threat in drinking and recreational water, contaminated food, day care centers, hospitals, and in persons with exposure to animals or unsanitary conditions, with potentially huge, long-term impact in malnourished children, as reviewed herein.

Biosecurity for neonatal gastrointestinal diseases

Infectious diarrhea is an important cause of neonatal calf morbidity and mortality that results in significant economic losses in the beef and dairy industries. Although numerous risk factors related to the occurrence of neonatal diarrhea have been identified, they can all be categorized into those that are related to the calf, the pathogens involved, or the environment of the calf. The immune status of calves, specifically the level of passively acquired immunity through colostrum, is the major risk factor related to the calf and the occurrence of diarrhea. Although numerous pathogens have been implicated in the occurrence of neonatal diarrhea, only a relatively limited number are commonly involved. Most should be viewed as secondary opportunists rather than primary pathogens, because none are extraordinarily virulent, and with the exception of Salmonella spp., most are present within the gastrointestinal tract of many healthy, mature cattle. Important risk factors related to pathogens involved in neonatal calf diarrhea involve the size of the inoculum and the occurrence of multiple infections. Finally, when considering the environment and housing conditions in which beef and dairy calves may reside, it is clear that tremendous variations exist. Despite these variations, the risk factors associated with the environment of the calf are also those that are the most amenable to the implementation of general environmental control and monitoring strategies as well as specific biosecurity measures.

Laboratory-acquired parasitic infections from accidental exposures

Parasitic diseases are receiving increasing attention in developed countries in part because of their importance in travelers, immigrants, and immunocompromised persons. The main purpose of this review is to educate laboratorians, the primary readership, and health care workers, the secondary readership, about the potential hazards of handling specimens that contain viable parasites and about the diseases that can result. This is accomplished partly through discussion of the occupationally acquired cases of parasitic infections that have been reported, focusing for each case on the type of accident that resulted in infection, the length of the incubation period, the clinical manifestations that developed, and the means by which infection was detected. The article focuses on the cases of infection with the protozoa that cause leishmaniasis, malaria, toxoplasmosis, Chagas' disease (American trypanosomiasis), and African trypanosomiasis. Data about 164 such cases are discussed, as are data about cases caused by intestinal protozoa and by helminths. Of the 105 case-patients infected with blood and tissue protozoa who either recalled an accident or for whom the likely route of transmission could be presumed, 47 (44.8%) had percutaneous exposure via a contaminated needle or other sharp object. Some accidents were directly linked to poor laboratory practices (e.g., recapping a needle or working barehanded). To decrease the likelihood of accidental exposures, persons who could be exposed to pathogenic parasites must be thoroughly instructed in safety precautions before they begin to work and through ongoing training programs. Protocols should be provided for handling specimens that could contain viable organisms, using protective clothing and equipment, dealing with spills of infectious organisms, and responding to accidents. Special care should be exercised when using needles and other sharp objects.

Epidemiology of Cryptosporidium: transmission, detection and identification

There are 10 valid species of Cryptosporidium and perhaps other cryptic species hidden under the umbrella of Cryptosporidium parvum. The oocyst stage is of primary importance for the dispersal, survival, and infectivity of the parasite and is of major importance for detection and identification. Because most oocysts measure 4-6 microm, appear nearly spherical, and have obscure internal structures, there are few or no morphometric features to differentiate species and in vitro cultivation does not provide differential data as for bacteria. Consequently, we rely on a combination of data from three tools: morphometrics, molecular techniques, and host specificity. Of 152 species of mammals reported to be infected with C. parvum or an indistinguishable organism, very few oocysts have ever been examined using more than one of these tools. This paper reviews the valid species of Cryptosporidium, their hosts and morphometrics; the reported hosts for the human pathogen, C. parvum; the mechanisms of transmission; the drinking water, recreational water, and food-borne outbreaks resulting from infection with C. parvum; and the microscopic, immunological, and molecular methods used to detect and identify species and genotypes.

Enhancement of solar water pasteurization with reflectors

A simple and reliable method that could be used in developing countries to pasteurize milk and water with solar energy is described. A cardboard reflector directs sunshine onto a black jar, heating water to pasteurizing temperatures in several hours. A reusable water pasteurization indicator verifies that pasteurization temperatures have been reached.

The prevalence of shedding of Cryptosporidium and Giardia spp. based on a single fecal sample collection from each of 91 horses used for backcountry recreation

Cryptosporidium parvum and Giardia duodenalis are now recognized as primary enteric pathogens in animals and humans. Regulatory agencies, such as the Environmental Protection Agency are under increasing pressure to reduce the concentration of these protozoa in surface waters. Given the popularity of recreational riding of horses on public land in California backcountry, concerns have been raised by various regulatory agencies as to whether horses used for backcountry recreation are a significant source of C. parvum and G. duodenalis for the environment. The prevalence of fecal shedding of Cryptosporidium and Giardia in horses with a history of being ridden in California backcountry during 1993 and 1994 was estimated. Using both direct fluorescent antibody and levitation centrifugation tests, none of 91 single-collection fecal samples from throughout California had Cryptosporidium oocysts or Giardia cysts. Horses ranged from 4 to 24 years of age. Because none of the 91 samples, collected 1 time from each horse, were positive and assuming that the sensitivity and specificity of the test methods employed were 100%, the highest probable prevalence of shedding for either protozoal pathogen was < 3.2% for the cohort of horses studied.

Prevalence, detection and control of Cryptosporidium parvum in food

The role of Cryptosporidium parvum as a foodborne pathogen has not been well documented. Epidemiological features of this parasitic protozoon lead to the assumption that the incidence of cryptosporidiosis due to contaminated food is under-estimated. The high prevalence of C. parvum among dairy herds has increased the spread of oocysts in the farm environment, and their potential presence in raw milk and other raw foods. In October 1993, the first well-documented foodborne outbreak was reported in Maine, USA, and was caused by contaminated hand-pressed apple cider. Although various cases of cryptosporidiosis among humans have pointed to raw milk and other raw foods as possible sources of infection, a conclusive demonstration of foodborne cryptosporidiosis has rarely been established. The limited numbers of oocysts in the suspected samples and the lack of sensitive detection methods adapted for oocyst detection in food contribute to this under-reporting. This review paper discusses various aspects of Cryptosporidium spp. and cryptosporidiosis, including the routes of transmission, the control of oocysts in food, and the available detection methods. The polymerase chain reaction (PCR) combined with DNA probe hybridization is a promising detection method. Recent knowledge on the molecular biology of the parasite for the development of new PCR assays and their potential use in the detection of C. parvum in food are described.

Effect of high temperature on infectivity of Cryptosporidium parvum oocysts in water

Cryptosporidium parvum oocysts suspended in 0.5 ml of distilled water were pipetted into plastic vials which were inserted into wells in the heated metal block of a thermal DNA cycler. Block temperatures were set at 5 degrees C incremental temperatures from 60 to 100 degrees C. At each temperature setting four vials containing C. parvum oocysts were placed into wells and held for 15 s before time was recorded as zero, and then pairs of vials were removed 1 and 5 min later. Upon removal, all vials were immediately cooled on crushed ice. Also, at each temperature interval one vial containing 0.5 ml of distilled water was placed in a well and a digital thermometer was used to record the actual water temperature at 30-s intervals. Heated oocyst suspensions as well as unheated control suspensions were orally inoculated by gavage into 7- to 10-day-old BALB/c mouse pups to test for infectivity. At 96 h after inoculation the ileum, cecum, and colon from each mouse were removed and prepared for histology. Tissue sections were examined microscopically. Developmental-stage C. parvum was found in all three gut segments from all mice that received oocysts in unheated water and in water that reached temperatures of 54.4, 59.9, and 67.5 degrees C at 1 min when vials were removed from the heat source. C. parvum was also found in the ileum of one of six mice that received oocysts in water that reached a temperature of 59.7 degrees C at 5 min.(ABSTRACT TRUNCATED AT 250 WORDS)

Cryptosporidium oocysts in water for human consumption. Comparison of staining methods

A study was carried out on the presence of oocysts of Cryptosporidium spp. in water for human consumption in the Province of Salamanca, Spain, using four different staining techniques: Ziehl-Neelsen, auramine, indirect immunofluorescence with monoclonal antibodies (Meridian, USA) and direct immunofluorescence with monoclonal antibodies (Pasteur, France). The presence of oocysts was detected in the water used for the washing of sand filters in the four water purifying plants and in the drinking water of two of the six geographical areas studied. The Ziehl-Neelsen and auramine staining techniques were found to have excellent diagnostic correlation. Immunofluorescence stainings with monoclonal antibodies proved to be less sensitive.

Cryptosporidiosis

Before 1982, only eight case reports of human cryptosporidiosis and fewer than 30 papers on Cryptosporidium spp. appeared in the biomedical literature. At that time, cryptosporidiosis was thought to be an infrequent infection in animals and rarely an opportunistic infection in humans. The concept of Cryptosporidium spp. as pathogens has changed dramatically within the past 8 years because of improved diagnostic techniques, increased awareness within the biomedical community, and the development of basic research programs in numerous laboratories. Presently, greater than 1,000 publications including over 400 case reports in the biomedical literature address Cryptosporidium spp. and cryptosporidiosis. Cryptosporidium parvum is now thought to be one of the three most common enteropathogens causing diarrheal illness in humans worldwide, especially in developing countries. It is likely that cryptosporidiosis was previously included in the 25 to 35% of diarrheal illness with unknown etiology. Because of the severity and length of diarrheal illness and because no effective therapy has been identified, cryptosporidiosis is one of the most ominous infections associated with AIDS. The role of C. parvum as an enteropathogen is well established; documentation of its role as a cause of hepatobiliary and respiratory diseases is now appearing in the literature. Our present understanding of the natural history, epidemiology, biology, and immunology of Cryptosporidium spp. as well as the clinical features, pathogenicity, and treatment of cryptosporidiosis are reviewed here.

In vitro activities of lytic peptides against the sporozoites of Cryptosporidium parvum

Cryptosporidium parvum is a protozoan parasite that causes mild to severe diarrheal disease in animals and humans. There are currently no effective chemotherapeutic agents available for the treatment of cryptosporidiosis. Recent studies have described small, naturally occurring antimicrobial lytic peptides with antiprotozoal activities. In the present study, the anticryptosporidial activities of three synthetic lytic peptides were determined in an in vitro sporozoite susceptibility assay. Sporozoite viability was assessed microscopically by the uptake of the vital dyes fluorescein diacetate and propidium iodide. Sporozoite viability was reduced by 93.5% following a 60-min exposure to 10 microM Hecate-1 at 37 degrees C. Shiva-10 reduced sporozoite viability by approximately 74.0% after a 60-min exposure at 100 microM and 37 degrees C. The cecropin-b analog SB-37 reduced sporozoite viability by 6.0% following a 60-min exposure at 100 microM and 37 degrees C. A control peptide showed no anticryptosporidial activity.

Symptoms and transmission of intestinal cryptosporidiosis

Cryptosporidium spp are a cause of diarrhoea in toddlers. Symptoms and routes of transmission were investigated in a prospective case-control study in the city and surroundings of Basel, Switzerland. Twenty one (4.6%) out of 455 children with diarrhoea who attended paediatric and general practices from June to September 1988 were positive for cryptosporidium. The mothers of each case, of two controls with diarrhoea of another origin, and of two healthy controls were interviewed with a standardised questionnaire. In comparison with controls with diarrhoea of another origin, respiratory symptoms were significantly more frequent in children with cryptosporidiosis: eight of 19 (42%) compared with five of 38 (13%). In comparison with healthy controls, preceding contact with a person suffering from diarrhoea was associated with the greatest relative risk for cryptosporidiosis, followed by travel in a Mediterranean country. Transient cryptosporidial infection of the respiratory tract may be common in immunocompetent children. In the area investigated person to person transmission may account for most cases.

Epidemiological aspects of human cryptosporidiosis

The coccidian protozoan parasiteCryptosporidiumhas been described in many host species since its discovery in the early part of the century, but it remained obscure until the recognition by veterinary workers in the 1970s of its importance as a cause of scours in young livestock animals [1–4].

Human cryptosporidiosis

Cryptosporidium is an enteric coccidial protozoan recognized in humans in 1976. Since its manifestation as an acquired immunodeficiency syndrome (AIDS)-related infection, new diagnostic techniques have improved recognition of Cryptosporidium oocysts, making apparent its true prevalence in human populations. Cryptosporidium represents 5 to 15% of all enteric pathogens in children in warm climate countries. It is responsible for both endemic and epidemic disease. Day-care center spread is well known, and evidence is strong for person-to-person transmission. The spectrum of illness caused by Cryptosporidium is broad, and while self-limited in immunocompetent individuals, gastrointestinal symptoms can be severe. Asymptomatic infection has been described in population surveys and outbreak investigations. Severe dehydration with malabsorption and failure-to-thrive in children from developing countries has been attributed to this organism. Intractable, incurable diarrhea can be fetal in immunosuppressed adults. Cryptosporidiosis in human immunodeficiency virus-infected individuals is declining in frequency in New York City, possibly reflecting changing sexual behaviors and comparatively low infectivity. No effective treatment for Cryptosporidium has been documented, but clinical trials are in progress.

Cryptosporidium spp. and cryptosporidiosis

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