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Ma DW, Lee MR, Hong SH, Cho SH, Lee SE. Molecular Prevalence and Genotypes of Cryptosporidium parvum and Giardia duodenalis in Patients with Acute Diarrhea in Korea, 2013-2016. THE KOREAN JOURNAL OF PARASITOLOGY 2019; 57:531-536. [PMID: 31715696 PMCID: PMC6851252 DOI: 10.3347/kjp.2019.57.5.531] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/31/2019] [Accepted: 09/09/2019] [Indexed: 01/24/2023]
Abstract
Cryptosporidium parvum and Giardia duodenalis are the main diarrhea-causing parasitic pathogens; however, their prevalence in Korea is unknown. Here, we conducted a survey to determine the prevalence and genotype distribution of these 2 pathogens causing acute diarrhea in 8,571 patients hospitalized in 17 Regional Institute of Health Environment sites in Korea, during 2013–2016. C. parvum and G. duodenalis were detected and genotyped by nested PCR, and the isolate were molecularly characterized by sequencing the glycoprotein 60 (Gp60) and β-giardin genes, respectively. The overall prevalence of C. parvum and G. duodenalis was 0.37% (n=32) and 0.55% (n=47), respectively, and both pathogens were more prevalent in children under 9 years old. Molecular epidemiological analysis showed that the C. parvum isolates belonged to the IIa family and were subtyped as IIaA13G2R1, IIaA14G2R1, IIaA15G2R1, and IIaA18G3R1. Analysis of the β-giardin gene fragment from G. duodenalis showed that all positive strains belong to assemblage A. This is the first report on the molecular epidemiology and subtyping of C. parvum and G. duodenalis in such a large number of diarrheal patients in Korea. These results highlight the need for continuous monitoring of these zoonotic pathogens and provide a basis for implementing control and prevention strategies. Further, the results might be useful for epidemiological investigation of the source of outbreak.
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Affiliation(s)
- Da-Won Ma
- Division of Vectors and Parasitic Diseases, Centers for Disease Control and Prevention, Osong 28159, Korea
| | - Myoung-Ro Lee
- Division of Vectors and Parasitic Diseases, Centers for Disease Control and Prevention, Osong 28159, Korea
| | - Sung-Hee Hong
- Division of Vectors and Parasitic Diseases, Centers for Disease Control and Prevention, Osong 28159, Korea
| | - Shin-Hyeong Cho
- Division of Vectors and Parasitic Diseases, Centers for Disease Control and Prevention, Osong 28159, Korea
| | - Sang-Eun Lee
- Division of Vectors and Parasitic Diseases, Centers for Disease Control and Prevention, Osong 28159, Korea
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Bahk YY, Cho PY, Ahn SK, Park S, Jheong WH, Park YK, Shin HJ, Lee SS, Rhee O, Kim TS. Monitoring of Noxious Protozoa for Management of Natural Water Resources. THE KOREAN JOURNAL OF PARASITOLOGY 2018; 56:205-210. [PMID: 29742877 PMCID: PMC5976025 DOI: 10.3347/kjp.2018.56.2.205] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/21/2017] [Revised: 03/12/2018] [Accepted: 03/19/2018] [Indexed: 11/23/2022]
Abstract
Waterborne parasitic protozoa, particularly Giardia lamblia and Cryptosporidium spp., are common causes of diarrhea and gastroenteritis worldwide. The most frequently identified source of infestation is water, and exposure involves either drinking water or recreation in swimming pools or natural bodies of water. In practice, studies on Cryptosporidium oocysts and Giardia cysts in surface water are challenging owing to the low concentrations of these microorganisms because of dilution. In this study, a 3-year monitoring of Cryptosporidium parvum, Giardia lamblia, and Naegleria fowleri was conducted from August 2014 to June 2016 at 5 surface water sites including 2 lakes, 1 river, and 2 water intake plants. A total of 50 water samples of 40 L were examined. Cryptosporidium oocysts were detected in 22% of samples and Giardia cysts in 32%. Water at the 5 sampling sites was all contaminated with Cryptosporidium oocysts (0-36/L), Giardia cysts (0-39/L), or both. The geometric mean concentrations of Cryptosporidium and Giardia were 1.14 oocysts/L and 4.62 cysts/L, respectively. Thus, effective monitoring plans must take into account the spatial and temporal parameters of contamination because they affect the prevalence and distribution of these protozoan cysts in local water resources.
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Affiliation(s)
- Young Yil Bahk
- Department of Biotechnology, College of Biomedical and Health Sciences, Konkuk University, Chungju 27478, Korea
| | - Pyo Yun Cho
- Protist Resources Research Division, Nakdonggang National Institute of Biological Resources Sciences, Sangju 37242, Korea
| | - Sung Kyu Ahn
- Department of Tropical Medicine and Parasitology, Inha University School of Medicine, Incheon 22212, Korea
| | - Sangjung Park
- Water Supply and Sewerage Research Division, National Institute of Environmental Research, Incheon 22689, Korea
| | - Won Hwa Jheong
- Environmental Health Research Division, National Institute of Environmental Research, Incheon 22689, Korea
| | - Yun-Kyu Park
- Department of Tropical Medicine and Parasitology, Inha University School of Medicine, Incheon 22212, Korea
| | - Ho-Joon Shin
- Department of Microbiology, Ajou University School of Medicine, Suwon 16499, Korea
| | - Sang-Seob Lee
- Department of Life Science, Kyonggi University, Suwon 16227, Korea
| | - Okjae Rhee
- DK EcoV Environmental Microbiology Lab., Cheonan 31075, Korea
| | - Tong-Soo Kim
- Department of Tropical Medicine and Parasitology, Inha University School of Medicine, Incheon 22212, Korea
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Sim S, Won J, Kim JW, Kim K, Park WY, Yu JR. Simultaneous Molecular Detection of Cryptosporidium and Cyclospora from Raw Vegetables in Korea. THE KOREAN JOURNAL OF PARASITOLOGY 2017; 55:137-142. [PMID: 28506035 PMCID: PMC5450956 DOI: 10.3347/kjp.2017.55.2.137] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/14/2017] [Revised: 03/07/2017] [Accepted: 03/19/2017] [Indexed: 01/10/2023]
Abstract
Cryptosporidium and Cyclospora are well-known coccidian protozoa that can cause waterborne and foodborne diarrheal illnesses. There have been a few reports regarding contamination in different vegetables with Cryptosporidium, but no data are available regarding the sources of Cyclospora infections in Korea. In the present study, we collected 6 kinds of vegetables (perilla leaves, winter-grown cabbages, chives, sprouts, blueberries, and cherry tomatoes) from July 2014 to June 2015, and investigated contamination by these 2 protozoa using multiplex quantitative real-time PCR. Among 404 vegetables, Cryptosporidium and Cyclospora were detected in 31 (7.7%) and 5 (1.2%) samples, respectively. In addition, Cryptosporidium was isolated from all 6 kinds of vegetables, whereas Cyclospora was detected in 4 kinds of vegetables (except perilla leaves and chives). Cryptosporidium (17.8%) and Cyclospora (2.9%) had the highest detection rates in chives and winter-grown cabbages, respectively. Cryptosporidium was detected all year long; however, Cyclospora was detected only from October to January. In 2 samples (sprout and blueberry), both Cryptosporidium and Cyclospora were detected. Further investigations using TaqI restriction enzyme fragmentation and nested PCR confirmed Cryptosporidium parvum and Cyclospora cayetanensis, respectively. In conclusion, we detected C. cayetanensis in vegetables for the first time in Korea. This suggests that screening should be employed to prevent these protozoal infections in Korea.
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Affiliation(s)
- Seobo Sim
- Department of Environmental and Tropical Medicine & International Healthcare Research Institute, Konkuk University School of Medicine, Seoul 05029, Korea
| | - Jua Won
- Department of Environmental and Tropical Medicine & International Healthcare Research Institute, Konkuk University School of Medicine, Seoul 05029, Korea
| | - Jae-Whan Kim
- Department of Environmental and Tropical Medicine & International Healthcare Research Institute, Konkuk University School of Medicine, Seoul 05029, Korea
| | - Kyungjin Kim
- Department of Environmental and Tropical Medicine & International Healthcare Research Institute, Konkuk University School of Medicine, Seoul 05029, Korea
| | - Woo-Yoon Park
- Department of Radiation Oncology, College of Medicine, Chungbuk National University, Cheongju 28644, Korea
| | - Jae-Ran Yu
- Department of Environmental and Tropical Medicine & International Healthcare Research Institute, Konkuk University School of Medicine, Seoul 05029, Korea
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Cryptosporidium Contamination and Attributed Risks in Yunlong Lake in Xuzhou, China. CANADIAN JOURNAL OF INFECTIOUS DISEASES & MEDICAL MICROBIOLOGY 2017; 2017:4819594. [PMID: 28386287 PMCID: PMC5366237 DOI: 10.1155/2017/4819594] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/27/2016] [Revised: 01/06/2017] [Accepted: 02/23/2017] [Indexed: 11/18/2022]
Abstract
Swimming in surface water bodies (e.g., lakes, rivers) can expose the human body to substantial risk of infection by Cryptosporidium. These findings are from a one-year investigation on the occurrence and distribution of the protozoan parasite Cryptosporidium in Yunlong Lake, Xuzhou, China. Cryptosporidium oocysts were detected by immunofluorescence microscopy. From January to November of 2015, 180 samples (120 water samples and 60 sediment samples) were collected and analyzed. Among them, 42 (35%) water samples and 28 (47%) sediment samples tested positive for Cryptosporidium. The concentration of Cryptosporidium oocysts in the water samples was 0-8/10 L and 0-260/g in sediment samples. Results revealed that July was the highest risk period for both swimming and diving with an estimated probability of infection from swimming of greater than 18 per 10,000 swim sessions. It was concluded that swimming or diving in Yunlong Lake has a higher risk of Cryptosporidium infection than the acceptable risk level set by the United States Environmental Protection Agency. Thus, regular monitoring of water quality in recreation water bodies is strongly recommended.
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Cho EJ, Yang JY, Lee ES, Kim SC, Cha SY, Kim ST, Lee MH, Han SH, Park YS. A waterborne outbreak and detection of cryptosporidium oocysts in drinking water of an older high-rise apartment complex in seoul. THE KOREAN JOURNAL OF PARASITOLOGY 2013; 51:461-6. [PMID: 24039290 PMCID: PMC3770878 DOI: 10.3347/kjp.2013.51.4.461] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/22/2012] [Revised: 05/20/2013] [Accepted: 05/29/2013] [Indexed: 12/13/2022]
Abstract
From May to June 2012, a waterborne outbreak of 124 cases of cryptosporidiosis occurred in the plumbing systems of an older high-rise apartment complex in Seoul, Republic of Korea. The residents of this apartment complex had symptoms of watery diarrhea and vomiting. Tap water samples in the apartment complex and its adjacent buildings were collected and tested for 57 parameters under the Korean Drinking Water Standards and for additional 11 microbiological parameters. The microbiological parameters included total colony counts, Clostridium perfringens, Enterococcus, fecal streptococcus, Salmonella, Shigella, Pseudomonas aeruginosa, Cryptosporidium oocysts, Giardia cysts, total culturable viruses, and Norovirus. While the tap water samples of the adjacent buildings complied with the Korean Drinking Water Standards for all parameters, fecal bacteria and Cryptosporidium oocysts were detected in the tap water samples of the outbreak apartment complex. It turned out that the agent of the disease was Cryptosporidium parvum. The drinking water was polluted with sewage from a septic tank in the apartment complex. To remove C. parvum oocysts, we conducted physical processes of cleaning the water storage tanks, flushing the indoor pipes, and replacing old pipes with new ones. Finally we restored the clean drinking water to the apartment complex after identification of no oocysts.
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Affiliation(s)
- Eun-Joo Cho
- Seoul Waterworks Research Institute, Seoul 716-010, Korea
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Moon S, Kwak W, Lee S, Kim W, Oh J, Youn SK. Epidemiological characteristics of the first water-borne outbreak of cryptosporidiosis in Seoul, Korea. J Korean Med Sci 2013; 28:983-9. [PMID: 23853479 PMCID: PMC3708096 DOI: 10.3346/jkms.2013.28.7.983] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2012] [Accepted: 05/14/2013] [Indexed: 11/30/2022] Open
Abstract
The first case of human cryptosporidiosis was reported in Korea in 1995; however, an outbreak of Cryptosporidium has not been reported in Korea until now. This paper describes the first outbreak of cryptosporidiosis in Korea. On May 24, 2012, a local public health center filed a report on 126 residents with gastrointestinal symptoms in an old apartment complex in Seoul. Epidemiological investigations were implemented on 125 of the 126 patients. The patients were reported continuously over a period of 22 days. Diarrhea was the most common clinical symptom, and lasted for 5 days on average. The tap water was the only common exposure of the patients. During the environmental investigation it was discovered that the water and septic tanks were situated closely and that the waste water pipes were corroded where they passed over the water pipes. Cryptosporidium parvum was detected in 3 of the 7 stool specimens by PCR-RFLP. A number of Cryptosporidium oocysts were also detected in the water specimens from the water tank. In conclusion, Cryptosporidium parvum was the key causal pathogen of this outbreak. It is presumed that the tap water was contaminated by a sewage leak from the aged pipelines.
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Affiliation(s)
- Shinje Moon
- Division of Epidemic Intelligence Service, Korea Centers for Disease Control and Prevention, Cheongwon, Korea
| | - Wooseok Kwak
- Division of Epidemic Intelligence Service, Korea Centers for Disease Control and Prevention, Cheongwon, Korea
| | - Sangwon Lee
- Division of Epidemic Intelligence Service, Korea Centers for Disease Control and Prevention, Cheongwon, Korea
| | - Won Kim
- Division of Health Policy, Seoul Metropolitan Government, Seoul, Korea
| | - Jaeyeon Oh
- Healthcare Department of Dongdaemun-gu Public Health Center, Seoul, Korea
| | - Seung-Ki Youn
- Division of Epidemic Intelligence Service, Korea Centers for Disease Control and Prevention, Cheongwon, Korea
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Cheun HI, Chung BS, Ma DW, Goo BL, Cho SH, Ji MJ, Lee WJ. Development of a Diagnostic Kit to Detect Cryptosporidium parvum and Giardia lamblia. Osong Public Health Res Perspect 2013; 4:146-51. [PMID: 24159546 PMCID: PMC3787530 DOI: 10.1016/j.phrp.2013.04.006] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2013] [Revised: 03/25/2013] [Accepted: 04/05/2013] [Indexed: 11/25/2022] Open
Abstract
Objectives This study aims to develop a high-sensitivity antibody diagnostic kit that will enable a rapid and accurate detection of Cryptospofidium parvum and Giardia lamblia in patients with diarrhea. Methods The cultivated C. parvum oocysts and G. lamblia cysts in each calf and dog were injected to mice to obtain antibodies, which were titrated. Spleen cells of the immunized mouse were separated and blended with myelomas to produce hybrid cell lines that form monoclonal antibodies. Using ELISA method, antibodies that specifically respond to C. parvum and G.lamblia were then selected. The cells were injected into the abdominal cavity of a BALB/c mouse to isolate hydrops abdominis containing high level of antibodies. The IgG antibody was purified using protein G gel. Results The detection limit of monoclonal antibodies for Cryptosporidium parvum and Giardia lamblia was 125 oocysts/mL and 1250 cysts/mL, respectively. In addition, during testing they did not show cross-reactivity to viruses (n = 15), bacteria (n =17), and parasites (n = 9). Conclusion The rapid diagnostic antibody kit developed in this study, which specifically responds to C. parvum and G. lamblia, will be useful in detecting and monitoring diarrheal infections.
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Affiliation(s)
- Hyeng-Il Cheun
- Division of Malaria and Parasitic Diseases, Korea National Institute of Health, Osong, Korea ; Division of Epidemic Intelligence Service, Korea Centers for Disease Control and Prevention, Osong, Korea
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Xiao G, Qiu Z, Qi J, Chen JA, Liu F, Liu W, Luo J, Shu W. Occurrence and potential health risk of Cryptosporidium and Giardia in the Three Gorges Reservoir, China. WATER RESEARCH 2013; 47:2431-45. [PMID: 23478072 DOI: 10.1016/j.watres.2013.02.019] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/23/2012] [Revised: 02/03/2013] [Accepted: 02/07/2013] [Indexed: 05/20/2023]
Abstract
The Three Gorges Reservoir (TGR) is the biggest lake in the world and a major water source in China. There is no information about occurrence and impact of Cryptosporidium and Giardia on the aquatic ecosystem. 61 surface water samples from 23 monitoring sites and 5 treated effluent samples were collected and analyzed. Cryptosporidium oocysts and Giardia cysts were found, respectively, in 86.4% and 65.2% of a total of 66 water samples, with high concentrations in treated effluent. The mean percent recovery was 29.14% for oocysts and 34.86% for cysts. A seasonal pattern was observed, with positive samples for Cryptosporidium more frequent in flood period and positive samples for Giardia more frequent in impounding period. Counts of enterococci, fecal coliforms and total coliforms, and turbidity were significantly associated with Cryptosporidium concentration in backwater (water in a main river which is backed up by the Three Gorges Dam) areas of tributaries but not Giardia. High associations were also found between oocyst and cyst in backwater areas of tributaries and cities. The risks of infection and illness due to water consumption in four different exposure routes were estimated. The results showed that swimming in the TGR has the highest infection risk with 1.39 × 10(-3) per time (95% confidence interval (CI): 0.05-600.3 × 10(-5)) for Cryptosporidium and 2.08 × 10(-4) per time (95% CI: 0.05-878.87 × 10(-6)) for Giardia, while directly drinking unboiled tap water treated with the conventional process has the highest morbidity with 524.98 per 100,000 population per year (95% CI: 10.35-2040.26) for Cryptosporidium and 5.89 per 100,000 population per year (95% CI: 0.08-22.67) for Giardia. This study provides new useful information for drinking water plants, health care workers and managers to improve the safety of tap water and deduce the risk of surface water contamination in China.
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Affiliation(s)
- Guosheng Xiao
- Department of Environmental Hygiene, School of Military Preventive Medicine, Third Military Medical University, 400038 Chongqing, China
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Lee MY, Cho EJ, Lee JH, Han SH, Park YS. A ten-year survey of Giardia cysts in drinking water supplies of Seoul, the Republic of Korea. THE KOREAN JOURNAL OF PARASITOLOGY 2011; 49:9-15. [PMID: 21461263 PMCID: PMC3063933 DOI: 10.3347/kjp.2011.49.1.9] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/13/2010] [Revised: 12/13/2010] [Accepted: 12/16/2010] [Indexed: 11/23/2022]
Abstract
To understand the distribution of Giardia cysts in drinking water supplies in Seoul, Korea, we collected water samples quarterly at 6 intakes in the Han River, its largest stream and 6 conventional water treatment plants (WTPs) serving drinking water, from 2000 to 2009. Giardia cysts in each of 10 L water were confirmed in 35.0% of intake water samples and the arithmetic mean was 1.65 cysts/10 L (range 0-35 cysts/10 L). The lowest cyst density was observed at Paldang and Kangbuk intakes, and the pollution level was higher at 4 intakes downstream. It seemed that these 4 intakes were under influence of Wangsuk stream at the end of which cysts were found in all samples with the mean of 140 cysts/10 L. The annual mean number of cysts was 0.21-4.21 cysts/10 L, and the cyst level at the second half of the 10 years was about 1/5 of that at first half on average. The cysts were more frequently found in winter, and their mean density was 3.74 cysts/10 L in winter and 0.80-1.08 cysts/10 L in other seasons. All finished water samples collected at 6 WTPs were negative for Giardia in each of 100 L sample for 10 years and cyst removal by physical process was average 2.9-log. It was concluded that conventional water treatment at 6 WTPs of Seoul appears to remove the cysts effectively under the present level of their source water. Domestic wastewater from the urban region could be an important source of Giardia pollution in the river.
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Affiliation(s)
- Mok-Young Lee
- Seoul Waterworks Research Institute, Seoul 143-202, Korea.
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