Cryptosporidium infections in asymptomatic calves up to 4 months in Poland: a cross-sectional population study

Cattle cryptosporidiosis is noted worldwide with varied frequency of infection prevalence depending on geographical, environmental and husbandry factors. In this study, the prevalence of Cryptosporidium infections in cattle was determined on the basis of molecular results obtained by testing 1601 faecal samples collected from calves up to 4 months of age housed in all Polish provinces from 2014 to 2018. Detection and identification of Cryptosporidium species was performed at the 18 small subunit ribosomal RNA (18S rRNA) locus by conducting PCR-RFLP analysis of the amplified DNA fragments. The prevalence of Cryptosporidium infections in the cattle population was 45.3% (CI 95%: 42.8-47.7; 725/1601). The infected animals were housed on 233/267 (87.3%) of monitored farms with regional prevalence ranging from 27.8 to 62%. The restriction pattern of 18S rRNA amplicons for positive samples was characteristic of C. parvum, C. bovis, C. ryanae, C. andersoni, and unexpectedly also of C. baileyi and C. suis. Infections of C. bovis and C. ryanae prevailed in the studied cattle population relegating C. parvum to third in prevalence. Likewise, mixed infections caused by C. bovis and C. ryanae as well as C. parvum and C. bovis were observed. A relationship between the infecting parasite species and animal breed was found. For instance, C. parvum prevailed in Black and White lowland breed, C. ryanae in Limousine cattle and C. andersoni in dairy animals of mixed dairy breeds. Furthermore, differences in prevalence of particular parasite species between cattle breeds were also shown.

Prevalence and molecular characterization of Cryptosporidium spp. in dairy cattle in Central Inner Mongolia, Northern China

BACKGROUND

Cryptosporidium is a gastrointestinal protozoan that widely exists in nature, it is an established zoonotic pathogen. Infected cattle are considered to be associated with cryptosporidiosis outbreaks in humans. In the present study, we aimed to assess the prevalence and species distribution of Cryptosporidium in dairy cattle in Central Inner Mongolia.

METHODS

We focused on the small subunit ribosomal RNA gene (SSU rRNA) of Cryptosporidium and 60-kDa glycoprotein gene (gp60) of Cryptosporidium parvum. We collected 505 dairy cattle manure samples from 6 sampling sites in Inner Mongolia in 2021; the samples were divided into 4 groups based on age. DNA extraction, polymerase chain reaction (PCR), sequence analysis, and restriction fragment length polymorphism (RFLP) using SspI and MboII restriction endonucleases were performed. RFLP analysis was performed to determine the prevalence and species distribution of Cryptosporidium.

RESULTS

SSU rRNA PCR revealed that the overall prevalence of Cryptosporidium infection was 29.90% (151/505), with a prevalence of 37.67% (55/146) and 26.74% (96/359) in diarrheal and nondiarrheal samples, respectively; these differences were significant. The overall prevalence of Cryptosporidium infection at the 6 sampling sites ranged from 0 to 47.06% and that among the 4 age groups ranged from 18.50 to 43.81%. SSU rRNA sequence analysis and RFLP analysis revealed the presence of 4 Cryptosporidium species, namely, C. bovis (44.37%), C. andersoni (35.10%), C. ryanae (21.85%), and C. parvum (11.92%), along with a mixed infection involving two or three Cryptosporidium species. Cryptosporidium bovis or C. andersoni was the most common cause of infection in the four age groups. The subtype of C. parvum was successfully identified as IIdA via gp60 analysis; all isolates were identified as the subtype IIdA19G1.

CONCLUSIONS

To the best of our knowledge, this is the first report of dairy cattle infected with four Cryptosporidium species in Inner Mongolia, China, along with a mixed infection involving two or three Cryptosporidium species, with C. bovis and C. andersoni as the dominant species. Moreover, this is the first study to identify C. parvum subtype IIdA19G1 in cattle in Inner Mongolia. Our study findings provide detailed information on molecular epidemiological investigation of bovine cryptosporidiosis in Inner Mongolia, suggesting that dairy cattle in this region are at risk of transmitting cryptosporidiosis to humans.

Genetic diversity of Cryptosporidium species in Njoro Sub County, Nakuru, Kenya

Cryptosporidium spp. cause cryptosporidiosis in humans through zoonotic and anthroponotic transmission. Previous studies illustrated the significance of domestic animals as reservoirs of this parasite. Cryptosporidium occurs in Njoro River; a main source of water to humans and animals. However, there is no information on the Cryptosporidium spp. and genotypes circulating in Njoro Sub County. A total of 2174 samples from humans, cattle, chickens, sheep and goats were assessed for the presence of Cryptosporidium spp. Thirty-three positive samples were subsequently successfully sequenced and compared to Cryptosporidium sequences in the GenBank repository using NCBI's (National Center for Biotechnology Information) online BLAST (Basic Local Alignment Search Tool) algorithmic program. Sequence alignment was done using the Clustal W program and phylogenetic analysis was executed in MEGA X (Molecular Evolutionary Genetics Analysis version X). The prevalence of cryptosporidiosis in Njoro Sub County is 6.99%. Cryptosporidium spp. present in the watershed showed great genetic diversity and nine Cryptosporidium species were recorded: Cryptosporidium parvum, Cryptosporidium hominis, Cryptosporidium ubiquitum, Cryptosporidium meleagridis, Cryptosporidium andersoni, Cryptosporidium baileyi, Cryptosporidium muris, Cryptosporidium xiaoi and Cryptosporidium viatorum. This is the first study to report the presence of C. viatorum in Kenya. Cattle is the major reservoir of zoonotic Cryptosporidium spp. while goats harbored the lowest number of species. Humans and domestic animals drink the contaminated water from Njoro River, humans are therefore, exposed to a high cryptosporidiosis risk.

The Age-Related Cryptosporidium Species Distribution in Asymptomatic Cattle from North-Western SPAIN

Simple Summary

An age-related distribution of Cryptosporidium species has been reported in cattle, with the pathogenic and zoonotic C. parvum being predominant in suckling calves, C. bovis and C. ryanae being predominant in post-weaned calves and C. andersoni being predominant in adults. However, variants to this pattern have recently been reported. Unravelling the age-related species distribution pattern in cattle from a particular region will allow determining those age classes posing a higher risk to public and animal health. Thus, fecal samples from asymptomatic cattle were collected in north-western Spain. Cryptosporidium detection and species identification was performed by molecular methods. Cryptosporidium prevalence was 16.7%; it significantly decreased with age. Cryptosporidium andersoni, C. bovis, C. occultus, C. parvum, C. ryanae and C. xiaoi were identified. Cryptosporidium parvum was predominant in calves younger than 1 month and C. bovis was predominant in the rest of the age groups. The presence of C. parvum in all age groups implies animal and public health concerns. The predominance of C. bovis in cattle older than 1 month supports the idea that the age-related pattern of Cryptosporidium species described in cattle is not fully consistent, and thus further studies are needed to identify those factors determining the species distribution.

Abstract

An age-related distribution of Cryptosporidium species has been reported in cattle, with C. parvum being predominant in suckling calves, C. bovis and C. ryanae being predominant in post-weaned calves and C. andersoni being predominant in adults. However, variants to this pattern have recently been reported. Thus, fecal samples (n = 594) from asymptomatic cattle were collected in north-western Spain. Animals were classified as <1 month (G1), 1–2 months (G2), 2–12 months (G3), 12–24 months (G4) and >2 years (G5). Cryptosporidium detection and species identification were performed by SSU rRNA PCR. Individual Cryptosporidium prevalence was 16.7%; it significantly decreased with age. Cryptosporidium parvum was predominant in G1 and C. bovis was predominant in the rest of the age classes; C. bovis and C. ryanae were especially prevalent in G2 and G3. Cryptosporidium occultus was not found in suckling calves. Finally, C. andersoni and C. xiaoi were occasionally detected in G5. The presence of C. parvum in all age classes implies significant animal and public health concerns. The predominance of C. bovis in cattle older than 1 month supports the idea that the age-related pattern of Cryptosporidium species described in cattle is not fully consistent, and thus further studies are still needed to identify those factors determining the species distribution.

Prevalence and genotyping identification of Cryptosporidium in adult ruminants in central Iran

Background

Apicomplexan parasites of the genus Cryptosporidium infect a wide range of animal species as well as humans. Cryptosporidium spp. can cause life threatening diarrhea especially in young animals, children, immunocompromised patients and malnourished individuals. Asymptomatic cryptosporidial infections in animals can also occur, making these animals potential reservoirs of infection.

Methods

In the present study, a molecular survey of Cryptosporidium spp. in ruminants that were slaughtered for human consumption in Yazd Province, located in central Iran was conducted. Faeces were collected per-rectum from 484 animals including 192 cattle, 192 sheep and 100 goats. DNA was extracted from all samples and screened for Cryptosporidium by PCR amplification of the 18S rRNA gene. Positives were Sanger sequenced and further subtyped by sequence analysis of the 60 kDa glycoprotein (gp60) locus.

Results

In total, Cryptosporidium spp. were detected in 22 animals: C. andersoni and C. bovis in seven and two cattle faecal samples, respectively, C. ubiquitum in five sheep, and C. xiaoi in six sheep and two goat samples, respectively. To our knowledge, this study provides for the first time, molecular information concerning Cryptosporidium species infecting goats in Iran, and is also the first report of C. ubiquitum and C. xiaoi from ruminants in Iran.

Conclusion

The presence of potentially zoonotic species of Cryptosporidium in ruminants in this region may suggest that livestock could potentially contribute to human cryptosporidiosis, in particular among farmers and slaughterhouse workers, in the area. Further molecular studies on local human populations are required to more accurately understand the epidemiology and transmission dynamics of Cryptosporidium spp. in this region.

Prevalence and molecular characterization of Cryptosporidium spp. and Giardia duodenalis in deer in Henan and Jilin, China

Background

Little is known about the prevalence and zoonotic potential of Cryptosporidium spp. and Giardia duodenalis in deer in China. In this study, 662 fecal samples were collected from 11 farms in Henan and Jilin Provinces between July 2013 and August 2014, and were screened for the presence of Cryptosporidium and G. duodenalis with genotyping and subtyping methods.

Results

Cryptosporidium spp. and G. duodenalis were detected in 6.80% (45/662) and 1.21% (5/662) of samples, respectively. Six Cryptosporidium species/genotypes were identified based on the small subunit ribosomal ribonucleic acid (SSU rRNA) gene: C. parvum (n = 11); C. andersoni (n = 5); C. ubiquitum (n = 3); C. muris (n = 1); C. suis-like (n = 1); and Cryptosporidium deer genotype (n = 24). When five of the 11 C. parvum isolates were subtyped by sequencing the 60 kDa glycoprotein (gp60) gene, zoonotic subtypes IIaA15G2R2 (n = 4) and IIdA19G1 (n = 1) were found. According to a subtype analysis, three C. ubiquitum isolates belonged to XIIa subtype 2. In contrast, only assemblage E was detected in the five Giardia-positive samples with small subunit ribosomal ribonucleic acid (SSU rRNA) gene sequencing.

Conclusions

To our knowledge, this is the first study to report C. andersoni, as well as C. parvum zoonotic subtypes IIaA15G2R2 and IIdA19G1 in cervids. These data, though limited, suggest that cervids may be a source of zoonotic Cryptosporidium and Giardia. Cervids in the present study are likely to be of low zoonotic potential to humans, and more molecular epidemiological studies are required to clarify the prevalence and public health significance of Cryptosporidium and G. duodenalis in cervids throughout China.

Molecular detection and prevalence of Cryptosporidium spp. infections in two types of domestic farm animals in the Qinghai-Tibetan Plateau Area (QTPA) in China

The objective of this study was to determine the prevalence of Cryptosporidium species infections in young cattle and sheep in the north-eastern part of the Qinghai-Tibetan Plateau Area (QTPA), north-western China. A total number of 454 faecal samples (389 from cattle and 65 from sheep) were collected and investigated to determine the prevalence of Cryptosporidium spp. oocysts. Cryptosporidium spp. infections detected in cattle (n = 56 positive samples) and sheep (n = 4 positive samples) were as following: C. andersoni (16/56, 28.6%) was the dominant species, followed by C. canis (9/56, 16.1%), C. bovis (9/56, 16.1%), C. hominis (8/56, 14.3%), C. struthionis (7/56, 12.5%), C. ryanae (5/56, 8.9%), and C. serpentis (2/56, 3.6%). Two Cryptosporidium species were detected in sheep: C. parvum (2/4) and C. canis (2/4). There were no mixed infections. C. hominis, C. struthionis, and C. serpentis are reported in domestic animals for the first time at the QTPA of China and our results indicate an anthropozoonotic transmission of C. hominis. The identification of Cryptosporidium spp. in domestic animals warrants better care of the farm animals in order to avoid contamination in vulnerable animal and human populations.

Foodborne cryptosporidiosis

Foodborne illness, the majority of which is caused by enteric infectious agents, costs global economies billions of dollars each year. The protozoan parasite Cryptosporidium is particularly suited to foodborne transmission and is responsible for >8 million cases of foodborne illness annually. Procedures have been developed for sensitive detection of Cryptosporidium oocysts on fresh produce and molecular diagnostic assays have been widely used in case linkages and infection source tracking, especially during outbreak investigations. The integrated use of advanced diagnostic techniques with conventional epidemiological studies is essential to improve our understanding of the occurrence, source and epidemiology of foodborne cryptosporidiosis. The implementation of food safety management tools such as Good Hygienic Practices (GHP), Hazard Analysis and Critical Control Points (HACCP), and Quantitative Microbial Risk Assessment (QMRA) in industrialised nations and Water, Sanitation, and Hygiene (WASH) in developing countries is central for prevention and control and foodborne cryptosporidiosis in the future.

Molecular epidemiologic tools for waterborne pathogens Cryptosporidium spp. and Giardia duodenalis

Molecular diagnostic tools have played an important role in improving our understanding of the transmission of Cryptosporidium spp. and Giardia duodenalis, which are two of the most important waterborne parasites in industrialized nations. Genotyping tools are frequently used in the identification of host-adapted Cryptosporidium species and G. duodenalis assemblages, allowing the assessment of infection sources in humans and public health potential of parasites found in animals and the environment. In contrast, subtyping tools are more often used in case linkages, advanced tracking of infections sources, and assessment of disease burdens attributable to anthroponotic and zoonotic transmission. More recently, multilocus typing tools have been developed for population genetic characterizations of transmission dynamics and delineation of mechanisms for the emergence of virulent subtypes. With the recent development in next generation sequencing techniques, whole genome sequencing and comparative genomic analysis are increasingly used in characterizing Cryptosporidium spp. and G. duodenalis. The use of these tools in epidemiologic studies has identified significant differences in the transmission of Cryptosporidium spp. in humans between developing countries and industrialized nations, especially the role of zoonotic transmission in human infection. Geographic differences are also present in the distribution of G. duodenalis assemblages A and B in humans. In contrast, there is little evidence for widespread zoonotic transmission of giardiasis in both developing and industrialized countries. Differences in virulence have been identified among Cryptosporidium species and subtypes, and possibly between G. duodenalis assemblages A and B, and genetic recombination has been identified as one mechanism for the emergence of virulent C. hominis subtypes. These recent advances are providing insight into the epidemiology of waterborne protozoan parasites in both developing and developed countries.

A survey for potentially zoonotic gastrointestinal parasites in domestic cavies in Cameroon (Central Africa)

Background

Farm animals are usually suspected to transmit infections to humans. Domestic cavies (Cavia porcellus) are hosts to a variety of pathogens, some of which are zoonotic. Several parasites including the protozoa Giardia spp. and Cryptosporidium spp. may be causative agents of gastrointestinal disorders in domestic cavies and humans. The aim of the study was to investigate the occurrence of potentially zoonotic protozoa as well as any potential zoonotic gastrointestinal parasite in domestic cavies raised under a semi extensive system in the rural areas of Cameroon.

Results

Giardia/Cryptosporidium antigens were detected in 12.90% of cavies. Helminthe eggs were found in 1.52% of animals. The prevalence of Paraspidodera uncinata, Heligmosomoides polygyrus (also known as Nematospiroides dubius) and Trichuris sp. was 1% (4/397), 0.3% (1/397), and 0.3% (1/397), respectively. Presence of Giardia/Cryptosporidium was unrelated to the occurrence of diarrhea, as none of the positive samples was from a diarrheic individual.

Conclusion

Domestic cavies are hosts of Giardia/Cryptosporidium and appear as potential source of human giardiasis, cryptosporidiosis and infection with H. polygyrus in Cameroon. In keeping with the One Health Initiative, veterinarians and medical doctors should collaborate to address the problem of Giardia and Cryptosporidium infection in cavies and cavy breeders both in Cameroon and other countries with a similar cavy breeding system. Follow-up studies are required to further taxonomically characterize these cavy parasites and to determine their routes of transmission to humans.

Electronic supplementary material

The online version of this article (doi:10.1186/s12917-017-1096-2) contains supplementary material, which is available to authorized users.

Epidemiology of Cryptosporidium infection in cattle in China: a review

The present review discusses the findings of cryptosporidiosis research conducted in cattle in China and highlights the currently available information on Cryptosporidium epidemiology, genetic diversity, and distribution in China, which is critical to understanding the economic and public health importance of cryptosporidiosis transmission in cattle. To date, 10 Cryptosporidium species have been detected in cattle in China, with an overall infection rate of 11.9%. The highest rate of infection (19.5%) was observed in preweaned calves, followed by that in juveniles (10.69%), postweaned juveniles (9.0%), and adult cattle (4.94%). The dominant species were C. parvum in preweaned calves and C. andersoni in postweaned, juvenile, and adult cattle. Zoonotic Cryptosporidium species (C. parvum and C. hominis) were found in cattle, indicating the possibility of transmission between humans and cattle. Different cattle breeds had significant differences in the prevalence rate and species of Cryptosporidium. This review demonstrates an age-associated, breed-associated, and geographic-related occurrence of Cryptosporidium and provides references for further understanding of the epidemiological characteristics, and for preventing and controlling the disease.

Molecular investigation of Cryptosporidium in small caged pets in northeast China: host specificity and zoonotic implications

This study screened 151 pet-derived fecal specimens randomly collected from four commercial markets in northeast China for the presence of Cryptosporidium by genus-specific nested PCRs of the small subunit rRNA gene. Of these, 14 specimens (9.3 %) from nine species of birds, two types of rodents, and a hedgehog were positive for Cryptosporidium. Sequence analysis on the PCR-positive isolates facilitated identification of three Cryptosporidium species (C. baileyi, C. galli, and C. ubiquitum) and two Cryptosporidium genotypes (ferret genotype and avian genotype V). The study birds were affected predominantly with bird-specific C. baileyi (Atlantic canary, budgerigar, crested myna, rock dove, and silky fowl), C. galli (Chinese hwamei), and Cryptosporidium avian genotype V (Fischer's lovebird and rosy-faced lovebird). Cryptosporidium ferret genotype previously considered rodent-adapted was identified in three specimens from budgerigar, chipmunk, and red squirrel. Two specimens collected from common hill myna and hedgehog were positive for C. ubiquitum. The species of birds that can be colonized by Cryptosporidium were extended. Moreover, the data expanded the host range of Cryptosporidium ferret genotype and C. ubiquitum, especially the birds. The carriage of zoonotic C. ubiquitum in small caged pets is of public health importance.

Public health significance of zoonotic Cryptosporidium species in wildlife: Critical insights into better drinking water management

Cryptosporidium is an enteric parasite that is transmitted via the faecal-oral route, water and food. Humans, wildlife and domestic livestock all potentially contribute Cryptosporidium to surface waters. Human encroachment into natural ecosystems has led to an increase in interactions between humans, domestic animals and wildlife populations. Increasing numbers of zoonotic diseases and spill over/back of zoonotic pathogens is a consequence of this anthropogenic disturbance. Drinking water catchments and water reservoir areas have been at the front line of this conflict as they can be easily contaminated by zoonotic waterborne pathogens. Therefore, the epidemiology of zoonotic species of Cryptosporidium in free-ranging and captive wildlife is of increasing importance. This review focuses on zoonotic Cryptosporidium species reported in global wildlife populations to date, and highlights their significance for public health and the water industry.

Cryptosporidium muris: infectivity and illness in healthy adult volunteers

Although Cryptosporidium parvum and C. hominis cause the majority of human cryptosporidiosis cases, other Cryptosporidium species are also capable of infecting humans, particularly when individuals are immunocompromised. Ten C. muris cases have been reported, primarily in human immunodeficiency virus (HIV) -positive patients with diarrhea. However, asymptomatic cases were reported in two HIV-negative children, and in another case, age and immune status were not described. This study examines the infectivity of C. muris in six healthy adults. Volunteers were challenged with 10(5) C. muris oocysts and monitored for 6 weeks for infection and/or illness. All six patients became infected. Two patients experienced a self-limited diarrheal illness. Total oocysts shed during the study ranged from 6.7 × 10(6) to 4.1 × 10(8), and the number was slightly higher in volunteers with diarrhea (2.8 × 10(8)) than asymptomatic shedders (4.4 × 10(7)). C. muris-infected subjects shed oocysts longer than occurred with other species studied in healthy volunteers. Three volunteers shed oocysts for 7 months. Physical examinations were normal, with no reported recurrence of diarrhea or other gastrointestinal complaints. Two persistent shedders were treated with nitazoxanide, and the infection was resolved. Thus, healthy adults are susceptible to C. muris, which can cause mild diarrhea and result in persistent, asymptomatic infection.

Cryptosporidiosis in Iranian Farm Workers and Their Household Members: A Hypothesis about Possible Zoonotic Transmission

Objectives. The prevalence of Cryptosporidium and the risk factors of zoonotic transmission in Najafabad, Isfahan, Iran dairy farms were examined. Methods. One fecal sample was collected from all calves less than 6 months old in eight dairy farms around Najafabad (Isfahan province, Central Iran) as well as individuals working in these farms and their household members. A two-step nested PCR protocol was used to amplify the 18S rRNA gene (830 bp). Results. Cryptosporidium was identified in the stool of 36 (prevalence 8.5%) of 96 farm workers and 326 household members. Furthermore, 31 (14.2%) of 218 calf samples were positive. Cryptosporidium parvum was identified in 15 (72%) of the positive farm workers and 10 (65%) of the positive household members. Of the positive calves, 20 (64.5%) were infected with C. parvum, indicating possible zoonotic transmission in these farms. Contact with calves (P < 0.0001) was the most significant risk factor of C. parvum infection. A considerable negative association was observed between C. parvum infection and cleaning of shoes/boots after daily work (P = 0.004), hand washing (P = 0.013), and use of piped water (P < 0.006). In the multivariate analysis with logistic regression, only contact with calves was significant. Conclusion. Zoonotic transmission of C. parvum due to contact with calves is predominant among farm workers and their household members of this region and appropriate health measures must be applied to control the infection and decrease of zoonotic transmission of this parasite.

Gastroenteritis caused by the Cryptosporidium hedgehog genotype in an immunocompetent man

The Cryptosporidium hedgehog genotype, which has been reported previously in hedgehogs and horses, was identified as the cause of the diarrheal disease cryptosporidiosis in an immunocompetent man in the Czech Republic. This is the first report of human illness caused by the Cryptosporidium hedgehog genotype.

Prevalence and molecular characterization of Cryptosporidium spp. in dairy cattle from farms in China

Fecal samples of 2,056 dairy cattle from 14 farms were collected in three geographical regions of China and stained using a modified acid-fast staining technique to identify Cryptosporidium oocysts. A total of 387 (18.82%) positive samples were identified and further analyzed by polymerase chain reaction (PCR) using primers designed to amplify DNA fragments from the small subunit ribosomal RNA. The PCR products were sequenced and the sequences were deposited in the GenBank database under accession numbers EU369377-84 and GU070730-33. Phylogenetic analysis was performed and a distances matrix generated from these sequences confirmed the existence of Cryptosporidium (C.) parvum 'mouse' genotype, C. bovis, C. andersoni, C. hominis, and C. serpentis in cattle. These results represent the first report on the prevalence and genetic identification of Cryptosporidium species, and may contribute to a better understanding of the epidemiology of Cryptosporidium in cattle in China.

Cryptosporidiosis-an overview

Apicomplexan protozoan parasites of the genus Cryptosporidium infect the gastrointestinal tract and lungs of a wide variety of animals, including humans. The majority of human infections are due to either Cryptosporidium hominis (C. hominis) and/or Cryptosporidium parvum (C. parvum). The parasite has a complex life cycle that includes both asexual and sexual stages. While there are invasive free living stages, proliferation and differentiation take place within a unique parasitrophorous vacuole under the host cell brush border but outside the host cell cytoplasm. Infection is spread by environmentally resistant spores that primarily contaminate drinking water and occasionally food sources, which may cause significant outbreaks of diarrhea that generally lasts less than 2 w in immunocompetent individuals. In immunodeficient or immunosuppressed individuals, diarrhea may be copious and can result in significant morbidity and mortality, particularly in AIDS patients. Although diagnosis is relatively simple, effective drug treatment, particulary for infections in immunodeficient patients, has not been uniformly successful. This overview summarizes the species known to infect humans, aspects of the parasite life cycle, sources of infection, the pathophysiology of cryptosporidiosis, the immune response to infection, diagnosis, treatment and some aspects of cryptosporidiosis in China.