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All About Cryptosporidium

Cryptosporidium species are a protozoan parasite that can survive long periods in the environment without inhabiting a host. This, together with their ability to resist water filtration barriers, and their resistance to all chlorine-based sanitising chemicals, render them highly contagious.

How do I know I have crypto?

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  • Watery diarrhea

  • Stomach cramps

  • Loss of appetite

  • Weight loss

  • Slight fever

  • Vomiting

  • Dehydration

  • Nausea

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The above symptoms usually appear around 7 days following infection, but can occur within 1-12 days of contracting the organism. Symptoms usually clear within 2-3 weeks, but can come and go for up to 4 weeks.

 

People with weakened immune systems may experience more severe effects of crypto infection, including malnutrition, weakness and muscle wasting. These groups include those with inherited or acquired immune deficiencies (e.g. HIV infection), and patients taking immune-suppressing medication (e.g. chemotherapy or anti-rejection drugs for transplant patients).

 

In severe cases crypto may (rarely) elicit bronchitis, pneumonia, and inflammation of the gall bladder and pancreas.

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What is crypto?

 

Cryptosporidium are a group of single-celled protozoan parasites, including C. parva and C. hominis (the most common sources of infection in humans), as well as C. felis, C. meleagridis, C. canis, and C. muris which are also known to cause disease worldwide in vertebrates including mammals, marsupials, birds, reptiles, fish and humans.

 

Found in nature within animals and water supplies, crypto species have the ability to survive long periods (up to 6 months) in the environment without inhabiting a host, and are highly resistant to chlorine treatment (including chloramines and chlorine dioxide). These characteristics alone render them highly contagious. Cryptosporidium parasites reproduce both sexually and asexually in the gut of infected hosts, and release thick-walled oocysts into the environment with feces (usually diarrhea).

 

Crypto is considered one of the most important protozoan parasites causing waterborne outbreaks worldwide. In 1993 crypto was behind the largest documented waterborne disease outbreak in the history of the United States, affecting over 400,000 people and officially accounting for at least 69 deaths in Milwaukee.

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How did I get infected?

 

Crypto lives in the intestine of infected humans and animals. The parasite is released into the environment through bowel movements, and can be found in soil, food, water and surfaces that have come into contact with contaminated feces. Modern food production methods may actually work in favor of the spread of cryptosporidium parasites.

 

Infection occurs when a crypto oocyst is accidentally swallowed, usually from contaminated food or water. People who are no longer symptomatic may continue to excrete viable oocysts for several weeks following infection.

 

Other ways of contracting a crypto infection include:

 

  • Swimming in public swimming pools

  • Travelling to unfamiliar regions or places with inadequate sewage treatment infrastructure

  • Men having sex with other men

  • Working in a healthcare setting

  • Living with infected people

  • Working with farm animals

  • Poor hygiene habits amongst young children

Modern food-production methods may actually work in favour of spreading cryptosporidium parasites.

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Prevalance

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The prevalence of crypto infection has increased in recent years. Official figures put the incidence of reported cases of Cryptosporidium infection at 3 cases per 100,000 in population worldwide (0.003%). It has been estimated though that the real occurrence of this parasite may be up to 100 times higher than this official figure (0.3% worldwide), although other studies place global prevalence as high as 7.6%. Despite under-reporting from developing countries, crypto is now acknowledged as being behind up to 15% of all cases of severe diarrheal illness in malnourished children under the age of 5.

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Is crypto infestation dangerous?

 

Effects of crypto infection are usually limited to digestive problems as outlined above and are noted as self-limiting (they resolve without medical intervention), but have included malnutrition, muscle wasting, weakness, bronchitis, pneumonia, cholecystitis (inflammation of gall bladder) and pancreatitis in rare cases. Of the 69 people that died of Cryptosporidiosis in the 1993 Milwaukee outbreak, 93% of these mortalities were amongst people who were positive to AIDS.

 

In reality, any immune-suppressing event, such as a symptomatic cryptosporidium infection, can leave one susceptible to opportunistic organisms already present in the system, and from co-infections. As an example, an association has been noted in literature between crypto and Campylobacter and rotavirus in young children across different age groups.

 

Studies from South America have noted short-term growth faltering and impaired cognitive development in young children following diarrhea associated with crypto infection.

 

Can I prevent crypto infestation?

 

As the Cryptosporidium parasite survives in oocyst form outside the host's body, it essentially is protected by a thick outer shell that allows it to live in the environment for up to 6 months before re-infection. This hardiness of the organism to survive in the environment, and its resistance to protective measures such as filtration and chlorination, makes it extremely difficult to eradicate from human contact.

 

Not limited to livestock, crypto can inhabit wild animals in remote vicinities, whereby soil and, eventually, bodies of water may become contaminated.

 

Despite the ubiquitous nature of this single-celled parasite, various measures can be taken to limit exposure and hence the likelihood of contracting Cryptosporidium species:

 

  • Do not drink untreated or tap water. When using suspect water is unavoidable, boil water for at least 1 minute, or 3 minutes in higher altitude areas over 2000 meters (6,562 feet), or filter water through a 1 micron size filter or filter that is rated for cyst removal

  • Avoid ice made from untreated or tap water in regions with crypto outbreaks or in countries where the water supply may be suspect

  • Wash in safe water and peel all raw fruit and vegetables before eating

  • Avoid eating uncooked foods (including salads) in countries with insufficient water treatment systems

  • Use disposable plates and utensils, if possible, in areas of risk. Dishwashers can be used if they reach at least 150 degrees Fahrenheit or 66 degrees Celsius during the final rinse, or if they have a sanitizing cycle

  • When handwashing dishes, soak rinsed dishes in water containing unscented bleach (1 teaspoon per 1 gallon or 4 liters of water). Air dry dishes

  • Do not swallow recreational water

  • Practice good hygiene - washing hands after using the toilet and before handling food

  • Wash your hands and your child's hands after changing diapers/nappies or assisting them with toileting

  • Sanitize all baby bottles

  • Clean washable toys with bottled or boiled water

  • Wash hands thoroughly after touching surfaces that may be contaminated, including trash cans, cleaning cloths, drains, soil, or animals and their toys, leashes, litter trays or cleaning their feces

  • Do not swim in recreational water (pools, hot tubs, lakes, rivers, the ocean, etc.) for up to one week after crypto-related diarrhea ceases. (You or your child can pass infection even after symptoms cease)

  • Shower with soap and water before swimming in recreational water. Wash children thoroughly, especially their bottoms, after they use the toilet or their diapers are changed and before they enter the water. Do not swallow shower or bath water

  • Brush teeth with bottled or boiled water

  • While swimming, take children on frequent toilet breaks and check their nappies or diapers often. Change nappies/diapers only in bathrooms or specified changing areas

  • Avoid fecal exposure during sexual activity, especially while experiencing crypto-related diarrhea

  • Keep your child out of childcare until well after symptoms of cryptosporidiosis cease

  • Provide bottled or boiled (note: not distilled) water for all pets

 

Can I be safely treated for crypto?

 

Treating Cryptosporidiosis involves both the elimination of the parasite, and the treatment of symptoms that may continue for months after the infection has ceased.

 

As one of the universal symptoms of Cryptosporidiosis is diarrhea, treatment should always involve a regime of replacing fluids and nutrients, including beneficial bacteria and minerals (electrolytes). This is particularly critical for infants as rapid loss of fluids from diarrhea can be life threatening.

 

Young children and pregnant women may also be more susceptible to diarrhea-related dehydration.

 

Holistic herbal treatments that subscribe to the philosophy of weed, seed and feed thus lend themselves well to treating protozoan enteric infections, such as crypto, and its associated effects. Herbs such as clove, garlic and olive leaf have demonstrated an effective anti-protozoan action both in recorded traditions and in scientific testing, with garlic having demonstrated particular effectiveness against Cryptosporidium parva. Practitioners trained in natural medicine prescribe wellness programs that include probiotics and minerals to "seed" and "feed" the system - replacing what was lost.

 

The availability of reliable and effective herbal treatments is now greater than ever. Scientific advancements enhance the understanding of how phytochemicals in these herbs work to eliminate parasites like crypto. Pharmaceutical-grade manufacturing requirements in the highly regulated industries of Australia and Germany ensure safe and effective natural medicines are readily available.

 

Alternative: Nitazoxanide is the drug of choice for treating Cryptosporidium infections, but does not match effectiveness benchmarks for the immune-compromised or the malnourished. Understanding on how to treat this parasite medically is hampered by a lack of knowledge of how the body responds to the parasite and how to clear it in cases of the immune-compromised, who remain particularly vulnerable. Additionally, the effects of broad-spectrum antimicrobial drugs on growing children’s gut health is poorly understood.

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Research:

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  1. Minnesota Department of Health  Cryptosporidiosis Fact Sheet  https://www.health.state.mn.us/diseases/cryptosporidiosis/crypto.html (26 October 2022)

  2. Centers for Disease Control and Prevention  Symptoms of Crypto  https://www.cdc.gov/cryptosporidium/signs-symptoms/index.html  (5 June 2024)

  3. Victorian Department of Health  Cryptosporidiosis  https://www.health.vic.gov.au/infectious-diseases/cryptosporidiosis  (27 May 2024)

  4. Gerace E, Lo Presti VDM, Biondo C. Cryptosporidium Infection: Epidemiology, Pathogenesis, and Differential Diagnosis. Eur J Microbiol Immunol (Bp). 2019 Oct 22;9(4):119-123. doi: 10.1556/1886.2019.00019. PMID: 31934363; PMCID: PMC6945992.

  5. Porter MA  The Inside Story on Gut Health  Ocean Reeve Publishing (2023)  pp 50-58

  6. Dong S, Yang Y, Wang Y, Yang D, Yang Y, Shi Y, Li C, Li L, Chen Y, Jiang Q, Zhou Y. Prevalence of Cryptosporidium Infection in the Global Population: A Systematic Review and Meta-analysis. Acta Parasitol. 2020 Dec;65(4):882-889. doi: 10.2478/s11686-020-00230-1. Epub 2020 Jun 8. PMID: 32514837.

  7. Stephen Gradus, PHD. Milwaukee 1993: The Largest Documented Waterbone Disease Outbreak in US History https://waterandhealth.org/safe-drinking-water/drinking-water/milwaukee-1993-largest-documented-waterborne-disease-outbreak-history/ (Jan 10, 2014)

  8. Korpe PS, Valencia C, Haque R, Mahfuz M, McGrath M, Houpt E, Kosek M, McCormick BJJ, Penataro Yori P, Babji S, Kang G, Lang D, Gottlieb M, Samie A, Bessong P, Faruque ASG, Mduma E, Nshama R, Havt A, Lima IFN, Lima AAM, Bodhidatta L, Shreshtha A, Petri WA Jr, Ahmed T, Duggal P. Epidemiology and Risk Factors for Cryptosporidiosis in Children From 8 Low-income Sites: Results From the MAL-ED Study. Clin Infect Dis. 2018 Nov 13;67(11):1660-1669. doi: 10.1093/cid/ciy355. PMID: 29701852; PMCID: PMC6233690.

  9. Centers for Disease Control and Prevention  Preventing Crypto at Home During a Boil Water Advisory  https://www.cdc.gov/cryptosporidium/prevention/crypto-home-boil-water.html#:~:text=Use%20bottled%20or%20boiled%20water,and%20water%20from%20a%20refrigerator.  (5 June 2024)

  10. El-Shewehy DMM, Elshopakey GE, Ismail A, Hassan SS, Ramez AM. Therapeutic Potency of Ginger, Garlic, and Pomegranate Extracts Against Cryptosporidium parvum-Mediated Gastro-Splenic Damage in Mice. Acta Parasitol. 2023 Mar;68(1):32-41. doi: 10.1007/s11686-022-00635-0. Epub 2022 Nov 8. PMID: 36348178; PMCID: PMC10011320.

  11. Sparks H, Nair G, Castellanos-Gonzalez A, White AC Jr. Treatment of Cryptosporidium: What We Know, Gaps, and the Way Forward. Curr Trop Med Rep. 2015 Sep;2(3):181-187. doi: 10.1007/s40475-015-0056-9. Epub 2015 Aug 1. PMID: 26568906; PMCID: PMC4640180.

  12. Prabakaran M, Weible LJ, Champlain JD, Jiang RY, Biondi K, Weil AA, Van Voorhis WC, Ojo KK. The Gut-Wrenching Effects of Cryptosporidiosis and Giardiasis in Children. Microorganisms. 2023 Sep 15;11(9):2323. doi: 10.3390/microorganisms11092323. PMID: 37764167; PMCID: PMC10538111.

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This page is for information only and is not meant to be used for self-diagnosis or as a substitute for consultation with a health care professional. If you have any questions about the disease described above or think that you may have a parasitic infection, consult a health care professional.

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