Cryptosporidiosis

PATHOGENS

• Cryptosporidium: intracellular protozoan parasite. Most common species infecting humans are C. hominis, C. parvum, and C. meleagridis.
• Sporulated oocysts (4-6 micrometers in diameter) are ingested, then excyst and attach to intestinal epithelium; trophozoites mature to meronts, which release merozoites leading to zygote formation; oocysts then released through feces into environment.
• In immunocompromised pts, parasites develop intracellularly throughout GI tract, within epithelial cells of biliary tree and pancreatic ducts. Infection causes loss of villi, crypt hyperplasia, and reduction in brush border enzyme activity.
• Environmental oocysts infectious when shed, small in size, can survive for at least 6 mos (if kept moist), and are resistant to chlorination. Sensitive to dessication, hydrogen peroxide, ozone and UV radiation.
• Person-to-person transmission among family members and close contacts tends to occur because infectious dose is small (as few as 10 oocysts); zoonotic and food-borne (raw oysters) transmission also possible; most outbreak cases due to contaminated water, as in Milwaukee, Wisconsin (1993).