Cryptosporidium Surveillance

Cryptosporidiosis is a highly communicable parasitic disease caused by parasites of the genus Cryptosporidium .  It is one of the most common causes of waterborne disease in the United States .  The incubation period averages 7 days and the disease is characterized by loose, watery diarrhea, accompanied by dehydration, weight loss, abdominal cramping, nausea and vomiting.  In healthy individuals, symptoms are self-limiting and usually last for 1-2 weeks, although they may be intermittent for up to 30 days.

Individuals with weakened immune systems may experience more severe, longer-lasting or life-threatening illness.  Nitazoxanide has been approved for treatment of diarrhea in healthy individuals aged one year or older; the effectiveness of nitazoxanide in immunocompromised individuals is unclear.

Transmission occurs via the fecal-oral route, most commonly by swallowing or ingesting recreational water contaminated with feces from an infected person or animal.  The disease can also be easily spread from person to person, particularly in childcare settings, by putting something in your mouth that has been contaminated or by touching your mouth with contaminated hands. 

  • Up to 1 billion oocysts can be released in a single bowel movement and the infectious dose is as low as 10-30 oocysts.
  • To prevent the spread of Cryptosporidiosis, the public should not swim with diarrhea, should wait 2 weeks after diarrhea has stopped before swimming and should wash hands with soap and water after using the toilet, changing diapers and before eating or preparing food.

Information for physicians:

  • Consider Cryptosporidiosis in the differential diagnosis of a patient with diarrhea and recreational water exposure.
  • Specifically request Cryptosporidium when submitting a stool sample for testing.
  • Notify your local health department if you suspect Cryptosporidiosis in a patient or cluster of patients.
  • Remember that Cryptosporidiosis is a reportable disease.
  • Educate patients on Cryptosporidiosis prevention and swimming hygiene.


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