Cryptosporidiosis is the name given to a diarrheal disease. It is caused by cryptosporidia.
What is cryptosporidiosis?
Cryptosporidiosis is one of the diarrheal diseases and is caused by the parasite Cryptosporidium. Cryptosporidium is one of the unicellular parasites and is found in about 40 species of vertebrates. These include cattle, sheep, goats and horses, but also cats, dogs and birds. Cryptosporidiosis rarely occurs in humans. However, individuals suffering from a cellular immunodeficiency disease such as AIDS are considered at risk. Cryptosporidia are found all over the world. Sometimes they also infect healthy people who, however, do not show any symptoms. The parasites are excreted in the stool. Thus, cryptosporidia could be found in the feces of 1 to 4 percent of all non-infected persons. A higher incidence of cryptosporidiosis than in industrialized countries can be observed in developing countries. Persons at risk of contracting cryptosporidiosis include AIDS patients and people undergoing immunosuppression due to organ transplantation. But there is also an increased risk of infection in smaller children up to 24 months of age. In Germany, cryptosporidiosis is subject to mandatory medical notification.
Causes
Cryptosporidiosis is caused by the cryptosporidium genera Cryptosporidium parvum and Cryptosporidium hominis, which belong to the parasitic protozoa. In contrast, other cryptosporidia such as Cryptosporidium felis or Cryptosporidium canis rarely cause the infection. The excretion of the pathogens from the body of animals takes place through oocysts. These are egg-like reproductive stages of the cryptosporidia. In most cases, humans become infected with the parasites through contaminated water. Drinking water or bath water can also be infected by the germs. In addition, there is a risk that fruit and vegetables cleaned with contaminated water will also be contaminated. Another source of infection is meat infested with cryptosporidia. In addition, transmission from person to person or from animal to person is possible through smear infections. If the oocysts enter the human body, they penetrate into the small intestine. There, release of infectious sporozoites occurs. Through reproduction, these can multiply and in the further course form further oocysts, which in turn are excreted with the feces. Through them, there is a risk of infection for about two years. Because thin-walled oocysts often burst open in the intestine, there is a risk of autoinfection, which is especially true for people with immunodeficiency. The incubation period of cryptosporidiosis is between one and twelve days. In most cases, the disease appears seven to ten days after the onset of infection. Even after symptoms subside, there is still a risk of infection for several weeks.
Symptoms, complaints, and signs
Cryptosporidiosis is noticeable by pronounced watery diarrhea. This threatens a significant loss of fluid. Furthermore, symptoms such as fever, nausea, abdominal pain, and weight loss may set in. If the person has an intact immune system, the symptoms disappear after a week. However, in the case of immunodeficiency or in babies, there is a risk of complications. These include, above all, dehydration (decrease in body fluid). Normally, the symptoms of cryptosporidiosis are limited to the intestinal region. However, if the patient suffers from AIDS, colonization of the parasites in other regions of the body is also within the realm of possibility. These primarily include the liver as well as the bile ducts.
Complications
Due to cryptosporidiosis, affected individuals suffer from very severe diarrhea. As a result, the quality of life of the affected person is also significantly limited and reduced, so that there are also restrictions in the daily life of the patient. Due to the permanent diarrhea, there is also a very high loss of fluid in the patient, so that they also suffer from increased thirst. Furthermore, the immune system can also be weakened due to cryptosporidiosis, so that the patients fall ill more often with infections or inflammations. Complications can occur if the affected person already suffers from a weakened immune system and also has AIDS, for example.The liver and gallbladder can also be significantly damaged by this disease. Treatment of cryptosporidiosis usually depends on the cause of the disease. In most cases, however, the symptoms disappear again after a few days, so there are no particular complications or limitations. In other cases, treatment with the help of medication must take place so that the complaints can be limited. Without treatment, various complications can occur. If the affected person also has AIDS, the disease can also lead to death if it is not treated.
When should you go to the doctor?
When diarrhea, fever, nausea, abdominal pain and other signs of cryptosporidiosis are noticed, a quick visit to the doctor is a good idea. Although the diarrheal illness is not life-threatening in most cases, it must still be monitored by a physician because of the severe fluid loss. Persons suffering from the above-mentioned signs of illness should ideally visit the doctor’s office immediately and have the symptoms clarified. Medical advice must be sought after two to three days at the latest if the symptoms have not improved in the meantime. If further symptoms occur, a visit to the doctor is recommended. HIV patients and people with immunodeficiency should inform the responsible specialist about the symptoms. Babies and young children with diarrhea must be taken to the pediatrician in any case. In extreme cases, parents should take the child to a hospital or directly involve the emergency services. Cryptosporidiosis is treated by the general practitioner or an internist. In case of severe fluid loss or high fever, treatment in the intensive care unit may be necessary.
Treatment and therapy
To diagnose cryptosporidiosis, microscopic evidence of the parasites in the patient’s stool is required. For this purpose, several stool samples must be provided. The samples are analyzed under the microscope on different days. In addition, antigens of the cryptosporidia can be detected, but this is less conclusive. Thus, only a determination at the genus level is feasible. A histological diagnosis can be made from tissue samples obtained from the small intestine with the aid of an endoscope. The course and duration of cryptosporidiosis depend on whether an immune deficiency is present and its extent. In most people, the disease disappears after one to two weeks and immunity to the parasites is maintained for the rest of the patient’s life. However, in the case of immunodeficiency such as AIDS, the disease often takes a chronic course, so that the symptoms persist. If the immune system is severely weakened, there is even a risk of a fatal course of the disease.
Outlook and prognosis
The prognosis of cryptosporidiosis is considered favorable. If medical care is sought, administration of drugs occurs. These take effect within a few days, so that recovery usually occurs within two weeks. A special feature of the disease is that a re-infestation with the disease-causing germs is no longer possible later in life. The body develops immunity to the parasites leading to cryptosporidiosis. The prognosis worsens in patients who have a weakened immune system. There may be delays during the healing process. In addition, severe impairment of quality of life is possible. In particularly rare cases, the body’s immune system collapses. This can happen if the patient has reached an advanced age and suffers from additional diseases. Without seeking medical care, delays in recovery can also be expected. Nevertheless, with a healthy stable immune system, relief from symptoms occurs within a few weeks. The organism manages to successfully fight off the pathogens and kill them. Subsequently, they are removed from the body in a natural way. In people who have pre-existing conditions or immunodeficiency, the prognosis worsens considerably if they refuse medical treatment.
Prevention
To date, it has not been possible to develop a specific treatment for cryptosporidiosis. For this reason, therapy is limited to controlling the symptoms.The most important measures include compensation for electrolyte and fluid loss. If the patient suffers from AIDS, highly active antiretroviral therapy (HAART) is considered effective. Clinical improvement can also be achieved by administration of the broad-spectrum antibiotic nitrazoxanide. Other helpful drugs include the antibiotics azithromycin and paromomycin. In acute episodes of cryptosporidiosis, a combination of azithromycin and nitrazoxanide is not uncommon. The oocysts of cryptosporidia are resistant to all disinfectants. To prevent them, water should be boiled. Hot water heated to 60 degrees Celsius for at least 30 minutes safely kills the parasites. Infection can be prevented by careful hygiene, such as regular hand washing after going to the toilet or before preparing food. It is important that infected persons refrain from visits to the sauna or swimming pool.
Aftercare
In cryptosporidiosis, the measures of an aftercare are often severely limited. Thereby, with this disease, the affected person should primarily see a doctor at an early stage, so that there are no further complications and also no further worsening of the symptoms. Cryptosporidiosis cannot heal itself, so that an examination and treatment by a doctor is usually always necessary. Most patients are dependent on taking various medications. The patient should always follow the doctor’s instructions and contact him or her if there are any questions or uncertainties. It is also important to ensure that the medication is taken regularly, and of course the correct dosage should be observed. In the event of other damage to the body or other complaints, a doctor should also be contacted. In many cases, patients with cryptosporidiosis are dependent on the help and care of their own family. This can make the daily life of the affected person much easier. In many cases, however, cryptosporidiosis reduces the life expectancy of the affected person, since a complete cure is usually not possible.
What you can do yourself
People who suspect cryptosporidiosis must first submit several stool samples. With the help of the samples, the doctor can determine the disease and initiate appropriate therapy. Depending on the type of treatment, those affected can take some measures themselves to promote recovery. Basically, an active lifestyle with a healthy diet and sufficient exercise is recommended. The considerable loss of fluids can be compensated for by taking in sufficient water. Nausea and abdominal pain can also be reduced by dietary measures. If fever develops during the course of the disease, the patient must take it easy. The symptoms will subside after a few days, provided that the immune system is not further stressed. If cryptosporidiosis occurs in a child, close medical monitoring is indicated. Parents should be alert to any symptoms and seek immediate pediatrician attention in case of complications. Special feeding bottles and baby food help to provide the child with sufficient nutrition despite the lack of appetite. If the course is positive, these measures are sufficient to support medical treatment. In severe cases, hospitalization may be necessary. Parents should talk to the responsible medical professional about this.
