Cryptosporidium and Giardia in recreational water in Belgium

Ehsan, Amimul; Casaert, Stijn; Levecke, Bruno; Rooy, Liesbet Van; Pelicaen, Joachim; Smis, Anne; Backer, Joke De; Vervaeke, Bart; Smedt, Sandra De; Schoonbaert, Filip; Lammens, Saskia; Warmoes, Thierry; Geurden, Thomas; Claerebout, Edwin

doi:10.2166/wh.2015.268

Cited by 18 publications

(8 citation statements)

References 45 publications

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“…Given the epidemiological characteristics of swimming pools observed in this study (Table 1) the positivity results for Giardia cysts (19%) and Cryptosporidium oocysts (9.5%) determined by IFA were not surprising. In Belgium, Ehsan et al (2015) found that three out of 37 swimming pool samples (8.1%) tested positive for Cryptosporidium, Giardia or both protozoa. In the USA, Shields, Gleim, and Beach (2008) sampled 160 swimming pools not associated with outbreaks and found that 13 (8.1%) were positive for one or both parasites, ten (6.2%) for Giardia cysts, two (1.2%) for Cryptosporidium oocysts and one (0.6%) for both parasites.…”

Section: Discussionmentioning

confidence: 99%

Toxoplasmagondii oocysts, Giardia cysts and Cryptosporidium oocysts in outdoor swimming pools in Brazil

Pineda

Leal

Fiúza

et al. 2020

Zoonoses and Public Health

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The accidental ingestion of treated recreational water is an important transmission route of waterborne protozoa worldwide. The present study aimed to provide the first evaluation of swimming pools in Brazil, analysing the presence of pathogenic protozoa (Toxoplasma gondii, Cryptosporidium spp. and Giardia spp.) by parasitological and molecular methods. A total of 57 samples were collected from 21 public swimming pools, either directly from the pool or filter backwash water and concentrated using the membrane filtration technique. Giardia cysts and Cryptosporidium oocysts were visualized by direct immunofluorescence assay after purification by immunomagnetic separation. Toxoplasma gondii oocysts were detected by autofluorescence visualization using the supernatant discarded during the purification step as a sample. Positive samples were submitted to molecular analysis. The molecular markers were used: SSU-rRNA, tpi, gdh and bg, for Giardia DNA amplification, and 18S rRNA gene fragment amplification was used for the Cryptosporidium oocysts. The 529-bp repeat element (REP529) fragment and the 35-fold repetitive B1 gene were employed as a target for T. gondii. Amplified products were submitted to sequencing and phylogenetic analysis. Giardia cysts were detected in 19.0% and Cryptosporidium oocysts in 9.5% of swimming pools. In one swimming pool (4.7%), both protozoa were detected on at least one occasion. Structures similar to T. gondii oocysts were detected in 33.3% of the samples, ranging from one to 23 per slide. Giardia was confirmed by DNA amplification in three swimming pools; Giardia duodenalis Assemblage A was identified by the phylogenetic positioning of the β-giardin gene. Toxoplasma gondii DNA was detected in 14.2% of swimming pools. The present study represents the first report of the occurrence of T. gondii oocysts in swimming pools. Recreational activity in swimming pools contaminated by chlorine-resistant protozoa can represent a high risk of infection for bathers and swimmers.

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Section: Discussionmentioning

confidence: 99%

Toxoplasmagondii oocysts, Giardia cysts and Cryptosporidium oocysts in outdoor swimming pools in Brazil

Pineda

Leal

Fiúza

et al. 2020

Zoonoses and Public Health

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“…Most AGI outbreaks in treated recreational water are associated with ingesting Cryptosporidium . Cryptosporidium has been detected in treated recreational water and associated with outbreaks internationally [ 5 , 6 , 7 , 8 ]. From 2000–2014, Cryptosporidium caused 58% of treated recreational water outbreaks in the U.S. [ 9 ].…”

Section: Introductionmentioning

confidence: 99%

Validation of Questionnaire Methods to Quantify Recreational Water Ingestion

Suppes

Ernst

Abrell

et al. 2018

IJERPH

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Swimming pool water ingestion volumes are necessary for assessing infection risk from swimming. Pool water ingestion volumes can be estimated by questionnaire or measuring a chemical tracer in swimmer urine. Questionnaires are often preferred to the chemical tracer method because surveys are less time consuming, but no research exists validating questionnaires accurately quantify pool water ingestion volumes. The objective of this study was to explore if questionnaires are a reliable tool for collecting pool water ingestion volumes. A questionnaire was issued at four pool sites in Tucson, Arizona to 46 swimmers who also submitted a urine sample for analyzing cyanuric acid, a chemical tracer. Perceived ingestion volumes reported on the questionnaire were compared with pool water ingestion volumes, quantified by analyzing cyanuric acid in swimmer urine. Swimmers were asked if they swallowed (1) no water or only a few drops, (2) one to two mouthfuls, (3) three to five mouthfuls, or (4) six to eight mouthfuls. One mouthful is the equivalent of 27 mL of water. The majority (81%) of swimmers ingested <27 mL of pool water but reported ingesting >27 mL (“one mouthful”) on the questionnaire. More than half (52%) of swimmers overestimated their ingestion volume. These findings suggest swimmers are over-estimating pool water ingestion because they perceive one mouthful is <27 mL. The questionnaire did not reliably collect pool water ingestion volumes and should be improved for future exposure assessment studies. Images of the ingestion volume categories should be included on the questionnaire to help swimmers visualize the response options.

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“…1). Despite much lower numbers being examined, the positivity rate for Giardia was higher than Cryptosporidium in 10 of the laboratories (ID 1, 4, 5, 9, 12, 14, 15,16,18,19) where the percentage positivity for Giardia ranging from 0% to 3•71% ( Fig. 2) with 166 laboratoryconfirmed cases.…”

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confidence: 95%

“…For Cryptosporidium, the majority of laboratories (17/19) performed microscopy to detect oocysts. The most common staining method chosen was AP confirmed by mZN in eight laboratories (ID 1, 3, 5-7, 11,16,19). Three laboratories performed mZN alone (ID 9, 14, 18), six employed AP staining only (ID 4, 8, 10, 12, 13, 15), one laboratory used a lateral flow immunochromatographic antigen assay (ID17), and another performed a manually washed plate-based EIA (ID 2).…”

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confidence: 99%

An audit of Cryptosporidium and Giardia detection in Scottish National Health Service Diagnostic Microbiology Laboratories

Alexander¹,

Currie²,

Pollock

et al. 2017

Epidemiol. Infect.

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Giardia duodenalis and Cryptosporidium species are protozoan parasites capable of causing gastrointestinal disease in humans and animals through the ingestion of infective faeces. Whereas Cryptosporidium species can be acquired locally or through foreign travel, there is the mis-conception that giardiasis is considered to be largely travel-associated, which results in differences in laboratory testing algorithms. In order to determine the level of variation in testing criteria and detection methods between diagnostic laboratories for both pathogens across Scotland, an audit was performed. Twenty Scottish diagnostic microbiology laboratories were invited to participate with questions on sample acceptance criteria, testing methods, testing rates and future plans for pathogen detection. Reponses were received from 19 of the 20 laboratories representing each of the 14 territorial Health Boards. Detection methods varied between laboratories with the majority performing microscopy, one using a lateral flow immunochromatographic antigen assay, another using a manually washed plate-based enzyme immunoassay (EIA) and one laboratory trialling a plate-based EIA automated with an EIA plate washer. Whereas all laboratories except one screened every stool for Cryptosporidium species, an important finding was that significant variation in the testing algorithm for detecting Giardia was noted with only four laboratories testing all diagnostic stools. The most common criteria were 'travel history' (11 laboratories) and/or 'when requested' (14 laboratories). Despite only a small proportion of stools being examined in 15 laboratories for Giardia (2%-18% of the total number of stools submitted), of interest is the finding that a higher positivity rate was observed for Giardia than Cryptosporidium in 10 of these 15 laboratories. These findings highlight that the underreporting of Giardia in Scotland is likely based on current selection and testing algorithms.

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Cryptosporidium and Giardia in recreational water in Belgium

Cited by 18 publications

References 45 publications

Toxoplasmagondii oocysts, Giardia cysts and Cryptosporidium oocysts in outdoor swimming pools in Brazil

Toxoplasmagondii oocysts, Giardia cysts and Cryptosporidium oocysts in outdoor swimming pools in Brazil

Validation of Questionnaire Methods to Quantify Recreational Water Ingestion

An audit of Cryptosporidium and Giardia detection in Scottish National Health Service Diagnostic Microbiology Laboratories

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