Cyclospora Species -- A New Protozoan Pathogen of Humans

Ortega, Ynés R.; Sterling, Charles R.; Gilman, Robert H.; Cama, Vitaliano; Díaz, Fernando

doi:10.1056/nejm199305063281804

Cited by 396 publications

(257 citation statements)

References 15 publications

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“…Cyclospora cayetanensis is more closely related genetically to Eimeria species than to Cryptosporidium species (5), and the two organisms have biological differences. For example, C. parvum is infectious when excreted and can be transmitted directly from person to person; Cyclospora cayetanensis requires a period of time in the environment to sporulate into the infectious form (3), decreasing the likelihood of direct person-to-person spread. Cryptosporidium parvum infects both humans and a variety of mammals (6), and evidence is mounting that non- parvum zoonotic Cryptosporidium species can also infect immunocompetent humans (7,8).…”

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Epidemiologic Differences Between Cyclosporiasis and Cryptosporidiosis in Peruvian Children

Bern

Ortega

Checkley

et al. 2002

Emerg. Infect. Dis.

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We compared the epidemiologic characteristics of cyclosporiasis and cryptosporidiosis in data from a cohort study of diarrhea in a periurban community near Lima, Peru. Children had an average of 0.20 episodes of cyclosporiasis/year and 0.22 episodes of cryptosporidiosis/year of follow-up. The incidence of cryptosporidiosis peaked at 0.42 for 1-year-old children and declined to 0.06 episodes/child-year for 5- to 9-year-old children. In contrast, the incidence of cyclosporiasis was fairly constant among 1- to 9-year-old children (0.21 to 0.28 episodes/child-year). Likelihood of diarrhea decreased significantly with each episode of cyclosporiasis; for cryptosporidiosis, this trend was not statistically significant. Both infections were more frequent during the warm season (December to May) than the cooler season (June to November). Cryptosporidiosis was more frequent in children from houses without a latrine or toilet. Cyclosporiasis was associated with ownership of domestic animals, especially birds, guinea pigs, and rabbits.

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Epidemiologic Differences Between Cyclosporiasis and Cryptosporidiosis in Peruvian Children

Bern

Ortega

Checkley

et al. 2002

Emerg. Infect. Dis.

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114

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“…En 1994, cuando Ortega y Cryptosporidium, Isospora, Cyclospo'ra y colaboradores describieron el parásito como Microspora, se han descrito como causa de Cyclospora cayetanensis (1 O), se confirmó que en patología intestinal tanto en los pacientes con el intestino existían formas intraepiteliales del alteraciones de la inmunidad como en personas parásito en su estado asexual en las biopsias de inmunocompetentes (1,2). los pacientes sintomáticos (9).…”

Section: Identificación De Cyclosporaunclassified

“…Materiales y métodos -posteriormente, lo definieron como la especie En la consulta médica del Colombiano Cyclospora cayetanensis (9,10), al demostrar con de Medicina Tropical se tiene como norma que, el microscopio electrónico que los ooquistes en los pacientes con diarrea de más de una tenian esporozoitos con organelos caracteristicos de duración, además del examen de las coccidias, phylum Apicomplexa. La coprológico para búsqueda de parásitos confirmación en el intestino se hizo al observar intestinales, se haga una preparación para las formas intraepiteliales del parásito en su colorearla por el método de Ziehl-Neelsen estadio asexual en las biopsias de intestino de modificado (9), Con este método se encontraron los pacientes sintomáticos (9,IO).…”

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“…La coprológico para búsqueda de parásitos confirmación en el intestino se hizo al observar intestinales, se haga una preparación para las formas intraepiteliales del parásito en su colorearla por el método de Ziehl-Neelsen estadio asexual en las biopsias de intestino de modificado (9), Con este método se encontraron los pacientes sintomáticos (9,IO). En 1996, quistes ácido.resistentes que se estudiaron Relman y colaboradores deteminaron la secuencia detenidamente por su tamaiio, Se tres de ADN al hacer un análisis filogenético (11) Y casos con estructuras semejantes a Crypto.…”

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Infección por Cyclospora sp. en tres pacientes inmunocompetentes

et al. 2000

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ResumenSe presentan tres casos de pacientes inmunocompetentes con síndrome diarreico que consultaron al Instituto Colombiano de Medicina Tropical en Medellin. El único agente patógeno aislado de sus muestras fecales fue Cyclospora sp. Una paciente fue tratada con un medicamento antiparasitario experimental, la nitazoxanida, y los otros dos pacientes con trimetroprim-sulfametoxazole, todos con buenos resultados. Se presenta una revisión de algunos aspectos de la enfermedad y se recomienda que, en casos de diarrea prolongada, se disponga de un protocolo completo para estudio de parásitos en materia fecal, además de capacitar muy bien al personal de salud que lee los coprológicos para establecer un diagnóstico diferencial entre el grupo de las coccidias.Palabras clave: coccidia, Cyclospora, diarrea crónica Cyclospora sp. infection i n three immunocompetent patients We describe three patients seen at the Instituto Colombiano de Medicina Tropical in Medellin, in whose case the only parasitic agent incriminated as the cause of prolonged diarrhea was the protozoan Cyclospora sp. One patient was treated with a new antiparasitic drug, nitazoxanide, and the other two with trimethoprim-sulfamethoxazole, al1 with good results. A revision of some aspects of the illness is presented. It is recommended that in cases of prolonged diarrhea, a complete protocol for the study of parasites in faeces be established and that the microscopists be trained to identify the coccidian pathogens.

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“…The outbreaks of cyclosporiasis epidemiologically linked to contamination of berries or vegetables 10,13 have been consequently classified as foodborne, although contamination of field watering systems with the oocysts was possible. Epidemiologic circumstances presented in the cases, outbreaks, or non-outbreak settings of C. cayetanensis infections, 10,14 together with the prolonged pathogen sporulation period, 15 strongly indicate waterborne transmission of the oocysts. 16 It has been demonstrated that Corbicula fluminea clams are capable of recovery and sedimentation of infectious waterborne oocysts of Cryptosporidium parvum, 17,18 which is a pathogen with an oocyst diameter of 3.5-6.0-m.…”

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Recovery of waterborne oocysts of Cyclospora cayetanensis by Asian freshwater clams (Corbicula fluminea).

Graczyk

Ortega²,

Conn³

1998

The American Journal of Tropical Medicine and Hygiene

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Abstract. Asian freshwater clams (Corbicula fluminea) were exposed for 24 hr in 38 liters of water contaminated with 1.0 ϫ 10 5 Cyclospora cayetanensis oocysts (2.6 ϫ 10 3 oocysts/L). The hemolyph and gill smears of 30 clams were examined by acid-fast stain on days 1, 3,5,7,10,13, and 18 postexposure (PE). Since no oocysts were detected in the water 24 hr after contamination by the membrane filter-dissolution method, the oocyst retention rate was 4.6 ϫ 10 2 oocysts/clam. The prevalence of oocyst-positive clams significantly decreased (P Ͻ 0.01) from 93% to 47% during 13 days PE. None of the clams contained oocysts on day 18 PE; no oocysts were detected in the clam feces. The numbers of oocysts recovered from six clam size classes varied and significantly decreased with smaller clam size (P Ͻ 0.01). The lowest prevalence values of oocyst-positive clams, 45% and 34%, were observed in the two lowest size classes: 12.1-14.0 mm and 14.1-16.0 mm, respectively. The prevalence values in the remaining four classes ranged from 84% to 100%. The sampling program demonstrated that the population of 180 clams examined during the study up to 13 day PE could be assessed for C. cayetanensis positivity by random testing of a minimum of 75 clams (42%). When the two lowest clam size classes are eliminated, the population of 114 clams could be assessed by sampling a minimum of 32 clams (28%). The results demonstrate that Corbicula fluminea can recover waterborne oocysts of C. cayetanensis, and could be used as biological indicators of contamination of water with C. cayetanensis oocysts.The Asian freshwater clam Corbicula fluminea, which was introduced to North America in the early 1900s, 1 is well adapted to life in unstable and unpredictable habitats. 2 The species is highly successful in agricultural drainage systems 3 and can survive in waters receiving agricultural and industrial pollution, and urban waste. 2 Corbicula fluminea serves as a biological indicator of water pollution with organochlorine insecticides, metals, 4-7 and waterborne mutagens. 8 It is an efficient suspension feeder able to filter detrital particles of 10-m-diameter at a rate up to 2.50 L/hr. 2 Cyclospora cayetanensis is an intestinal coccidian protozoon that causes prolonged diarrheal illness in adults and children worldwide. 9-11 Waterborne transmission of C. cayetanensis is believed to be the main mode of transmission; 10 however, with the exception of one confirmed drinking water outbreak, 12 it remains epidemiologically unproven. The outbreaks of cyclosporiasis epidemiologically linked to contamination of berries or vegetables 10,13 have been consequently classified as foodborne, although contamination of field watering systems with the oocysts was possible. Epidemiologic circumstances presented in the cases, outbreaks, or non-outbreak settings of C. cayetanensis infections, 10,14 together with the prolonged pathogen sporulation period, 15 strongly indicate waterborne transmission of the oocysts. 16 It has been demonstrated that Corbicula fluminea clams...

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Cyclospora Species -- A New Protozoan Pathogen of Humans

Abstract: We have identified organisms of the genus cyclospora that are remarkably similar to cryptosporidia in their morphologic features and the diarrheal disease that they produce in humans. The complete life cycle and epidemiology of this new protozoan parasite remain to be described.

Cited by 396 publications

References 15 publications

Epidemiologic Differences Between Cyclosporiasis and Cryptosporidiosis in Peruvian Children

Epidemiologic Differences Between Cyclosporiasis and Cryptosporidiosis in Peruvian Children

Infección por Cyclospora sp. en tres pacientes inmunocompetentes

Recovery of waterborne oocysts of Cyclospora cayetanensis by Asian freshwater clams (Corbicula fluminea).

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