Overwhelming Watery Diarrhea Associated with a Cryptosporidium in an Immunosuppressed Patient

Meisel, Jane L.; Perera, David; Meligro, C.; Rubin, Cyrus E.

doi:10.1016/s0016-5085(76)80331-9

Cited by 389 publications

(136 citation statements)

References 17 publications

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“…Originally, human cryptosporidiosis was considered to be an exclusively zoonotic disease as the first patients had reported close contact with livestock (Nime et al 1976;Meisel et al 1976). Subsequent cases, in which patients had no animal contact, brought this theory into question.…”

Section: Introductionmentioning

confidence: 99%

Intra-isolate variation of Cryptosporidium parvum small subunit ribosomal RNA genes from human hosts in England

Gibbons-Matthews

Prescott

2003

Parasitology Research

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Cryptosporidium parvum is a protozoan parasite responsible for a number of water-borne outbreaks of human gastrointestinal infection. The importance of this parasite for human health has led to several investigations into its epidemiology. In the present study, sequence and PCR-RFLP analyses were performed on cloned SSU rRNA genes from human and bovine C. parvum isolates. Each cloned gene was assigned a genotype using AseI restriction digestion profiles. Although sequence heterogeneity was observed, six of seven human isolates contained human genotype SSU rRNA genes and one human isolate contained bovine genotype genes. No intra-isolate variation was observed between the SSU rRNA genes analysed from a single bovine (Iowa) isolate. Intra-isolate variation did not occur at the Ase I restriction sites and therefore did not interfere with the assignment of C. parvum genotypes by RFLP. Mixed RFLP genotypes (human and bovine) were not observed in any of the C. parvum isolates analysed.

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Section: Introductionmentioning

confidence: 99%

Intra-isolate variation of Cryptosporidium parvum small subunit ribosomal RNA genes from human hosts in England

Gibbons-Matthews

Prescott

2003

Parasitology Research

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“…Paromomycin was not shown to be more effective than placebo for the treatment of symptomatic cryptosporidial enteritis. However, inadequate statistical power prevents definitive rejection of the usefulness of paromomycin as therapy for this infection.The first human cases of Cryptosporidium parvum infection were reported in 1976 [1,2], and the first AIDS-related cases were reported in 1982 [3]. This enteric parasite can cause chronic, voluminous diarrhea frequently complicated by dehydration and electrolyte abnormalities.…”

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confidence: 99%

Paromomycin: No More Effective than Placebo for Treatment of Cryptosporidiosis in Patients with Advanced Human Immunodeficiency Virus Infection

et al. 2000

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To evaluate the efficacy of paromomycin for the treatment of symptomatic cryptosporidial enteritis in human immunodeficiency virus-infected adults, we conducted a prospective, randomized, double-blind, placebo-controlled trial before the widespread introduction of highly active antiretroviral therapy (HAART). Seven units under the auspices of the AIDS Clinical Trials Group enrolled 35 adults with CD4 cell counts of < or = 150/mm(3). Initially, 17 patients received paromomycin (500 mg 4 times daily) and 18 received matching placebo for 21 days. Then all patients received paromomycin (500 mg q.i.d.) for an additional 21 days. Clinical definitions of response were measured by an average number of bowel movements per day in association with concurrent need for antidiarrheal agents that was lower than that before study entry. There was no treatment response during the placebo-controlled phase of the study according to protocol-defined criteria (P=.88). Three paromomycin recipients (17.6%) versus 2 placebo recipients (14.3%) responded completely. Rates of combined partial and complete responses in the paromomycin arm (8 out of 17, 47.1%) and the placebo arm (5 out of 14, 35.7%) of the study were also similar (P=.72). The clinical course of cryptosporidiosis was quite variable. Paromomycin was not shown to be more effective than placebo for the treatment of symptomatic cryptosporidial enteritis. However, inadequate statistical power prevents definitive rejection of the usefulness of paromomycin as therapy for this infection.

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“…The first two human cases of C. parvum infection were reported in 1976 (Meisel et al, 1976;Nime et al, 1976) and most of the early case reports involved veterinarians or animal handlers. Major incidents of Cryptosporidium infection also occurred as a result of environmental contamination of municipal water supplies, such as the 1993 outbreak in Milwaukee, Wisconsin that affected over 50% of a population of 800,000 people and produced at least 69 deaths (Hoxie et al, 1997;Pan and Graczyk, 1997).…”

Section: Introductionmentioning

confidence: 99%

A Probabilistic Risk Assessment of Cryptosporidium Exposure Among Baltimore Urban Anglers

Roberts¹,

Silbergeld

Graczyk

2007

Journal of Toxicology and Environmental Health, Part A

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In some urban settings, recreational fishing in industrialized waterways may pose a substantial health risk due to the presence of pathogenic microbes such as Cryptosporidium, a pathogen that produces a moderate to fatal gastrointestinal illness in humans. This pilot study examined the risk of exposure to Cryptosporidium based on fish samples and hand wash samples taken from urban anglers. Information regarding fishing frequency and consumption were also collected through an interview questionnaire to further characterize this risk. There were a total of 56 anglers interviewed and 46 fish and hand wash samples collected (18 hand wash samples and 28 fish samples). It was determined that the mean probability of infection using the U.S. Environmental Protection Agency's (EPA) dose-response model for Cryptosporidium and the fish and hand wash samples was 0.11 and 0.81, respectively. Among the positive fish samples, this mean probability was found to be 0.41. Depending on a variety of confounding factors, such as immunity, pre-existing illnesses and other host specific factors, this probability indicated that on average 1 to 8 out of 10 anglers could become infected. The current fish consumption advisories in Maryland and elsewhere provide no apparent information in regard to any microbiological contaminant. This pilot study provided data for possible modifications and improvements to be made to policy and risk communication regarding the potential health risks due to Cryptosporidium exposure from fishing.

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Overwhelming Watery Diarrhea Associated with a Cryptosporidium in an Immunosuppressed Patient

Cited by 389 publications

References 17 publications

Intra-isolate variation of Cryptosporidium parvum small subunit ribosomal RNA genes from human hosts in England

Intra-isolate variation of Cryptosporidium parvum small subunit ribosomal RNA genes from human hosts in England

Paromomycin: No More Effective than Placebo for Treatment of Cryptosporidiosis in Patients with Advanced Human Immunodeficiency Virus Infection

A Probabilistic Risk Assessment of Cryptosporidium Exposure Among Baltimore Urban Anglers

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