Cryptosporidium spp. and Giardia duodenalis as pathogenic contaminants of water in Galicia, Spain: The need for safe drinking water

Assessment of the potential occurrence of Cryptosporidium species in various water sources in Sharqia Governorate, Egypt

Cryptosporidium species are enteric apicomplexan parasites associated with diarrhoeal disease in humans and animals globally. Waterborne outbreaks resulting from contamination with the infective oocysts are common worldwide. Updated reports on waterborne protozoal infections are needed to identify emerging pathogens and susceptible populations. Therefore, this study aimed to assess the current profile of Cryptosporidium contamination of various water sources in Sharqia Governorate, Northeastern Egypt. For this purpose, eighty samples were collected from five different water types (canal, tap, tank, filtered, and groundwater), distributed in four major cities (El-Hessenia, Fakous, Zagazig, and Belbies) in Sharqia Governorate. All water samples were examined using conventional microscopy, ELISA, and real-time PCR (RT-PCR) techniques. Based on microscopic analysis, the Cryptosporidium protozoan was identified in 25% of the tested water samples. The RT-PCR assay has allowed for the quantification of Cryptosporidium oocysts in different types of water. Canal water exhibited the highest Cryptosporidium contamination levels (mean = 85.15 oocysts/L), followed by water tanks (mean = 12.031 oocysts/L). The study also provided a comparative evaluation of ELISA and RT-PCR for the diagnosis of Cryptosporidium infection. RT-PCR performed better than ELISA in terms of analytical accuracy (97.50% vs. 86.25%) and specificity (100% vs. 83.33%). However, ELISA showed a higher sensitivity (95.00% vs. 90.00%) for Cryptosporidium recovery. Our findings could serve as a platform for further investigations into the potential risks associated with water contamination in Sharqia Governorate.

Supplementary Information

The online version contains supplementary material available at 10.1007/s12639-024-01675-1.

Fresh Leafy Vegetables and Parasitic Contamination: Practical Solutions

This study aimed at investigating the parasitic contamination of fresh leafy vegetables in Tehran, Iran, during 2020-2021. A cross-sectional study was conducted and 180 fresh leafy vegetables (including leek, watercress, mint, spring onion, radish, basil, parsley, lettuce, and spinach) were collected randomly in the five regions of Tehran, Iran. Each 200-g sample was soaked with tap water containing detergent, and the obtained sediment was centrifuged and examined for parasitic stages using a light microscope. The overall rate of parasitic contamination was 19.4%, with Trichostrongylus and Toxocara eggs being the most prevalent parasites (3.9%) and the highest rate of parasitic contamination was observed in spinach (40%), whereas no contamination was found in spring onions. Except for radish, other vegetable samples had multiple parasitic infections. Due to the contamination of vegetables, it is necessary to have a suitable method to reduce the parasites. Consequently, policymakers should safeguard public health by consistently monitoring contaminants in food and prioritizing education and research on methods to mitigate their presence in the food chain.

Burden and Epidemiology of Human Intestinal Giardia duodenalis Infection in Colombia: A Systematic Review

The genus Giardia is a unicellular protozoan able to parasitize both humans and animals. Cysts of Giardia can be found in soil samples, aquatic environments, food, and any surface that gets in contact with the feces of parasitized animals. The aim of this systematic review was to analyze the burden and epidemiology of Giardia infection in Colombia summarizing recent scientific reports and existing knowledge and to identify knowledge gaps that may be addressed in future investigations. This work follows the guidelines established by "Preferred Reporting Items for Systematic Reviews and Meta-Analyzes" (PRISMA). Published scientific literature from 1 January 2010 to 18 September 2022 was searched in six electronic scientific databases using the search terms: "Giardia" OR "Giardiasis" AND "Colombia". Twenty-three scientific articles were performed in 22 departments of Colombia at rural, urban, and a combination of rural and urban contexts. The prevalence of Giardia in the Colombian population was between 0.9 and 48.1% when the samples were analyzed with classical microscopy; the range of Giardia prevalence was even bigger (4.2-100%) when qPCR and nested PCR were used. The dominant Giardia assemblages found in Colombia were A and B, and most frequent subassemblages were AII, BIII, and BIV.

Detection of Cryptosporidium spp. and Giardia spp. in Environmental Water Samples: A Journey into the Past and New Perspectives

Among the major issues linked with producing safe water for consumption is the presence of the parasitic protozoa Cryptosporidium spp. and Giardia spp. Since they are both responsible for gastrointestinal illnesses that can be waterborne, their monitoring is crucial, especially in water sources feeding treatment plants. Although their discovery was made in the early 1900s and even before, it was only in 1999 that the U.S. Environmental Protection Agency (EPA) published a standardized protocol for the detection of these parasites, modified and named today the U.S. EPA 1623.1 Method. It involves the flow-through filtration of a large volume of the water of interest, the elution of the biological material retained on the filter, the purification of the (oo)cysts, and the detection by immunofluorescence of the target parasites. Since the 1990s, several molecular-biology-based techniques were also developed to detect Cryptosporidium and Giardia cells from environmental or clinical samples. The application of U.S. EPA 1623.1 as well as numerous biomolecular methods are reviewed in this article, and their advantages and disadvantages are discussed guiding the readers, such as graduate students, researchers, drinking water managers, epidemiologists, and public health specialists, through the ever-expanding number of techniques available in the literature for the detection of Cryptosporidium spp. and Giardia spp. in water.

Occurrence of Cryptosporidium and Giardia in surface water supply from 2016 to 2020 in South Brazil

The objectives of this research are to evaluate Giardia and Cryptosporidium contamination in surface water supply in Rio Grande do Sul (RS) State in South Brazil in the years 2016 to 2020, assess seasonality, and to infer the population that may have been exposed to these protozoa through drinking water based on drinking water treatment efficiency. Data were obtained through the drinking water surveillance national information system. From 204 DWT plants in the state, 66 have been analyzed for protozoa. A total of 2304 analyses of protozoa in raw water were evaluated, of which 223 had both Giardia spp. cysts and/or Cryptosporidium spp. oocysts in concentrations that varied from 0.1 to 21.5/L. A total of 2,712,125 people from 48 cities were at risk of having the presence of pathogenic protozoa in their drinking water. The probability of finding these protozoa was higher in winter. Giardia cysts were more likely to be found in a period without rain, suggesting that sewage was the main source of contamination. It is concluded that the springs of Rio Grande do Sul are impacted and the circulation of pathogenic protozoa through the territory is endemic with a probable source of contamination to sewage and livestock activity.

Prevalence of Cryptosporidium spp. in water: a global systematic review and meta-analysis

Cryptosporidium spp., as a genus of protozoan intestinal parasites, is recognized as responsible for cryptosporidiosis. The present study was conducted to provide an overview of the prevalence of Cryptosporidium based on water. In this regard, some databases such as Scopus, PubMed, Embase, and Web of Science were screened in order to retrieve the related citations from 1 January 1983 to 10 September 2019. The pooled prevalence of Cryptosporidium spp. was calculated by using a random effect model (REM) based on defined subgroups, including countries, water type, treatment conditions (treated and untreated), economic condition, World Health Organization (WHO) regions, and method of detection. In contrast, this index for treated and untreated water was 25.7% and 40.1%, respectively. Also, the overall prevalence of Cryptosporidium spp. among all water types was defined as 36 (95% CI: 31.4-40.7). The rank order of prevalence of Cryptosporidium spp. based on water type was wastewater (46.9%) > surface water (45.3%) > raw water (31.6%) > drinking water (25.5%) > reservoirs water (24.5%) > groundwater (18.8%) > swimming pool water (7.5%) > marine water (0.20%). Identifying the key contributing factors to Cryptosporidium spp. survival can help provide solutions at both local and global scales.

Adsorption/Coagulation/Ceramic Microfiltration for Treating Challenging Waters for Drinking Water Production

Pressurized powdered activated carbon/coagulation/ceramic microfiltration (PAC/Alum/MF) was investigated at pilot scale for treating low turbidity and low natural organic matter (NOM) surface waters spiked with organic microcontaminants. A total of 11 trials with clarified or non-clarified waters spiked with pesticides, pharmaceutical compounds, or microcystins were conducted to assess the removal of microcontaminants, NOM (as 254 nm absorbance, A254, and dissolved organic carbon, DOC), trihalomethane formation potential (THMFP), aerobic endospores as protozoan (oo)cysts indicators, bacteriophages as viruses indicators, and regular drinking water quality parameters. PAC/(Alum)/MF achieved 75% to complete removal of total microcontaminants with 4-18 mg/L of a mesoporous PAC and 2 h contact time, with a reliable particle separation (turbidity < 0.03 NTU) and low aluminium residuals. Microcontaminants showed different amenabilities to PAC adsorption, depending on their charge, hydrophobicity (Log Kow), polar surface area and aromatic rings count. Compounds less amenable to adsorption showed higher vulnerability to NOM competition (higher A254 waters), greatly benefiting from DOC-normalized PAC dose increase. PAC/Alum/MF also attained 29-47% NOM median removal, decreasing THMFP by 26%. PAC complemented NOM removal by coagulation (+15-19%), though with no substantial improvement towards THMFP and membrane fouling. Furthermore, PAC/Alum/MF was a full barrier against aerobic endospores, and PAC dosing was crucial for ≥1.1-log reduction in bacteriophages.

Cryptosporidium spp. and Giardia duodenalis emissions from humans and animals in the Three Gorges Reservoir in Chongqing, China

Cryptosporidium spp. and Giardia duodenalis are two waterborne protozoan parasites that can cause diarrhea. Human and animal feces in surface water are a major source of these pathogens. This paper presents a GloWPa-TGR-Crypto model that estimates Cryptosporidium and G. duodenalis emissions from human and animal feces in the Three Gorges Reservoir (TGR), and uses scenario analysis to predict the effects of sanitation, urbanization, and population growth on oocyst and cyst emissions for 2050. Our model estimated annual emissions of 1.6 × 10¹⁵ oocysts and 2.1 × 10¹⁵ cysts from human and animal feces, respectively. Humans were the largest contributors of oocysts and cysts, followed by pigs and poultry. Cities were hot-spots for human emissions, while districts with high livestock populations accounted for the highest animal emissions. Our model was the most sensitive to oocyst excretion rates. The results indicated that 74% and 87% of total emissions came from urban areas and humans, respectively, and 86% of total human emissions were produced by the urban population. The scenario analysis showed a potential decrease in oocyst and cyst emissions with improvements in urbanization, sanitation, wastewater treatment, and manure management, regardless of population increase. Our model can further contribute to the understanding of environmental pathways, the risk assessment of Cryptosporidium and Giardia pollution, and effective prevention and control strategies that can reduce the outbreak of waterborne diseases in the TGR and other similar watersheds.

Pre-ozonation of surface water: An effective water treatment process to reduce the risk of infection by Giardia in drinking water

Giardia is a protozoan parasite of primary concern for the drinking water industry. High contact times are required for Giardia inactivation by chlorination, while ozonation may be effective at much lower Ct products. In this study, we have assessed the occurrence of Giardia cysts in raw water, and in chlorinated or ozonated water from a drinking water treatment plant (DWTP) in Brazil, over a 16-month period. Moreover, we analyzed the effects of primary disinfection on cysts, and calculated the infection risk caused by the occurrence of Giardia cysts in raw water, chlorinated or ozonated water. Furthermore, we assessed the correlation of Giardia cysts with indicator bacteria in raw water. Data referring to concentration of Giardia cysts in raw water showed adherence to a gamma distribution at a significance level α = 0.05. The detection frequency and the mean concentration of Giardia cysts were higher in raw water (86.6%, 26 cysts∙L^-1), than in chlorinated (46.1%, 15.7 cysts·L^-1) or ozonated water (43.5%, 11.1 cysts·L^-1). Overall, Giardia non-viable cysts were detected more frequently in ozonated water (80%) than in chlorinated water (68.2%) or raw water (37.7%). Ozonation and chlorination resulted, respectively, in ≈27.5- and ≈13- fold reduction of Giardia infection risk, when compared to the risk calculated for raw water. Total coliform and Escherichia coli proved to be suitable surrogates to predict the occurrence of Giardia cysts in raw surface water, however, the indicator bacteria may not be suitable surrogates to predict the disinfection of Giardia cysts, as no correlation was found between indicator bacteria and Giardia cysts in treated water. To our knowledge, this is the first study reporting the efficacy of chlorine and ozone at Ct products actually applied at a full-scale drinking water treatment plant against Giardia cysts naturally occurring in the source water, i.e. real situation. Ozonation has proven more efficient than chlorination against Giardia cysts in surface water. Escherichia coli proved to be suitable surrogate to predict Giardia cysts in raw surface water.

Detection of human intestinal protozoan parasites in vegetables and fruits: a review

Diarrheal diseases caused by intestinal protozoan parasites are a major food-borne public health problem across the world. Vegetables and fruits provide important nutrients and minerals, but are also common sources of some food-borne human pathogenic microorganisms. The contamination of raw vegetables and fruits with human pathogenic parasites are now a global public health threat, despite the health benefits of these foods in non-pharmacological prophylaxes against diseases. A large number of reports have documented the contamination of vegetables or fruits with human pathogenic microorganisms. In this paper, we reviewed the contamination and detection methods of human pathogenic intestinal protozoans that are frequently recovered from raw vegetables and fruits. The protozoan parasites include Cryptosporidium spp., Giardia duodenalis, Cyclospora cayetanensis, Entamoeba spp., Toxoplasma gondii, Balantioides coli, Blastocystis sp., Cystoisospora belli and Enterocytozoon bieneusi. The risk factors involved in the contamination of vegetables and fruits with parasites are also assessed.

Effect of Silver Nanoparticles on the Morphology of Toxoplasma gondii and Salmonella braenderup

The study of silver nanoparticles (AgNPs) has recently increased due to the different antimicrobial properties that have been evaluated. Studies have shown that AgNPs decrease the cell viability of some parasitic species and inhibit bacterial growth and biofilm formation. Toxoplasma gondii is a parasite with different stages of development including the oocyst, and it can survive in the environment for a long time generating contamination of vegetables and water. This parasite has the ability to generate congenital toxoplasmosis and chorioretinitis in humans. Another human pathogen present in water is Salmonella braenderup, this bacterium, when consumed, causes gastroenteritis and typhoid fever. We evaluate the affectation that causes the AgNPs in oocysts of T. gondii and S. braenderup using fluorescence microscopy and scanning electron microscopy techniques. The results showed that at different ratios of AgNPs and microorganisms, as well as at different exposure time during the treatments, morphological alteration of the cell structure of oocysts of T. gondii and S. braenderup was evidenced, suggesting a potential treatment method for the inhibition of the viability of these microorganisms.

Molecular Characterization of Giardia intestinalis Detected in Humans and Water Samples in Egypt

BACKGROUND

Giardia intestinalis is a common cause of gastrointestinal illness especially in children of developing countries. Giardia assemblages A and B are the major human infective genotypes.

OBJECTIVE

The present study aimed to investigate the role of water supply in the epidemiology of giardiasis via genotyping G. intestinalis detected in diarrheic children and in water samples in Egyptian rural areas.

METHODS

Stool samples of 100 diarrheic children, 40 drinking water samples and 10 raw water samples of canals were examined microscopically for Giardia. DNA was extracted from microscopically positive faecal samples and from all of the collected water samples. Amplification of Giardia tpi gene was performed by a nested PCR using assemblage A- and assemblage B-specific primers. Giardia gdh gene was amplified by a heminested PCR. Giardia genotypes were determined by restriction fragment polymorphism (RFLP) analysis of the amplified products. Sequencing of the amplified products was performed in two faecal and two water samples RESULTS: Giardia intestinalis was detected in 24 children, in none of the drinking water samples and in all canal water samples. Giardia sub-assemblage AII was identified in all stool and raw water samples. The RFLP pattern was confirmed in sequenced samples.

CONCLUSION

The presence of the same Giardia sub-assemblage in diarrheic children and in raw water samples shows by molecular evidence the potential for waterborne dissemination of Giardia in Egypt. Further studies are needed to monitor cyst levels and infectivity of the genotype detected in water for risk assessment and management.

Persistent contamination ofSalmonella,Campylobacter,Escherichia coli, andStaphylococcus aureusat a broiler farm in New Zealand

Intensive poultry production due to public demand raises the risk of contamination, creating potential foodborne hazards to consumers. The prevalence and microbial load of the pathogens Campylobacter, Salmonella, Staphylococcus aureus, and Escherichia coli was determined by standard methods at the farm level. After disinfection, swab samples collected from wall crevices, drinkers, and vents were heavily contaminated, as accumulated organic matter and dust likely protected the pathogens from the disinfectants used. The annex floor also showed high microbial concentrations, suggesting the introduction of pathogens from external environments, highlighting the importance of erecting hygiene barriers at the entrance of the main shed. Therefore, pathogen control measures and proper application of disinfectants are recommended as intervention strategies. Additionally, quantitative polymerase chain reaction (qPCR) was evaluated as a quantification tool. qPCR showed limitations with samples containing low microbial counts because of the low detection limit of the method. Thus, bacterial pre-enrichment of test samples may be necessary to improve the detection of pathogens by qPCR.

Antiprotozoal activity of silver nanoparticles against Cryptosporidium parvum oocysts: New insights on their feasibility as a water disinfectant

Cryptosporidium is a protozoan of extremely medical and veterinary impact; whose oocysts donate a considerable resistant to the water treatment processes. Therefore, this study aimed to explore the impacts of silver nanoparticles (AgNPs) on count and viability of the Cryptosporidium parvum (CP) isolated from different tap water samples. The oocysts were exposed to AgNPs at different dosages of 0.05, 0.1 and 1 ppm for several contact times (30 min to 4 h). The results showed a significant decrease in oocyst count and viability in a dose-dependent manner. Additionally, AgNPs at a conc. of 1 ppm for 30 min and 0.1 ppm for 1 h reduced the oocysts by 97.2 and 94.4%, respectively. Comparatively, there was a noticeable increase in the oocyst's viability at 2 and 4 h, which emphasized that the time of contact between AgNPs and CP was not a major influencing factor for successful application of AgNPs in the nano-water treatment.

To treat or not to treat? Misbeliefs in spa water disinfection

"Spa waters should be left untreated" says the dogmatic approach. Health authorities of European countries having traditional spa culture strictly control hygienic conditions of bathing in thermal/mineral waters. These regulations are based on the assumption that chemical treatment (disinfection) of such waters impacts their healing effects. However, a slow change of paradigm has been observed in studying the mode of action of spa waters that could help overcome recent attitudes. Organic content or the role of microbiome has also been emphasized by some authors recently. The article deals with possible interactions among aquatic microorganisms and the disinfection and health effects of spa waters and tries to explain the new findings in this field.

Pre-ozonation of source water: Assessment of efficacy against Giardia duodenalis cysts and effects on natural organic matter

The protozoan Giardia duodenalis is one of the parasites of primary concern in drinking water treatment plants, due to its resistance to chlorination. Another matter of concern regarding chlorination of drinking water is the formation of disinfection by-products in the presence of precursors such as natural organic matter (NOM). In this study, the effects of ozonation (5 mg L^-1) on G. duodenalis cysts in raw surface water from a drinking water treatment plant were evaluated, and the presence and alteration of NOM were assessed, as an indicative of the potential to prevent total organic halogen (TOX) formation during post-chlorination. Following ozone treatment, the presence of damaged cysts was observed by direct immunofluorescence assay (IFA) and confirmed by the molecular approach propidium monoazide-polymerase chain reaction (PMA-PCR). Using an animal model, analysis of the intestinal tissues revealed that 80% of the animals inoculated with ozonated water were positive for trophozoites. This study shows that analysis of intestinal fragments is imperative to accurately assess animal infection following inoculation of treated cysts. More importantly, considering the low infective dose of Giardia cysts in susceptible hosts, an ozone dosage usually applied in drinking water treatment plants did not completely inactivate G. duodenalis cysts in surface water. Nonetheless, the results suggest that competitive reactions with NOM have occurred, and the applied ozone dosage has proven useful to remove NOM reactivity, and thus prevent halogenated DBP formation during post-chlorination.

Use of ultrasound irradiation to inactivate Cryptosporidium parvum oocysts in effluents from municipal wastewater treatment plants

Water reuse is currently considered an innovative way to addressing water shortage that can provide significant economic, social and environmental benefits, particularly -but not exclusively- in water deficient areas. The potential transmission of infectious diseases is the most common concern in relation to water reclamation. Cryptosporidium is an important genus of protozoan enteropathogens that infect a wide range of vertebrate hosts, including humans. The infective form (oocyst) is highly resistant to the environmental conditions and disinfection treatments. Consequently, Cryptosporidium is the most common etiological agent identified in waterborne outbreaks attributed to parasitic protozoa worldwide. The present study evaluates the efficacy of ultrasound disinfection, at three power levels (60, 80 and 100 W), pulsed at 50% or in continuous mode, for inactivating the waterborne protozoan parasite Cryptosporidium parvum in simulated and real effluents from municipal wastewater treatment plants (MWTPs). Overall interpretation of the results shows that the application of ultrasound irradiation at 80 W power in continuous mode for an exposure time of 10 min drastically reduced the viability of C. parvum. Thus, oocyst viabilities of 4.16 ± 1.93%; 1.29 ± 0.86%; 3.16 ± 0.69%; and 3.15 ± 0.87% were obtained in distilled water, simulated, real and filtered MWTP effluents, respectively (vs 98.57 ± 0.01%, initial oocyst viability), as determined using inclusion/exclusion of the fluorogenic vital dye propidium iodide, an indicator of the integrity of the oocyst wall. Independently of the mode used (pulsed/continuous) and at 80 W power, higher level of oocyst inactivation was detected in MWTP effluents than in distilled water used as a control solution, may be due to the differences in the chemical composition of the samples. Comparison of the results obtained in both modes showed that use of the continuous mode yielded significantly lower oocyst viability. However, when the Dose parameter was considered (energy per volume unit), no statistically significant differences in oocyst viability were observed in relation to the type of mode used. The results demonstrate that ultrasound technology represents a promising alternative to the disinfection methods (ultraviolet irradiation and chlorine products) currently used in water reclamation as it drastically reduces the survival of Cryptosporidium oocysts, without changing the chemical composition of the water or producing toxic by-products.

Molecular detection and genotyping of pathogenic protozoan parasites in raw and treated water samples from southwest Colombia

BACKGROUND

Protozoan parasites such as Giardia duodenalis, Cryptosporidium spp., Cyclospora cayetanensis, Toxoplasma gondii and Entamoeba histolytica represent a great challenge to the systems producing water for human consumption because their cystic forms are persistent in the environment and resist to the disinfection methods conventionally used for their control. In this study, we investigated the presence of these protozoan pathogens in both raw and treated water samples used for the production of drinking water in Nariño Department, southwest Colombia. We collected 110 water samples (10 lof each sample) and analyzed them with real-time PCR (qPCR). qPCR-positive samples were genotyped with PCR and DNA sequencing.

RESULTS

Giardia duodenalis was detected in 35/110 (31.8%) of the samples and Cryptosporidium spp. in 9/110 (8.2%) of the samples; no sample was positive for T. gondii, E. histolytica or C. cayetanensis. Giardia duodenalis was detected in samples of both raw water (Drinking Water Treatment Plants (DWTP): 47.83%;Drinking Water Rural Plants (DWRP): 18.42%) and water collected either after conventional physicochemical treatment (26.09%) or after disinfection by chlorine (50%), whereas Cryptosporidium spp. were only detected in raw waters (DWTP: 17.39%; DWRP: 13.16%). The two pathogens were detected in both types of treatment plants supplying water to urban areas and to rural zones. Analysis of gdh and tpi markers identified assemblages AI, AII and H of G. duodenalis, while analysis of the small subunit rRNA and gp60 markers of Cryptosporidium-positive samples identified C. parvum (Subtype IIcA5G3c), C. galli, C. molnari, Cryptosporidium sp. genotype II of bats and Cryptosporidium sp. genotype VIII of birds.

CONCLUSIONS

The results obtained demonstrate the presence of protozoan parasites in the water of the study region, and the need to improve the surveillance systems for these pathogens and identify the corresponding sources of contamination.

Methods for the detection of Cryptosporidium and Giardia: From microscopy to nucleic acid based tools in clinical and environmental regimes

The detection and characterization of genotypes and sub genotypes of Cryptosporidium and Giardia is essential for their enumeration, surveillance, prevention, and control. Different diagnostic methods are available for the analysis of Cryptosporidium and Giardia including conventional phenotypic tools that face major limitations in the specific diagnosis of these protozoan parasites. The substantial advancement in the development of genetic signature based molecular tools for the quantification, diagnosis and genetic variation analysis has increased the understanding of the epidemiology and preventive measures of related infections. The conventional methods such as microscopy, antibody and enzyme based approaches, offer better detection results when combined with advanced molecular methods. Gene based approaches increase the precision of identification, for example, many signatures detected in environmental matrices represent species/genotype that are not infectious to humans. This review summarizes the available methods and the advantages and limitations of advance detection techniques like nucleic acid-based approaches for the detection of viable oocysts and cysts of Cryptosporidium and Giardia along with the conventional and widely accepted detection techniques like microscopy, antibody and enzyme based ones. This technical article also encourages the wide application of molecular methods in genetic characterization of distinct species of Cryptosporidium and Giardia, to adopt necessary preventive measures with reliable identification and mapping the source of contamination.

Occurrence and genetic diversity of Cryptosporidium and Giardia in urban wastewater treatment plants in north-eastern Spain

This study was designed to investigate the presence and removal efficiency of Cryptosporidium and Giardia in wastewater treatment plants at the 20 most populated towns in Aragón (north-eastern Spain). Samples of influent and effluent wastewater and dewatered sewage sludge were collected seasonally from 23 plants and processed according to USEPA Method 1623. All samples from raw and treated wastewater tested positive for Giardia, at an average concentration of 3247±2039cysts/l and 50±28cysts/l, respectively. Cryptosporidium was identified in most samples from both raw (85/92) and treated (78/92) wastewaters in a concentration significantly lower than Giardia, at both influent (96±105oocysts/l) and effluent samples (31±70oocysts/l) (P<0.001). The (oo)cyst counts peaked in summer in most plants. The removal efficiency was higher for Giardia (1.06-log to 2.34-log) than Cryptosporidium (0.35-log to 1.8-log). Overall, high removal efficiency values were found for Giardia after secondary treatment based on activated sludge, while tertiary treatment (microfiltration, chlorination and/or ultraviolet irradiation) was needed to achieve the greatest removal or inactivation of Cryptosporidium. Most samples of treated sludge were positive for Giardia (92/92) and Cryptosporidium (45/92), at an average concentration of 20-593cysts/g and 2-44oocyst/g, respectively. The molecular characterization of Cryptosporidium oocysts and Giardia cysts were attempted at the SSU rRNA/GP60 and bg/tpi loci, respectively. G. duodenalis sub-assemblage AII was identified in all plants, with a large proportion of samples (15/47) harboring mixed assemblages (AII+B). Nine Cryptosporidium species and six subtypes were identified, with C. parvum IIaA15G2R1 being the most prevalent. The presence of significant numbers of (oo)cysts in samples of final effluents and treated sludge reveals the limited efficacy of conventional treatments in removing (oo)cysts and highlights the potential environmental impact and public health risks associated with disposal and reclamation of wastewater.

Detection of zoonotic and livestock-specific assemblages of Giardia duodenalis in free-living wild lizards

Giardia duodenalis is a zoonotic parasite that infects the gut of a wide range of vertebrates, including numerous wildlife species. However, little is known about this protozoan parasite in reptiles. Fecal samples from 31 wild lizards were collected in Galicia (northwest Spain) and screened for the presence of Giardia by PCR amplification and sequencing of the ITS1-5.8S-ITS2 region in the ribosomal unit. This allowed detection of the parasite in 5 samples (16.1%), and enabled identification of G. duodenalis assemblage A2 in two samples of Iberian rock lizard (Iberolacerta monticola), G. duodenalis assemblage B in other two samples of I. monticola, and G. duodenalis assemblage E in one sample of Bocage's wall lizard (Podarcis bocagei). The results obtained after PCR amplification and sequencing of the SSU-rDNA gene confirmed the presence of G. duodenalis assemblage A in two samples of I. monticola. This is the first report of G. duodenalis in free-living lizards, although further studies are needed to distinguish between actual infection and mechanical dissemination of cysts. The detection of zoonotic and livestock-specific assemblages of G. duodenalis demonstrates the wide environmental contamination by this parasite, possibly due to human activities.

Occurrence and removal of Giardia spp. cysts and Cryptosporidium spp. oocysts from a municipal wastewater treatment plant in Brazil

Sewage and sewage sludge have been recognized as potential sources of two important waterborne pathogenic protozoa: Giardia spp. and Cryptosporidium spp. Due to the lack of studies about the occurrence of these pathogens in sewage and sludge in Brazil, an investigation was conducted at various stages of a municipal wastewater treatment plant (WWTP) aiming to assess the occurrence of Giardia spp. cysts and Cryptosporidium spp. oocysts, their removal by the treatment processes, which are upflow anaerobic sludge blanket (UASB) reactor and dissolved air flotation process, and also the correlations between protozoa and indicator microorganisms. Significant quantities of cysts were detected in 100% of the analyzed wastewater samples, while oocysts were detected only in 39.0% of all wastewater samples. The overall removal of Giardia spp. cysts from the WWTP was on average 2.03 log, and the UASB reactor was more efficient than flotation. The sludge samples presented high quantities of (oo)cysts, implying the risks of contamination in the case of sludge reuse or inadequate disposal. Giardiasis prevalence was estimated between 2.21% and 6.7% for the population served by the WWTP, while cryptosporidiosis prevalence was much lower. Significant positive correlation was obtained only between cysts and Clostridium spores in anaerobic effluent.

Water-borne protozoa parasites: The Latin American perspective

Health systems, sanitation and water access have certain limitations in nations of Latin America (LA): typical matters of developing countries. Water is often contaminated and therefore unhealthy for the consumers and users. Information on prevalence and detection of waterborne parasitic protozoa are limited or not available in LA. Only few reports have documented in this field during the last forty years and Brazil leads the list, including countries in South America and Mexico within Central America region and Caribbean islands. From 1979 to 2015, 16 outbreaks of waterborne-protozoa, were reported in Latin American countries. T. gondii and C. cayetanensis were the protozoa, which caused more outbreaks and Giardia spp. and Cryptosporidium spp. were the most frequently found protozoa in water samples. On the other hand, Latin America countries have not got a coherent methodology for detection of protozoa in water samples despite whole LA is highly vulnerable to extreme weather events related to waterborne-infections; although Brazil and Colombia have some implemented laws in their surveillance systems. It would be important to coordinate all surveillance systems in between all countries for early detection and measures against waterborne-protozoan and to establish effective and suitable diagnosis tools according to the country's economic strength and particular needs.

Occurrence of Cryptosporidium and Giardia in raw and finished drinking water in north-eastern Spain

This paper collects the first large-sample-size study on the presence of Cryptosporidium oocysts and Giardia cysts in drinking water plants at the 20 most populated towns in Aragón (north-eastern Spain). Samples of influent raw water and effluent finished water were collected from each plant during different seasons and processed according to USEPA Method 1623. Cryptosporidium oocysts and Giardia cysts were detected in samples collected from 55% and 70% plants, respectively, with nine plants being positive for both protozoa and only four plants being negative over the study period. Both parasites were identified in the raw water throughout the year, with a lower frequency in autumn and a peak in winter, at a mean concentration of 67±38 oocysts per 100l and 125±241 cysts per 100l. The turbidity of raw water was not related to the presence or concentration of (oo)cysts, and the (oo)cyst removal efficiency was not related to the type of water treatment. One or both pathogens were identified in the finished water in 7 out of 11 plants with a conventional treatment process (coagulation, flocculation, sedimentation, filtration, and disinfection processes) compared to 4 out of 9 plants that did not apply one of the pre-chlorination treatment steps. Protozoa were detected in the finished water of positive plants at a mean concentration of 88±55 oocysts per 100l and 37±41 cysts per 100l, and most of them excluded propidium iodide so were considered potentially viable. The ubiquity of these parasites in the drinking water sources and the inefficiency of conventional water treatment in reducing/inactivating them may present a serious public health issue in this geographical area.

Contribution of environmental media to cryptosporidiosis and giardiasis prevalence in Tehran: a focus on surface waters

The occurrences of Cryptosporidium and Giardia in surface sources of drinking water in Tehran were monitored, using US EPA method 1623.1. The prevalence ratios (PR) of positive samples among other media (animal's stools, vegetables, and human's stools) were also estimated from literature data. The density of Giardia and Cryptosporidium in water samples were 0.129 ± 0.069 cysts/L and 0.005 ± 0.002 oocysts/L, respectively. Estimated PR in vegetables, animal stools, surface waters, and human stools were 6.65, 20.42, 21.05, and 4.28 % for Cryptosporidium and 6.46, 17.13, 73.68, and 15.65 % for Giardia, respectively. These reveal the importance of surface waters' and animal stools' roles in the prevalence of cryptosporidiosis and giardiasis in Tehran's population. Giardia's prevalence in untreated surface waters in Tehran was found 3.5 times as much as Cryptosporidium while this found 2.3 times on a global scale. Moreover, the prevalence of giardiasis to cryptosporidiosis infections in Tehran's human population was 3.65. These values could be a clue to attribute the infections to the occurrence of parasites in surface waters. Significant (p < 0.05) associations were observed between rainfalls and presence of Giardia (r = 0.62) and Cryptosporidium (r = 0.60) in surface waters. In autumn, rainfalls can increase the parasites occurrences in surface waters. Significant (p < 0.05) difference on the density of parasites was found between some seasons using Kruskal-Wallis and multiple comparison tests. A significant correlation (r = 0.86) between Giardia and Cryptosporidium densities also confirms the common sources of pollution in surface waters. Findings suggest that untreated surface waters in Tehran may be a potential route of human exposure to protozoan parasites.

Detection of protozoa in water samples by formalin/ether concentration method

Methods to detect protozoa in water samples are expensive and laborious. We evaluated the formalin/ether concentration method to detect Giardia sp., Cryptosporidium sp. and Toxoplasma in water. In order to test the properties of the method, we spiked water samples with different amounts of each protozoa (0, 10 and 50 cysts or oocysts) in a volume of 10 L of water. Immunofluorescence assay was used for detection of Giardia and Cryptosporidium. Toxoplasma oocysts were identified by morphology. The mean percent of recovery in 10 repetitions of the entire method, in 10 samples spiked with ten parasites and read by three different observers, were for Cryptosporidium 71.3 ± 12, for Giardia 63 ± 10 and for Toxoplasma 91.6 ± 9 and the relative standard deviation of the method was of 17.5, 17.2 and 9.8, respectively. Intraobserver variation as measured by intraclass correlation coefficient, was fair for Toxoplasma, moderate for Cryptosporidium and almost perfect for Giardia. The method was then applied in 77 samples of raw and drinkable water in three different plant of water treatment. Cryptosporidium was found in 28 of 77 samples (36%) and Giardia in 31 of 77 samples (40%). Theses results identified significant differences in treatment process to reduce the presence of Giardia and Cryptosporidium. In conclusion, the formalin ether method to concentrate protozoa in water is a new alternative for low resources countries, where is urgently need to monitor and follow the presence of theses protozoa in drinkable water.

Prevalence of Cryptosporidium and Giardia in the water resources of the Kuang River catchment, Northern Thailand

A catchment-scale investigation of the prevalence of Cryptosporidium and Giardia in the Kuang River Basin was carried out during the dry and rainy seasons. Water samples were collected from the Kuang River and its tributaries as well as a major irrigation canal at the study site. We also investigated the prevalence of gastrointestinal parasitic infection among dairy and beef cattle hosts. Cryptosporidium and/or Giardia were detected in all the rivers considered for this study, reflecting their ubiquity within the Kuang River Basin. The high prevalence of Cryptosporidium/Giardia in the upper Kuang River and Lai River is of a particular concern as both drain into the Mae Kuang Reservoir, a vital source of drinking-water to many local towns and villages at the research area. We did not, however, detected neither Cryptosporidium nor Giardia were in the irrigation canal. The frequency of Cryptosporidium/Giardia detection nearly doubled during the rainy season compared to the dry season, highlighting the importance of water as an agent of transport. In addition to the overland transport of these protozoa from their land sources (e.g. cattle manure, cess pits), Cryptosporidium/Giardia may also be re-suspended from the streambeds (a potentially important repository) into the water column of rivers during storm events. Faecal samples from dairy and beef cattle showed high infection rates from various intestinal parasites - 97% and 94%, respectively. However, Cryptosporidium and Giardia were only detected in beef cattle. The difference in management style between beef (freeranging) and dairy cattle (confined) may account for this disparity. Finally, phylogenetic analyses revealed that the Cryptosporidium/Giardia-positive samples contained C. ryanae (non-zoonotic) as well as Giardia intestinalis assemblages B (zoonotic) and E (non-zoonotic). With only basic water treatment facilities afforded to them, the communities of the rural area relying on these water supplies are highly at risk to Cryptosporidium/Giardia infections.

Evaluation of solar photocatalysis using TiO2 slurry in the inactivation of Cryptosporidium parvum oocysts in water

Cryptosporidium is a genus of enteric protozoan parasites of medical and veterinary importance, whose oocysts have been reported to occur in different types of water worldwide, offering a great resistant to the water treatment processes. Heterogeneous solar photocatalysis using titanium dioxide (TiO2) slurry was evaluated on inactivation of Cryptosporidium parvum oocysts in water. Suspensions of TiO2 (0, 63, 100 and 200mg/L) in distilled water (DW) or simulated municipal wastewater treatment plant (MWTP) effluent spiked with C. parvum oocysts were exposed to simulated solar radiation. The use of TiO2 slurry at concentrations of 100 and 200mg/L in DW yielded a high level of oocyst inactivation after 5h of exposure (4.16±2.35% and 15.03±4.54%, respectively, vs 99.33±0.58%, initial value), representing a good improvement relative to the results obtained in the samples exposed without TiO2 (51.06±9.35%). However, in the assays carried out using simulated MWTP effluent, addition of the photocatalyst did not offer better results. Examination of the samples under bright field and epifluorescence microscopy revealed the existence of aggregates comprising TiO2 particles and parasitic forms, which size increased as the concentration of catalyst and the exposure time increased, while the intensity of fluorescence of the oocyst walls decreased. After photocatalytic disinfection process, the recovery of TiO2 slurry by sedimentation provided a substantial reduction in the parasitic load in treated water samples (57.81±1.10% and 82.10±2.64% for 200mg/L of TiO2 in DW and in simulated MWTP effluent, respectively). Although further studies are need to optimize TiO2 photocatalytic disinfection against Cryptosporidium, the results obtained in the present study show the effectiveness of solar photocatalysis using TiO2 slurry in the inactivation of C. parvum oocysts in distilled water.

Detection by PCR of pathogenic protozoa in raw and drinkable water samples in Colombia

We evaluated the presence of DNA of Giardia, Toxoplasma, and Cryptosporidium by PCR, and of Giardia and Cryptosporidium genera by immunofluorescence antibody test (IFAT), in water samples, before, during, and after plant treatment for drinkable water. We applied this method in 38 samples of 10 l of water taken from each of the water treatment steps and in 8 samples taken at home (only for Toxoplasma PCR) in Quindio region in Colombia. There were 8 positive samples for Cryptosporidium parvum (21 %), 4 for Cryptosporidium hominis (10.5 %), 27 for Toxoplasma gondii (58.6 %), 2 for Giardia duodenalis assemblage A (5.2 %), and 5 for G. duodenalis assemblage B (13.1 %). By IFAT, 23 % were positive for Giardia and 21 % for Cryptosporidium. An almost perfect agreement was found between IFAT and combined results of PCR, by Kappa composite proportion analysis. PCR positive samples were significantly more frequent in untreated raw water for C. parvum (p = 0.02). High mean of fecal coliforms, high pH values, and low mean of chlorine residuals were strongly correlated with PCR positivity for G. duodenalis assemblage B. High pH value was correlated with PCR positivity for C. parvum. Phylogenetic analysis of DNA sequences was possible, showing water and human clinical sequences for Toxoplasma within the same phylogenetic group for B1 repeated sequence. PCR assay is complementary to IFAT assay for monitoring of protozoa in raw and drinkable water, enabling species identification and to look for phylogenetic analysis in protozoa from human and environmental sources.