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Brusa V, Costa M, Oteiza JM, Galli L, Barril PA, Leotta GA, Signorini M. Prioritization of vegetable-borne biological hazards in Argentina using a multicriteria decision analysis tool. FOOD SCI TECHNOL INT 2024; 30:680-696. [PMID: 37306110 DOI: 10.1177/10820132231180640] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Vegetables, especially those eaten raw, have been implicated in several foodborne disease outbreaks. Since multiple vegetable matrices and hazards are involved, risk managers have to prioritize those with the greatest impact on public health to design control strategies. In this study, a scientific-based risk ranking of foodborne pathogens transmitted by leafy green vegetables in Argentina was performed. The prioritization process included hazard identification, evaluation criteria identification and definition, criteria weighting, expert survey design and selection and call for experts, hazard score calculation, hazard ranking and variation coefficient, and result analysis. Regression tree analysis determined four risk clusters: high (Cryptosporidum spp., Toxoplasma gondii, Norovirus), moderate (Giardia spp., Listeria spp., Shigella sonnei), low (Shiga toxin-producing Escherichia coli, Ascaris spp., Entamoeba histolytica, Salmonella spp., Rotavirus, Enterovirus) and very low (Campylobacter jejuni, hepatitis A virus and Yersinia pseudotuberculosis). Diseases caused by Norovirus, Cryptosporidium spp. and T. gondii do not require mandatory notification. Neither viruses nor parasites are included as microbiological criteria for foodstuff. The lack of outbreak studies did not allow to accurately identify vegetables as a source of Norovirus disease. Information on listeriosis cases or outbreaks due to vegetable consumption was not available. Shigella spp. was the main responsible for bacterial diarrhea, but it has not been epidemiologically associated with vegetable consumption. The quality of the available information for all hazards studied was very low and low. The implementation of good practice guidelines throughout the entire vegetable production chain could prevent the presence of the identified hazards. The current study allowed the identification of vacancy areas and could help reinforce the need for performing epidemiological studies on foodborne diseases potentially associated with vegetable consumption in Argentina.
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Affiliation(s)
- Victoria Brusa
- Facultad de Ciencias Veterinarias UNLP, IGEVET - Instituto de Genética Veterinaria "Ing. Fernando N. Dulout" (UNLP - CONICET LA PLATA), La Plata, Argentina
| | - Magdalena Costa
- Facultad de Ciencias Veterinarias UNLP, IGEVET - Instituto de Genética Veterinaria "Ing. Fernando N. Dulout" (UNLP - CONICET LA PLATA), La Plata, Argentina
| | - Juan M Oteiza
- Centro de Investigación y Asistencia Técnica a la Industria (CIATI), Expedicionarios del desierto 1310, Neuquén, Argentina
| | - Lucía Galli
- Facultad de Ciencias Veterinarias UNLP, IGEVET - Instituto de Genética Veterinaria "Ing. Fernando N. Dulout" (UNLP - CONICET LA PLATA), La Plata, Argentina
| | - Patricia A Barril
- Centro de Investigación y Asistencia Técnica a la Industria (CIATI), Expedicionarios del desierto 1310, Neuquén, Argentina
| | - Gerardo A Leotta
- Facultad de Ciencias Veterinarias UNLP, IGEVET - Instituto de Genética Veterinaria "Ing. Fernando N. Dulout" (UNLP - CONICET LA PLATA), La Plata, Argentina
| | - Marcelo Signorini
- IDICAL - Instituto de Investigación de la Cadena Láctea (CONICET SANTA FE - INTA), Rafaela, Santa Fe, Argentina
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Robertson LJ, Woolsey ID, Jiménez-Meléndez A. Current and potential future impacts of food- and water-borne parasites in a changing world: A Norwegian perspective. CURRENT RESEARCH IN PARASITOLOGY & VECTOR-BORNE DISEASES 2024; 5:100181. [PMID: 38883144 PMCID: PMC11178983 DOI: 10.1016/j.crpvbd.2024.100181] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/26/2024] [Revised: 05/14/2024] [Accepted: 05/21/2024] [Indexed: 06/18/2024]
Abstract
In 2021, the Norwegian Scientific Committee for Food and Environment published a multi-criteria risk ranking of 20 potentially food-borne pathogens in Norway. The pathogens ranked included five parasite taxa (3 species, one genus, one family): Toxoplasma gondii, Echinococcus multilocularis, Giardia duodenalis, Cryptosporidium spp., and Anisakidae. Two of these, T. gondii and E. multilocularis, scored very highly (1st and 3rd place, respectively), Cryptosporidium was about midway (9th place), and G. duodenalis and Anisakidae ranked relatively low (15th and 20th place, respectively). Parasites were found, on average, more likely to present an increasing food-borne disease burden in the future than the other pathogens. Here, we review the current impact of these five potentially food-borne parasites in Norway, and factors of potential importance in increasing their future food-borne disease burden. Climate change may affect the contamination of water and fresh produce with transmission stages of the first four parasites, potentially leading to increased infection risk. Alterations in host distribution (potentially due to climate change, but also other factors) may affect the occurrence and distribution of Toxoplasma, Echinococcus, and Anisakidae, and these, coupled with changes in food consumption patterns, could also affect infection likelihood. Transmission of food-borne pathogens is complex, and the relative importance of different pathogens is affected by many factors and will not remain static. Further investigation in, for example, ten-years' time, could provide a different picture of the relative importance of different pathogens. Nevertheless, there is clearly the potential for parasites to exert a greater risk to public health in Norway than currently occurs.
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Affiliation(s)
- Lucy J Robertson
- Parasitology, Faculty of Veterinary Medicine, Norwegian University of Life Sciences (NMBU), P.O. Box 5003, NO-1432 Ås, Norway
| | - Ian D Woolsey
- Parasitology, Faculty of Veterinary Medicine, Norwegian University of Life Sciences (NMBU), P.O. Box 5003, NO-1432 Ås, Norway
| | - Alejandro Jiménez-Meléndez
- Parasitology, Faculty of Veterinary Medicine, Norwegian University of Life Sciences (NMBU), P.O. Box 5003, NO-1432 Ås, Norway
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Kubina S, Costa D, Cazeaux C, Villena I, Favennec L, Razakandrainibe R, La Carbona S. Persistence and survival of Cryptosporidium parvum oocysts on lamb's lettuce leaves during plant growth and in washing conditions of minimally-processed salads. Int J Food Microbiol 2023; 388:110085. [PMID: 36652747 DOI: 10.1016/j.ijfoodmicro.2023.110085] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Revised: 12/17/2022] [Accepted: 01/04/2023] [Indexed: 01/11/2023]
Abstract
Cryptosporidium is the causative agent of cryptosporidiosis, which results, among others, in profuse diarrhoea. Transmission to humans occurs via the faecal-oral route directly by contact with infected hosts or indirectly by waterborne or foodborne routes. For the latter, parasite transmission is closely linked to the oocyst's ability to persist and survive in food matrices. In this study, we evaluated the persistence and survival of Cryptosporidium oocysts in lamb's lettuce: i) during plant growth and ii) in conditions mimicking the industrial washing process applied in minimally-processed vegetables (MPV). Results show that oocysts persisted during the growth of lamb's lettuce, i.e. two months from the 2-leaf stage until the 8-leaf harvest time (-0.89 Log10 of oocysts). However, their survival decreased from as early as one week (-0.61 Log10), and only 6 % of oocysts remained infective at the time of harvest. The washing process had a limited effect on parasite load (<0.5 Log10) and no effect on survival; chlorination of washing water did not improve the efficiency (removal and inactivation) of the process. The ability of C. parvum to persist and survive throughout the food chain may drive its transmission to humans through MPV products. Appropriate management measures should be implemented at each operational level to limit contamination and ensure food safety of fresh produce.
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Affiliation(s)
- Sophie Kubina
- ACTALIA Food Safety Department, 310 Rue Popielujko, Saint-Lô 50000, France; Laboratoire de Parasitologie, EA 7510, Université de Rouen Normandie, Rouen 76000, France.
| | - Damien Costa
- Laboratoire de Parasitologie, EA 7510, Université de Rouen Normandie, Rouen 76000, France; Laboratoire de Parasitologie-Mycologie, CNR Laboratoire Expert Cryptosporidioses, Centre Hospitalier Universitaire de Rouen, Rouen 76000, France.
| | - Catherine Cazeaux
- ACTALIA Food Safety Department, 310 Rue Popielujko, Saint-Lô 50000, France.
| | - Isabelle Villena
- Laboratoire de Parasitologie-Mycologie, EA 7510, SFR CAP-Santé, Université Reims-Champagne Ardenne, CHU, Reims, 51100, France.
| | - Loïc Favennec
- Laboratoire de Parasitologie, EA 7510, Université de Rouen Normandie, Rouen 76000, France; Laboratoire de Parasitologie-Mycologie, CNR Laboratoire Expert Cryptosporidioses, Centre Hospitalier Universitaire de Rouen, Rouen 76000, France.
| | - Romy Razakandrainibe
- Laboratoire de Parasitologie, EA 7510, Université de Rouen Normandie, Rouen 76000, France; Laboratoire de Parasitologie-Mycologie, CNR Laboratoire Expert Cryptosporidioses, Centre Hospitalier Universitaire de Rouen, Rouen 76000, France.
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4
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Nasser AM. Transmission of Cryptosporidium by Fresh Vegetables. J Food Prot 2022; 85:1737-1744. [PMID: 36048914 DOI: 10.4315/jfp-22-152] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2022] [Accepted: 08/30/2022] [Indexed: 11/11/2022]
Abstract
ABSTRACT Consumption of fresh fruits and vegetables is increasing thanks to a greater awareness of the human health benefits. Vegetables may become contaminated by enteric pathogens (protozoan parasites, bacteria, and viruses) by irrigation with contaminated water, fertilization with fresh animal manure, or by infected food handlers. Cryptosporidium spp. are fecal-oral protozoan parasites, known to be highly persistent in the environment. Efficient methods were developed for releasing and concentrating Cryptosporidium oocysts from leafy vegetables, and sensitive and specific methods were applied for detection. The aims of this review are to discuss the development and optimization of methods applied to elute, concentrate, and detect oocysts from leafy vegetables, to review the prevalence of Cryptosporidium oocysts on fresh leafy vegetables from various parts of the world, and to discuss cryptosporidiosis outbreaks resulting from the consumption of leafy vegetables. Three solutions were used with comparable efficiency to release oocysts from leafy vegetables: 1 M glycine solution; 0.1% Alconox; and filter elution buffer, with an efficiency of 36.2, 72.6, and 44%, respectively. The prevalence of Cryptosporidium oocysts was reported in developed, as well as from developing countries, although simple detection methods were applied. Most of the cryptosporidiosis outbreaks were reported in developed countries, which can be related to the efficient surveillance system. Transmission of infectious pathogens, such as Cryptosporidium, may be facilitated by fresh vegetables, which are imported and transferred from less developed to highly developed countries and consumed uncooked. Monitoring of Cryptosporidium oocysts by sensitive detection methods may enhance measures to prevent transmission by freshly consumed vegetables. HIGHLIGHTS
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Affiliation(s)
- Abidelfatah M Nasser
- Water Quality Research Laboratory, National Public Health Laboratory, Ministry of Health, 69 Ben Zvi Road, Tel Aviv-Jaffa 6810416, Israel
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5
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An outbreak of Cryptosporidium parvum linked to pasteurised milk from a vending machine in England: a descriptive study, March 2021. Epidemiol Infect 2022; 150:e185. [PMID: 36305017 PMCID: PMC9987014 DOI: 10.1017/s0950268822001613] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
We describe the investigations and management of a Cryptosporidium parvum outbreak of linked to consumption of pasteurised milk from a vending machine. Multiple locus variable number of tandem repeats analysis was newly used, confirming that C. parvum detected in human cases was indistinguishable from that in a calf on the farm. This strengthened the evidence for milk from an on-farm vending machine as the source of the outbreak because of post-pasteurisation contamination. Bacteriological indicators of post-pasteurisation contamination persisted after the initial hygiene improvement notice. We propose that on-farm milk vending machines may represent an emerging public health risk.
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Gerstl F, Pongkitdachoti U, Unob F, Baeumner AJ. Miniaturized sensor for electroanalytical and electrochemiluminescent detection of pathogens enabled through laser-induced graphene electrodes embedded in microfluidic channels. LAB ON A CHIP 2022; 22:3721-3733. [PMID: 36043879 DOI: 10.1039/d2lc00593j] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
High performance, laser-induced graphene (LIG) electrodes were integrated into adhesive tape-based microfluidic channels to realize both electrochemical (EC) and electrochemiluminescent (ECL) detection approaches. This provides strategies for low limits of detection, simple hardware requirements and inexpensive fabrication, which are characteristics required for assays in the competitive point-of-care (POC) sensor field. Here, electrode design and microchannel dimensions were studied and a DNA hybridization assay with liposomes for signal amplification was developed for the specific detection of DNA derived from Cryptosporidium parvum as the model analyte. Liposomes entrapped either Ru(bpy)32+ or K4[Fe(CN)6] generating ECL- and EC-signal amplification, respectively. This new microchip provided all desirable analytical figures of merit needed for POC applications. Specifically, a desirable one-step assay was designed which provided a limit of detection of 3 pmol L-1 for the ECL and 47 pmol L-1 for the EC approach and furthermore enabled highly specific detection considering that at room temperature in this simple setup a single nucleotide polymorphism resulted in a signal decrease of 58%, whereas a decrease of > 98% was observed for non-matching sequences present in 10-fold excess. Direct detection in various matrices ranging from drinking water to soil extracts was also achieved. It is concluded that the simple and inexpensive fabrication in combination with signal amplification strategies makes these concepts relevant for on-site pathogen detection in resource-limited environments.
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Affiliation(s)
- Florian Gerstl
- Institute of Analytical Chemistry, Chemo- and Biosensors, University of Regensburg, Universitätsstraße 31, 93053 Regensburg, Germany.
| | - Uma Pongkitdachoti
- Department of Chemistry, Faculty of Science, Chulalongkorn University, Bangkok, 10330, Thailand
| | - Fuangfa Unob
- Department of Chemistry, Faculty of Science, Chulalongkorn University, Bangkok, 10330, Thailand
| | - Antje J Baeumner
- Institute of Analytical Chemistry, Chemo- and Biosensors, University of Regensburg, Universitätsstraße 31, 93053 Regensburg, Germany.
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7
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Surveillance of berries sold on the Norwegian market for parasite contamination using molecular methods. Food Microbiol 2022; 104:103980. [DOI: 10.1016/j.fm.2022.103980] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Revised: 01/10/2022] [Accepted: 01/11/2022] [Indexed: 12/20/2022]
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Ahlinder J, Svedberg AL, Nystedt A, Dryselius R, Jacobsson K, Hägglund M, Brindefalk B, Forsman M, Ottoson J, Troell K. Use of metagenomic microbial source tracking to investigate the source of a foodborne outbreak of cryptosporidiosis. Food Waterborne Parasitol 2022; 26:e00142. [PMID: 35024477 PMCID: PMC8728467 DOI: 10.1016/j.fawpar.2021.e00142] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Revised: 12/18/2021] [Accepted: 12/20/2021] [Indexed: 12/31/2022] Open
Abstract
Cryptosporidium is a protozoan parasite of global public health importance that causes gastroenteritis in a variety of vertebrate hosts, with many human outbreaks reported yearly, often from ingestion of contaminated water or food. Despite the major public health implications, little is typically known about sources of contamination of disease outbreaks caused by Cryptosporidium. Here, we study a national foodborne outbreak resulted from infection with Cryptosporidium parvum via romaine lettuce, with the main goal to trace the source of the parasite. To do so, we combined traditional outbreak investigation methods with molecular detection and characterization methods (i.e. PCR based typing, amplicon and shotgun sequencing) of romaine lettuce samples collected at the same farm from which the contaminated food was produced. Using 18S rRNA typing, we detected C. parvum in two out of three lettuce samples, which was supported by detections in the metagenome analysis. Microbial source tracking analysis of the lettuce samples suggested sewage water as a likely source of the contamination, albeit with some uncertainty. In addition, the high degree of overlap in bacterial species content with a public human gut microbial database corroborated the source tracking results. The combination of traditional and molecular based methods applied here is a promising tool for future source tracking investigations of food- and waterborne outbreaks of Cryptosporidium spp. and can help to control and mitigate contamination risks.
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Affiliation(s)
- J. Ahlinder
- CBRN Defence and Security, Swedish Defence Research Agency, FOI, Umeå, Sweden
| | - A.-L. Svedberg
- Department of Infection control, Region Norrbotten, Luleå, Sweden
| | - A. Nystedt
- Department of Infection control, Region Norrbotten, Luleå, Sweden
| | - R. Dryselius
- Department of Biology, National Food Agency, Uppsala, Sweden
| | - K. Jacobsson
- Department of Biology, National Food Agency, Uppsala, Sweden
| | - M. Hägglund
- Department of Microbiology, Tumor and Cell Biology, Clinical Genomics Facility, Stockholm, Sweden
| | - B. Brindefalk
- CBRN Defence and Security, Swedish Defence Research Agency, FOI, Umeå, Sweden
| | - M. Forsman
- CBRN Defence and Security, Swedish Defence Research Agency, FOI, Umeå, Sweden
| | - J. Ottoson
- Department of Risk and benefit assessment, National Food Agency, Uppsala, Sweden
| | - K. Troell
- Department of Microbiology, National Veterinary Institute, Uppsala, Sweden
- Department of Medical Biochemistry and Microbiology, Uppsala university, Uppsala, Sweden
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Craighead S, Huang R, Chen H, Kniel KE. The use of pulsed light to inactivate Cryptosporidium parvum oocysts on high-risk commodities (Cilantro, mesclun lettuce, spinach, and tomatoes). Food Control 2021. [DOI: 10.1016/j.foodcont.2021.107965] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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10
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Berrouch S, Escotte-Binet S, Amraouza Y, Flori P, Aubert D, Villena I, Hafid J. Cryptosporidium spp., Giardia duodenalis and Toxoplasma gondii detection in fresh vegetables consumed in Marrakech, Morocco. Afr Health Sci 2020; 20:1669-1678. [PMID: 34394227 PMCID: PMC8351826 DOI: 10.4314/ahs.v20i4.19] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Protozoan parasites such as Toxoplasma gondii, Giardia duodenalis, and Cryptosporidium spp., can be transmitted to humans via accidental consumption of contaminated water, fresh produce and foodstuffs. There is a lack of epidemiological data about these pathogens in Morocco. Hence the aim of this study, which is the determination of their prevalence in some leafy greens and root vegetables sold in Marrakech. METHODS A total of 132 vegetable samples including carrot, coriander, lettuce, parsley and radish were purchased monthly from three different markets in Marrakech from March 2017 to January 2018, pre-treated and subjected to microscopic and molecular analyses. RESULTS Of the 132 samples of vegetables analyzed by qPCR, the overall rate of protozoan was 21.21% (28/132); 22 samples were found to be contaminated with T. gondii, 6 with G. duodenalis, and none was positive for C. parvum/hominis. Whereas, modified Ziehl-Neelsen staining allowed the detection of Cryptosporidium spp. in 3% (4/132) of examined samples. CONCLUSION This survey on the presence of protozoan parasites in fresh vegetables revealed that vegetables sold in Marrakech are contaminated by these protozoan parasites, as it showed that leafy green vegetables were more susceptible for parasitic contamination than root ones.
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Affiliation(s)
- Salma Berrouch
- Laboratory of Food, Environment and Health, Faculty of Sciences and Techniques, Cadi Ayyad University, Marrakech, Morocco
- Laboratory of Parasitology-Mycology, ESCAPE EA 7510, SFR CAP SANTE, University of Reims Champagne-Ardenne, and CHU Reims, Hospital Maison Blanche, National Reference Centre of Toxoplasmosis, Reims, France
| | - Sandie Escotte-Binet
- Laboratory of Parasitology-Mycology, ESCAPE EA 7510, SFR CAP SANTE, University of Reims Champagne-Ardenne, and CHU Reims, Hospital Maison Blanche, National Reference Centre of Toxoplasmosis, Reims, France
| | - Yassine Amraouza
- Laboratory of Food, Environment and Health, Faculty of Sciences and Techniques, Cadi Ayyad University, Marrakech, Morocco
| | - Pierre Flori
- Laboratory of Infectious Agents- Parasitology section- GIMAP, Faculty of Medicine, Saint-Etienne, France
| | - Dominique Aubert
- Laboratory of Parasitology-Mycology, ESCAPE EA 7510, SFR CAP SANTE, University of Reims Champagne-Ardenne, and CHU Reims, Hospital Maison Blanche, National Reference Centre of Toxoplasmosis, Reims, France
| | - Isabelle Villena
- Laboratory of Parasitology-Mycology, ESCAPE EA 7510, SFR CAP SANTE, University of Reims Champagne-Ardenne, and CHU Reims, Hospital Maison Blanche, National Reference Centre of Toxoplasmosis, Reims, France
| | - Jamaleddine Hafid
- Laboratory of Food, Environment and Health, Faculty of Sciences and Techniques, Cadi Ayyad University, Marrakech, Morocco
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Deksne G, Davidson RK, Buchmann K, Kärssin A, Kirjušina M, Gavarāne I, Miller AL, Pálsdóttir GR, Robertson LJ, Mørk T, Oksanen A, Palinauskas V, Jokelainen P. Parasites in the changing world - Ten timely examples from the Nordic-Baltic region. Parasite Epidemiol Control 2020; 10:e00150. [PMID: 32435705 PMCID: PMC7232095 DOI: 10.1016/j.parepi.2020.e00150] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2019] [Revised: 04/11/2020] [Accepted: 04/15/2020] [Indexed: 12/11/2022] Open
Abstract
The world is changing, and parasites adapt. The Nordic-Baltic region in northern Europe - including the Nordic countries Denmark, Finland, Iceland, Norway and Sweden, and the Baltic States Estonia, Latvia and Lithuania - is facing new parasitological challenges due to changes in populations of parasites and their hosts and the spread of new parasites to the region due to climate change. Some changes can also be ascribed to increased awareness and detection. In this paper, we review and discuss a convenience selection of ten timely examples of recent observations that exemplify trends and challenges from different fields of parasitology, with particular focus on climate change and potential changes in epidemiology of pathogens in northern Europe. The examples illustrate how addressing parasitological challenges often requires both intersectoral and international collaboration, and how using both historical baseline data and modern methodologies are needed.
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Affiliation(s)
- Gunita Deksne
- Institute of Food safety, Animal health and Environment “BIOR”, Lejupes Str. 3, Riga LV-1076, Latvia
- Faculty of Biology, University of Latvia, Jelgavas Str. 1, Riga LV-1004, Latvia
| | | | - Kurt Buchmann
- Laboratory of Aquatic Pathobiology, Department of Veterinary and Animal Sciences, University of Copenhagen, Stigbøjlen 7, DK-1870 Frederiksberg C, Denmark
| | - Age Kärssin
- Veterinary and Food Laboratory, Kreutzwaldi 30, 51006 Tartu, Estonia
- Institute of Veterinary Medicine and Animal Sciences, Estonian University of Life Sciences, Kreutzwaldi 62, 51006 Tartu, Estonia
| | - Muza Kirjušina
- Institute of Life Sciences and Technology, Daugavpils University, Parādes Str. 1A, Daugavpils LV-5401, Latvia
| | - Inese Gavarāne
- Institute of Life Sciences and Technology, Daugavpils University, Parādes Str. 1A, Daugavpils LV-5401, Latvia
| | - Andrea L. Miller
- Norwegian Institute for Nature Research, Department for Terrestrial Ecology, Postboks 5685 Sluppen, 7485 Trondheim, Norway
| | - Guðný Rut Pálsdóttir
- Institute for Experimental Pathology at Keldur, University of Iceland, Keldnavegur 3, IS-112 Reykjavík, Iceland
| | - Lucy J. Robertson
- Norwegian University of Life Sciences, Department of Food Safety and Infection Biology, Section for Microbiology, Immunology, and Parasitology, Parasitology Lab, Adamstuen Campus, Ullevålsveien 72, 0454 Oslo, Norway
| | - Torill Mørk
- Norwegian Veterinary Institute, Stakkevollvegen 23b, 9010 Tromsø, Norway
| | - Antti Oksanen
- Finnish Food Authority (FINPAR), Elektroniikkatie 3, 90590 Oulu, Finland
| | | | - Pikka Jokelainen
- Laboratory of Parasitology, Department of Bacteria, Parasites & Fungi, Infectious Disease Preparedness, Statens Serum Institut, Artillerivej 5, 2300 Copenhagen S, Denmark
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Protozoan infections are under-recognized in Swedish patients with gastrointestinal symptoms. Eur J Clin Microbiol Infect Dis 2020; 39:2153-2160. [PMID: 32638222 PMCID: PMC7561559 DOI: 10.1007/s10096-020-03974-w] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Accepted: 06/29/2020] [Indexed: 11/29/2022]
Abstract
In acute gastroenteritis (GE), identification of the infectious agent is important for patient management and surveillance. The prevalence of GE caused by protozoa may be underestimated in Swedish patients. The purpose was to compare the prevalence of E. histolytica, Cryptosporidium spp., G. intestinalis, and C. cayetanensis in samples from patients where the clinician had requested testing for gastrointestinal parasites only (n = 758) to where testing for bacterial GE only (n = 803) or where both parasite and bacterial testing (n = 1259) was requested and a healthy control group (n = 197). This prospective cohort study was conducted in Region Jönköping County, Sweden (October 2018–March 2019). Fecal samples were analyzed with microscopy and real-time PCR. Cryptosporidium spp. was detected in 16 patients in the bacterial GE group and in 13 in the both bacterial and parasite group; no cases were detected in the group were only parasite infection was suspected. C. cayetanensis was detected in two patients in the bacterial GE group. One case of E. histolytica was detected in the bacterial group and one in the both bacterial and parasite group. G. intestinalis was detected in 14 patients in the parasite only group, 12 in the both parasite and bacterial group, three in the bacterial GE group, and one in the control group. Diarrhea caused by protozoa, especially Cryptosporidium was under–recognized by clinicians and is likely more common than hitherto estimated in Sweden. A more symptom-based diagnostic algorithm may increase detection and knowledge about protozoan infections.
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13
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A review of outbreaks of cryptosporidiosis due to unpasteurized milk. Infection 2020; 48:659-663. [PMID: 32297163 DOI: 10.1007/s15010-020-01426-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2019] [Accepted: 04/08/2020] [Indexed: 10/24/2022]
Abstract
PURPOSE This review analysed outbreaks of human cryptosporidiosis due to raw milk. The objective of our study was to highlight and identify underestimated and underreported aspects of transmission of the parasite as well as the added value of genotyping Cryptosporidium isolates. METHODS We conducted a descriptive literature review using the digital archives Pubmed and Embase. All original papers and case reports referring to outbreaks of Cryptosporidium due to unpasteurized milk were reviewed. The cross-references from these publications were also included. RESULTS Outbreaks have been described in the USA, Australia, and the UK. Laboratory evidence of Cryptosporidium from milk specimens was lacking in the majority of the investigations. However, in most recent reports molecular tests on stool specimens along with epidemiological data supported that the infection was acquired through the consumption of unpasteurized milk. As the incubation period for Cryptosporidium is relatively long (days to weeks) compared with many other foodborne pathogens (hours to days), these reports often lack microbiological confirmation because, by the time the outbreak was identified, the possibly contaminated milk was not available anymore. CONCLUSION Cryptosporidiosis is generally considered a waterborne intestinal infection, but several reports on foodborne transmission (including through raw milk) have been reported in the literature. Calves are frequently infected with Cryptosporidium spp., which does not multiply in milk. However, Cryptosporidium oocysts can survive if pasteurization fails. Thus, pasteurization is essential to inactivate oocysts. Although cryptosporidiosis cases acquired from raw milk are seldom reported, the risk should not be underestimated and Cryptosporidium should be considered as a potential agent of contamination. Genotyping Cryptosporidium isolates might be a supportive tool to strengthen epidemiologic evidence as well as to estimate the burden of the disease.
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Pozio E. How globalization and climate change could affect foodborne parasites. Exp Parasitol 2019; 208:107807. [PMID: 31751558 DOI: 10.1016/j.exppara.2019.107807] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2019] [Revised: 11/05/2019] [Accepted: 11/18/2019] [Indexed: 12/12/2022]
Abstract
Foodborne parasites, most of which are zoonotic, represent an important human health hazard. These pathogens which include both protozoa (e.g., Cryptosporidium spp., Cyclospora cayetanensis, Toxoplasma gondii) and helminths (e.g., liver and intestinal flukes, Fasciola spp., Paragonimus spp., Echinococcus spp., Taenia spp., Angiostrongylus spp., Anisakis spp., Ascaris spp., Capillaria spp., Toxocara spp., Trichinella spp., Trichostrongylus spp.), have accompanied the human species since its origin and their spread has often increased due to their behavior. Since both domesticated and wild animals play an important role as reservoirs of these pathogens the increase/decrease of their biomasses, migration, and passive introduction by humans can change their epidemiological patterns. It follows that globalization and climate change will have a tremendous impact on these pathogens modifying their epidemiological patterns and ecosystems due to the changes of biotic and abiotic parameters. The consequences of these changes on foodborne parasites cannot be foreseen as a whole due to their complexity, but it is important that biologists, epidemiologists, physicians and veterinarians evaluate/address the problem within a one health approach. This opinion, based on the author's experience of over 40 years in the parasitology field, takes into consideration the direct and indirect effects on the transmission of foodborne parasites to humans.
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Affiliation(s)
- Edoardo Pozio
- Department of Infectious Diseases, Istituto Superiore di Sanità, viale Regina Elena 299, 00161, Rome, Italy.
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15
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Chalmers RM, McCarthy N, Barlow KL, Stiff R. An evaluation of health protection practices for the investigation and management of Cryptosporidium in England and Wales. J Public Health (Oxf) 2019; 40:114-120. [PMID: 28039197 DOI: 10.1093/pubmed/fdw143] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2016] [Indexed: 11/13/2022] Open
Abstract
Background Cryptosporidium is a major cause of gastroenteritis (cryptosporidiosis). Case and outbreak report rates vary geographically, which may in part reflect public health practice. Methods To examine the public health management of cryptosporidiosis, an online questionnaire was administered to the 28 Health Protection Teams (HPTs) in England and Wales in 2014. Practices for investigation and management of cases and outbreaks were compared. Results Practice varied among the 24 (86%) respondents in terms of who undertook actions (HPT or Local Authority) to investigate and manage cryptosporidiosis. HPTs without exceedance monitoring detected fewer outbreaks (1/5, 20%) than those with it (13/19, 68%) (P = 0.12), and those that always administered a risk-factor questionnaire detected more outbreaks (12/19, 63%) than those who did this only sometimes (2/5, 40%) (P = 0.62). Significantly more HPTs with a system to detect common exposures reported at least one outbreak (14/19, 74%) compared to HPTs with no system (0/5) (P = 0.01). Conclusions Applying exceedance monitoring, using a standardized questionnaire taking into account the incubation period for Cryptosporidium, and having a structured system to detect common exposures increased outbreak detection. Information about all cases should be shared between local public health authorities, and current guidance used for the prevention of spread.
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Affiliation(s)
- R M Chalmers
- Public Health Wales Microbiology and Health Protection, Singleton Hospital, Swansea SA2 8QA, UK.,Swansea University Medical School, Grove Building, Swansea University, Singleton Park, Swansea SA2 8PP, UK
| | - N McCarthy
- Warwick Medical School, University of Warwick, Coventry CV4 7AL, UK.,NIHR Health Protection Research Unit in GI Infections, University of Oxford, Oxford OX1 3PS, UK
| | - K L Barlow
- Public Health England, 61 Colindale Avenue, London NW9 5EQ, UK
| | - R Stiff
- Health Protection Team, Public Health Wales, 2 Capital Quarter, Tyndall Street, Cardiff CF10 4BZ, UK
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Li J, Shi K, Sun F, Li T, Wang R, Zhang S, Jian F, Ning C, Zhang L. Identification of human pathogenic Enterocytozoon bieneusi, Cyclospora cayetanensis, and Cryptosporidium parvum on the surfaces of vegetables and fruits in Henan, China. Int J Food Microbiol 2019; 307:108292. [PMID: 31430663 DOI: 10.1016/j.ijfoodmicro.2019.108292] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2019] [Revised: 04/15/2019] [Accepted: 08/07/2019] [Indexed: 11/25/2022]
Abstract
Cryptosporidium spp., Giardia duodenalis, Cyclospora cayetanensis, and Enterocytozoon bieneusi are known etiological agents of self-limiting diarrhea, chronic disorders, and severe debilitating illnesses in humans, particularly children and patients with immunodeficiency diseases. To assess the pathogen carriage status of raw vegetables and fruits and the potential transmission routes of the aforementioned parasites in Henan province, China, a total of 1099 vegetables and fruits samples (21 items) were purchased and collected from agricultural farms or open markets. Cryptosporidium spp., E. bieneusi, C. cayetanensis and G. duodenalis were screened by employing polymerase chain reaction (PCR) amplification of species-specific genes. Three kinds of human pathogenic agent (E. bieneusi, C. cayetanensis and C. parvum) were identified on the surfaces of the vegetables and fruits (3.7%, 41/1099). E. bieneusi was found in 3.5% (38/1099) of the samples, whereas C. cayetanensis and C. parvum were only identified in two (0.2%) and one (0.1%) of the vegetable and fruit samples, respectively. No G. duodenalis contamination was detected in the present study. In total, 12 different E. bieneusi ITS genotypes (eight known and four novel) were detected, of which the ten (EbpA, CM8, CHG19, EbpC, CTS3, Henan-IV, and CHV1 to CHV4) that occurred in 20 samples (20/38, 52.6%) clustered into the previously described high potential zoonotic group 1 in the phylogenetic analysis. The remaining two known genotypes (BEB8 and CD6) detected in 18 samples (18/38, 47.4%) belonged to group 2. That C. cayetanensis, C. parvum and some E. bieneusi genotypes have been reported in humans, highlights the possible risk of foodborne related disease outbreaks.
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Affiliation(s)
- Junqiang Li
- International Joint Research Laboratory for Zoonotic Diseases of Henan Province China, College of Animal Science and Veterinary Medicine, Henan Agricultural University, Zhengzhou 450046, China; Scientific Research Experiment Center & Laboratory Animal Center, Henan University of Chinese Medicine, Zhengzhou 450046, China
| | - Ke Shi
- International Joint Research Laboratory for Zoonotic Diseases of Henan Province China, College of Animal Science and Veterinary Medicine, Henan Agricultural University, Zhengzhou 450046, China
| | - Fangfang Sun
- International Joint Research Laboratory for Zoonotic Diseases of Henan Province China, College of Animal Science and Veterinary Medicine, Henan Agricultural University, Zhengzhou 450046, China
| | - Tingwen Li
- International Joint Research Laboratory for Zoonotic Diseases of Henan Province China, College of Animal Science and Veterinary Medicine, Henan Agricultural University, Zhengzhou 450046, China
| | - Rongjun Wang
- International Joint Research Laboratory for Zoonotic Diseases of Henan Province China, College of Animal Science and Veterinary Medicine, Henan Agricultural University, Zhengzhou 450046, China
| | - Sumei Zhang
- International Joint Research Laboratory for Zoonotic Diseases of Henan Province China, College of Animal Science and Veterinary Medicine, Henan Agricultural University, Zhengzhou 450046, China
| | - Fuchun Jian
- International Joint Research Laboratory for Zoonotic Diseases of Henan Province China, College of Animal Science and Veterinary Medicine, Henan Agricultural University, Zhengzhou 450046, China
| | - Changshen Ning
- International Joint Research Laboratory for Zoonotic Diseases of Henan Province China, College of Animal Science and Veterinary Medicine, Henan Agricultural University, Zhengzhou 450046, China
| | - Longxian Zhang
- International Joint Research Laboratory for Zoonotic Diseases of Henan Province China, College of Animal Science and Veterinary Medicine, Henan Agricultural University, Zhengzhou 450046, China.
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Pignata C, Bonetta S, Bonetta S, Cacciò SM, Sannella AR, Gilli G, Carraro E. Cryptosporidium Oocyst Contamination in Drinking Water: A Case Study in Italy. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:E2055. [PMID: 31185673 PMCID: PMC6604028 DOI: 10.3390/ijerph16112055] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/28/2019] [Revised: 06/04/2019] [Accepted: 06/05/2019] [Indexed: 11/30/2022]
Abstract
The aim of this study was to evaluate the occurrence of Cryptosporidium oocysts in a drinking water treatment plant (DWTP) located in a rural area of northern Italy. Influent and effluent samples were collected at the DWTP over three years (2013-2016). In parallel, tap water samples from a public drinking fountain were collected as well. All samples were analyzed for the presence of Cryptosporidium spp. oocysts by a common method based on an immunomagnetic separation (IMS)/immunofluorescence assay (IFA), complemented by 4,6-diamidino-2-phenylindole (DAPI) staining. A reverse transcriptase-PCR (RT-PCR) protocol was added to evaluate oocyst viability. The results highlighted a high variability of oocyst concentrations across all samples (mean 4.3 ± 5.8/100 L) and a high variability in the percentage of DAPI-positive specimens (mean 48.2% ± 40.3%). Conversely, RT-PCR did not reveal the presence of viable C. parvum and C. hominis oocysts. A nested PCR targeting Cryptosporidium 18S ribosomal DNA, carried out in two water samples, confirmed the presence of a Cryptosporidium genotype associated with wild animals in the river and in tap water. The results obtained underline the vulnerability of the investigated surface water to Cryptosporidium spp. contamination. Although the recovered Cryptosporidium genotype is not a human pathogen, its presence demonstrates the existence of a potential pathogen Cryptosporidium spp. contamination risk. Moreover, these results underline the importance of also considering unconventional (not bacterial) biological contaminations (protozoa) in water resources in rural areas, including those of developed countries.
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Affiliation(s)
- Cristina Pignata
- Department of Public Health and Pediatrics, University of Torino, Via Santena 5bis, 10126 Torino, Italy.
| | - Silvia Bonetta
- Department of Public Health and Pediatrics, University of Torino, Via Santena 5bis, 10126 Torino, Italy.
| | - Sara Bonetta
- Department of Public Health and Pediatrics, University of Torino, Via Santena 5bis, 10126 Torino, Italy.
| | - Simone M Cacciò
- Istituto Superiore di Sanità, Viale Regina Elena 299, 00161 Roma, Italy.
| | - Anna R Sannella
- Istituto Superiore di Sanità, Viale Regina Elena 299, 00161 Roma, Italy.
| | - Giorgio Gilli
- Department of Public Health and Pediatrics, University of Torino, Via Santena 5bis, 10126 Torino, Italy.
| | - Elisabetta Carraro
- Department of Public Health and Pediatrics, University of Torino, Via Santena 5bis, 10126 Torino, Italy.
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Protocol standardization for the detection of Giardia cysts and Cryptosporidium oocysts in Mediterranean mussels (Mytilus galloprovincialis). Int J Food Microbiol 2019; 298:31-38. [PMID: 30903916 DOI: 10.1016/j.ijfoodmicro.2019.03.009] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2018] [Revised: 03/08/2019] [Accepted: 03/13/2019] [Indexed: 11/24/2022]
Abstract
Marine bivalve shellfish are of public health interest because they can accumulate pollutants in their tissues. As they are usually consumed raw or lightly cooked, they are considered to be a possible source of foodborne infections, including giardiosis and cryptosporidiosis. Although data indicating contamination of shellfish with Giardia cysts and Cryptosporidium oocysts have been published, comparing results from different studies is difficult, as there is no standardized protocol for the detection and quantification of these parasites in mussels, and different researchers have used different analytical approaches. The aim of this study was to identify and characterize the most sensitive protocol for the detection of Giardia cysts and Cryptosporidium oocysts in shellfish. In an effort to test the sensitivity and the detection limits of the protocol, every step of the process was investigated, from initial preparation of the mussel matrix through detection of the parasites. Comparative studies were conducted, including several methods previously applied by other researchers, on commercial mussels Mytilus galloprovincialis spiked with a known number of (oo)cysts of both parasites. As preparation of the mussel matrix plays an important role in the sensitivity of the method, different techniques were tested. These included: (ia) removal of the coarse particles from the matrix with sieving, (ib) extraction of the lipids with diethyl ether, and (ic) artificial digestion of the matrix with pepsin digestion solution, and (ii) the use or not of immunomagnetic separation (IMS) for the concentration of the (oo)cysts. Pre-treatment of the mussel homogenate with pepsin digestion solution, followed by IMS, then detection with a direct immunofluorescence assay, achieved the highest sensitivity: 32.1% (SD: 21.1) of Giardia cysts and 61.4% (SD: 26.2) Cryptosporidium oocysts were recovered, with a detection limit of 10 (oo)cysts per g of mussel homogenate. The outcome of the current study was the standardization of a protocol, with defined detection limits, for the detection of these two protozoan transmission stages in mussels, in order to be used as a reference technique in future studies. Further advantages of this protocol are that it uses the whole mussel as a starting material and does not require difficult handling procedures. The method has potential to be applied in larger surveys and, potentially, to other species of shellfish for the detection of these parasites. However, the composition (lipid to protein ratio) may be of relevance for detection efficiency for some other species of shellfish.
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Robertson LJ, Temesgen TT, Tysnes KR, Eikås JE. An apple a day: an outbreak of cryptosporidiosis in Norway associated with self-pressed apple juice. Epidemiol Infect 2019; 147:e139. [PMID: 30869057 PMCID: PMC6518447 DOI: 10.1017/s0950268819000232] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2019] [Accepted: 01/22/2019] [Indexed: 12/27/2022] Open
Abstract
In the autumn of 2018, an outbreak of cryptosporidiosis affected adult employees from the same company in Western Norway. The organism was Cryptosporidium parvum, GP60 subtype IIaA14G1R1. All those infected had drunk from the same container of self-pressed apple juice. Incubation period (1 week) and clinical signs were similar among those infected, although some experienced a more prolonged duration of symptoms (up to 2-3 weeks) than others. The infections resulted after consumption from only one of 40 containers of juice and not from any of the other containers. It seems that although Cryptosporidium oocysts were detected in a sample from another container, the contamination did not affect the whole batch. This is perhaps indicative of a restricted contamination event, either from contaminated ground in the orchard, or during collection of the fruit, or during processing. Although outbreaks of food-borne cryptosporidiosis have previously been associated with consumption of contaminated apple juice, most of the more recent outbreaks of food-borne cryptosporidiosis have been associated with salad vegetables or herbs. This outbreak, the first outside USA reported to be associated with apple juice, is a timely reminder that such juice is a suitable transmission vehicle for Cryptosporidium oocysts, and that appropriate hygienic measures are essential in the production of such juice, including artisanal (non-commercial) production.
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Affiliation(s)
- L. J. Robertson
- Parasitology Lab., Department of Food Safety and Infection Biology, Faculty of Veterinary Medicine, Norwegian University of Life Sciences, PO Box 369 sentrum, 0102 Oslo, Norway
| | - T. T. Temesgen
- Parasitology Lab., Department of Food Safety and Infection Biology, Faculty of Veterinary Medicine, Norwegian University of Life Sciences, PO Box 369 sentrum, 0102 Oslo, Norway
| | - K. R. Tysnes
- Parasitology Lab., Department of Food Safety and Infection Biology, Faculty of Veterinary Medicine, Norwegian University of Life Sciences, PO Box 369 sentrum, 0102 Oslo, Norway
| | - J. E. Eikås
- Smittevernlege, Postboks 184, Fjell kommune, 5342 Straume, Norway
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Koutsoumanis K, Allende A, Alvarez-Ordóñez A, Bolton D, Bover-Cid S, Chemaly M, Davies R, De Cesare A, Herman L, Hilbert F, Lindqvist R, Nauta M, Peixe L, Ru G, Simmons M, Skandamis P, Suffredini E, Cacciò S, Chalmers R, Deplazes P, Devleesschauwer B, Innes E, Romig T, van der Giessen J, Hempen M, Van der Stede Y, Robertson L. Public health risks associated with food-borne parasites. EFSA J 2018; 16:e05495. [PMID: 32625781 PMCID: PMC7009631 DOI: 10.2903/j.efsa.2018.5495] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Parasites are important food‐borne pathogens. Their complex lifecycles, varied transmission routes, and prolonged periods between infection and symptoms mean that the public health burden and relative importance of different transmission routes are often difficult to assess. Furthermore, there are challenges in detection and diagnostics, and variations in reporting. A Europe‐focused ranking exercise, using multicriteria decision analysis, identified potentially food‐borne parasites of importance, and that are currently not routinely controlled in food. These are Cryptosporidium spp., Toxoplasma gondii and Echinococcus spp. Infection with these parasites in humans and animals, or their occurrence in food, is not notifiable in all Member States. This Opinion reviews current methods for detection, identification and tracing of these parasites in relevant foods, reviews literature on food‐borne pathways, examines information on their occurrence and persistence in foods, and investigates possible control measures along the food chain. The differences between these three parasites are substantial, but for all there is a paucity of well‐established, standardised, validated methods that can be applied across the range of relevant foods. Furthermore, the prolonged period between infection and clinical symptoms (from several days for Cryptosporidium to years for Echinococcus spp.) means that source attribution studies are very difficult. Nevertheless, our knowledge of the domestic animal lifecycle (involving dogs and livestock) for Echinoccocus granulosus means that this parasite is controllable. For Echinococcus multilocularis, for which the lifecycle involves wildlife (foxes and rodents), control would be expensive and complicated, but could be achieved in targeted areas with sufficient commitment and resources. Quantitative risk assessments have been described for Toxoplasma in meat. However, for T. gondii and Cryptosporidium as faecal contaminants, development of validated detection methods, including survival/infectivity assays and consensus molecular typing protocols, are required for the development of quantitative risk assessments and efficient control measures.
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Asadpour M, Namazi F, Razavi SM, Nazifi S. Curcumin: A promising treatment for Cryptosporidium parvum infection in immunosuppressed BALB/c mice. Exp Parasitol 2018; 195:59-65. [DOI: 10.1016/j.exppara.2018.10.008] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2018] [Revised: 09/18/2018] [Accepted: 10/28/2018] [Indexed: 12/28/2022]
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Chalmers RM, Pérez-Cordón G, Cacció SM, Klotz C, Robertson LJ. Cryptosporidium genotyping in Europe: The current status and processes for a harmonised multi-locus genotyping scheme. Exp Parasitol 2018; 191:25-30. [PMID: 29908140 DOI: 10.1016/j.exppara.2018.06.004] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2018] [Revised: 05/11/2018] [Accepted: 06/12/2018] [Indexed: 11/29/2022]
Abstract
Due to the occurrence of genetic recombination, a reliable and discriminatory method to genotype Cryptosporidium isolates at the intra-species level requires the analysis of multiple loci, but a standardised scheme is not currently available. A workshop was held at the Robert Koch Institute, Berlin in 2016 that gathered 23 scientists with appropriate expertise (in either Cryptosporidium genotyping and/or surveillance, epidemiology or outbreaks) to discuss the processes for the development of a robust, standardised, multi-locus genotyping (MLG) scheme and propose an approach. The background evidence and main conclusions were outlined in a previously published report; the objectives of this further report are to describe 1) the current use of Cryptosporidium genotyping, 2) the elicitation and synthesis of the participants' opinions, and 3) the agreed processes and criteria for the development, evaluation and validation of a standardised MLG scheme for Cryptosporidium surveillance and outbreak investigations. Cryptosporidium was characterised to the species level in 7/12 (58%) participating European countries, mostly for human outbreak investigations. Further genotyping was mostly by sequencing the gp60 gene. A ranking exercise of performance and convenience criteria found that portability, biological robustness, typeability, and discriminatory power were considered by participants as the most important attributes in developing a multilocus scheme. The major barrier to implementation was lack of funding. A structured process for marker identification, evaluation, validation, implementation, and maintenance was proposed and outlined for application to Cryptosporidium, with prioritisation of Cryptosporidium parvum to support investigation of transmission in Europe.
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Affiliation(s)
- Rachel M Chalmers
- National Cryptosporidium Reference Unit, Public Health Wales Microbiology, Singleton Hospital, Swansea, SA2 8QA, UK; Swansea University Medical School, Grove Building, Swansea University, Singleton Park, Swansea, SA2 8PP, UK.
| | - Gregorio Pérez-Cordón
- National Cryptosporidium Reference Unit, Public Health Wales Microbiology, Singleton Hospital, Swansea, SA2 8QA, UK
| | - Simone M Cacció
- European Reference Laboratory for Parasites, Istituto Superiore di Sanità, Viale regina Elena 299, Rome 00161 Italy
| | - Christian Klotz
- Unit for Mycotic and Parasitic Agents and Mycobacteria, Department of Infectious Diseases, Robert Koch-Institute, 13353 Berlin, Germany
| | - Lucy J Robertson
- Department of Food Safety and Infection Biology, Faculty of Veterinary Medicine, Norwegian University of Life Sciences, Adamstuen Campus, Oslo, Norway
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Robertson LJ. Parasites in Food: From a Neglected Position to an Emerging Issue. ADVANCES IN FOOD AND NUTRITION RESEARCH 2018; 86:71-113. [PMID: 30077225 PMCID: PMC7129657 DOI: 10.1016/bs.afnr.2018.04.003] [Citation(s) in RCA: 52] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Foodborne parasites have long been a neglected group of pathogens, as they often have insidious, chronic effects, rather than being acute diseases, and they are often associated with impoverished or marginalized populations. In addition, due to the long incubation period for most foodborne parasites, source attribution is often difficult, if not impossible. However, global trends have enabled foodborne parasites to emerge in different populations in new locations, transmitted through different food types, and sometimes with unexpected symptoms. This emergence of foodborne parasites has brought them into focus. In this chapter, six foodborne parasites are used as examples on emergence: Echinococcus multilocularis is spreading to new locations; Cryptosporidium spp. are beginning to be associated not only with water, but also with salads; Trypanosoma cruzi is being manifest with acute disease due to foodborne transmission, particularly transmitted with juices; Trichinella spp. have become less of a burden regarding transmission via pork in many countries, but now game animals are becoming a concern; anisakiasis is becoming a global problem as the world develops a taste for sushi, and similarly for opisthorchiasis, which is increasingly being associated with cholangiocarcinoma. However, the emergence of these foodborne parasites provides an incentive for increased efforts being made toward control. In this chapter, having described how the parasites are emerging from their neglected position, the focus turns toward control. In addition to considering control measures that may be applied to the specific parasites, an overview is provided of some of the organized collaborations, projects, and consortia, as well as some of their outputs, that have in focus the control of these emerging and important pathogens.
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Affiliation(s)
- Lucy J Robertson
- Department of Food Safety and Infection Biology, Norwegian University of Life Sciences, Oslo, Norway.
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McKerr C, O’Brien SJ, Chalmers RM, Vivancos R, Christley RM. Exposures associated with infection with Cryptosporidium in industrialised countries: a systematic review protocol. Syst Rev 2018; 7:70. [PMID: 29720280 PMCID: PMC5932784 DOI: 10.1186/s13643-018-0731-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2018] [Accepted: 04/13/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Cryptosporidium is a protozoan parasite of humans and other animals worldwide and is one of the greatest contributors to human diarrhoeal illness. Transmission can occur indirectly via contaminated food or water, or directly via contact with animals or other infected people. Risk exposures are often identified from outbreak investigations, but a subset of cases remains unexplained, and sources for sporadic disease and pathways to infection are still unclear. Given the few systematic syntheses of reported evidence in industrialised populations, the aim of this review is to consolidate the literature to describe exposures associated with human cryptosporidiosis in industrialised countries, specifically including the UK, and describe any differences between outbreak-associated and sporadic disease. METHODS/DESIGN Where relevant, methods will follow the recommendations made in the Cochrane Handbook for Systematic Reviews of Interventions. Three steps will be used to identify the literature including electronic database searching using PubMed, Scopus, Embase and Web of Science; reference list trawling; and an exploration of the grey literature. Screening of results will be undertaken by two reviewers using pre-defined criteria. Studies conducted in industrialised countries and reporting on human subjects will be included. All observational studies will be included where they report exposures and relevant quantitative results. Data will be extracted using a standardised form. Study quality will be assessed using the ROBINS-I tool. Data will be summarised presenting the papers' main findings including population under study, outcomes, and exposures, and whether these were considered outbreak or sporadic cases. A narrative summary will also be included. Where populations are appropriate, available data will be pooled in a meta-analysis combining the significant exposures across studies. DISCUSSION This review aims to consolidate the evidence for transmission routes and exposures for Cryptosporidium in industrialised countries, with particular reference to how these may apply to the UK. In addition, the review will seek to describe differences between outbreak and sporadic cases. This will help to identify those most vulnerable, highlighting pathways where interventions and public health response may be appropriate. SYSTEMATIC REVIEW REGISTRATION PROSPERO number CRD42017056589 .
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Affiliation(s)
- Caoimhe McKerr
- NIHR Health Protection Research Unit in Gastrointestinal Infections, The University of Liverpool, Liverpool, UK
- NIHR Health Protection Research Unit in Emerging and Zoonotic Infections, The University of Liverpool, Liverpool, UK
- Institute of Infection and Global Health, University of Liverpool, Waterhouse Building (2nd Floor, Block F), 1-5 Brownlow Street, Liverpool, L69 3GL UK
| | - Sarah J. O’Brien
- NIHR Health Protection Research Unit in Gastrointestinal Infections, The University of Liverpool, Liverpool, UK
| | | | - Roberto Vivancos
- NIHR Health Protection Research Unit in Gastrointestinal Infections, The University of Liverpool, Liverpool, UK
- NIHR Health Protection Research Unit in Emerging and Zoonotic Infections, The University of Liverpool, Liverpool, UK
- Field Epidemiology Services, Public Health England, Liverpool, UK
| | - Robert M. Christley
- NIHR Health Protection Research Unit in Emerging and Zoonotic Infections, The University of Liverpool, Liverpool, UK
- Institute of Infection and Global Health, University of Liverpool, Waterhouse Building (2nd Floor, Block F), 1-5 Brownlow Street, Liverpool, L69 3GL UK
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25
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Ryan U, Hijjawi N, Xiao L. Foodborne cryptosporidiosis. Int J Parasitol 2017; 48:1-12. [PMID: 29122606 DOI: 10.1016/j.ijpara.2017.09.004] [Citation(s) in RCA: 116] [Impact Index Per Article: 16.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2017] [Revised: 09/05/2017] [Accepted: 09/07/2017] [Indexed: 11/26/2022]
Abstract
Foodborne illness, the majority of which is caused by enteric infectious agents, costs global economies billions of dollars each year. The protozoan parasite Cryptosporidium is particularly suited to foodborne transmission and is responsible for >8 million cases of foodborne illness annually. Procedures have been developed for sensitive detection of Cryptosporidium oocysts on fresh produce and molecular diagnostic assays have been widely used in case linkages and infection source tracking, especially during outbreak investigations. The integrated use of advanced diagnostic techniques with conventional epidemiological studies is essential to improve our understanding of the occurrence, source and epidemiology of foodborne cryptosporidiosis. The implementation of food safety management tools such as Good Hygienic Practices (GHP), Hazard Analysis and Critical Control Points (HACCP), and Quantitative Microbial Risk Assessment (QMRA) in industrialised nations and Water, Sanitation, and Hygiene (WASH) in developing countries is central for prevention and control and foodborne cryptosporidiosis in the future.
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Affiliation(s)
- Una Ryan
- School of Veterinary and Life Sciences, Vector- and Water-Borne Pathogen Research Group, Murdoch University, Murdoch, Western Australia 6150, Australia.
| | - Nawal Hijjawi
- Department of Medical Laboratory Sciences, Faculty of Allied Health Sciences, The Hashemite University, PO Box 150459, Zarqa 13115, Jordan
| | - Lihua Xiao
- Centers for Disease Control and Prevention, Atlanta, GA 30329, USA
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26
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Sim S, Won J, Kim JW, Kim K, Park WY, Yu JR. Simultaneous Molecular Detection of Cryptosporidium and Cyclospora from Raw Vegetables in Korea. THE KOREAN JOURNAL OF PARASITOLOGY 2017; 55:137-142. [PMID: 28506035 PMCID: PMC5450956 DOI: 10.3347/kjp.2017.55.2.137] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/14/2017] [Revised: 03/07/2017] [Accepted: 03/19/2017] [Indexed: 01/10/2023]
Abstract
Cryptosporidium and Cyclospora are well-known coccidian protozoa that can cause waterborne and foodborne diarrheal illnesses. There have been a few reports regarding contamination in different vegetables with Cryptosporidium, but no data are available regarding the sources of Cyclospora infections in Korea. In the present study, we collected 6 kinds of vegetables (perilla leaves, winter-grown cabbages, chives, sprouts, blueberries, and cherry tomatoes) from July 2014 to June 2015, and investigated contamination by these 2 protozoa using multiplex quantitative real-time PCR. Among 404 vegetables, Cryptosporidium and Cyclospora were detected in 31 (7.7%) and 5 (1.2%) samples, respectively. In addition, Cryptosporidium was isolated from all 6 kinds of vegetables, whereas Cyclospora was detected in 4 kinds of vegetables (except perilla leaves and chives). Cryptosporidium (17.8%) and Cyclospora (2.9%) had the highest detection rates in chives and winter-grown cabbages, respectively. Cryptosporidium was detected all year long; however, Cyclospora was detected only from October to January. In 2 samples (sprout and blueberry), both Cryptosporidium and Cyclospora were detected. Further investigations using TaqI restriction enzyme fragmentation and nested PCR confirmed Cryptosporidium parvum and Cyclospora cayetanensis, respectively. In conclusion, we detected C. cayetanensis in vegetables for the first time in Korea. This suggests that screening should be employed to prevent these protozoal infections in Korea.
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Affiliation(s)
- Seobo Sim
- Department of Environmental and Tropical Medicine & International Healthcare Research Institute, Konkuk University School of Medicine, Seoul 05029, Korea
| | - Jua Won
- Department of Environmental and Tropical Medicine & International Healthcare Research Institute, Konkuk University School of Medicine, Seoul 05029, Korea
| | - Jae-Whan Kim
- Department of Environmental and Tropical Medicine & International Healthcare Research Institute, Konkuk University School of Medicine, Seoul 05029, Korea
| | - Kyungjin Kim
- Department of Environmental and Tropical Medicine & International Healthcare Research Institute, Konkuk University School of Medicine, Seoul 05029, Korea
| | - Woo-Yoon Park
- Department of Radiation Oncology, College of Medicine, Chungbuk National University, Cheongju 28644, Korea
| | - Jae-Ran Yu
- Department of Environmental and Tropical Medicine & International Healthcare Research Institute, Konkuk University School of Medicine, Seoul 05029, Korea
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27
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Utaaker KS, Kumar A, Joshi H, Chaudhary S, Robertson LJ. Checking the detail in retail: Occurrence of Cryptosporidium and Giardia on vegetables sold across different counters in Chandigarh, India. Int J Food Microbiol 2017; 263:1-8. [PMID: 28988154 DOI: 10.1016/j.ijfoodmicro.2017.09.020] [Citation(s) in RCA: 38] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2017] [Revised: 09/17/2017] [Accepted: 09/26/2017] [Indexed: 11/18/2022]
Abstract
Fresh produce has been recognized as a vehicle of infection for protozoan parasites, particularly Cryptosporidium, and, to a lesser extent, Giardia. For both parasites, outbreaks associated with fresh produce have been documented. Although documented outbreaks tend to be from industrialized countries, contamination of fresh produce with these parasites is a global issue. In developing countries, infections with these parasites are often endemic in the community, and basic infrastructure and hygiene measures may be inadequate, thus the likelihood of contamination of fresh produce with these parasites may be higher. Realization of the importance of this transmission route comes against a backdrop of raw salads and more Western culinary habits gaining a foothold, and fresh produce being encouraged as part of the diet due to their associated health benefits. However, if consumption of uncooked fresh produce is going to increase its market sector in India, it is important that it is safe. In this study, various types of fresh produce obtained from three types of vendors in Chandigarh, a major city in Northern India, were analyzed for contamination with Cryptosporidium oocysts and Giardia cysts using a method that has been previously validated in inter-laboratory spiking experiments. A total of 284 samples of different fresh produce items were analyzed, obtained from the different retailers situated in different societal layers of the city. The overall prevalence of contamination of fresh produce with these parasites was just under 11%, with 6% of the vegetables contaminated with Cryptosporidium oocysts, and 5% with Giardia cysts. Contaminated vegetables included turnip, cabbage, carrot, chili, coriander, cucumber, radishes, and tomatoes. Molecular analyses identified contamination with Cryptosporidium parvum and Giardia duodenalis of Assemblage A and Assemblage D, indicating that contamination from animals may be of relevance. Although the prevalence of contamination is similar to those reported in previous studies, the levels of contamination on some items of fresh produce were relatively high. Although the different socioeconomic areas of Chandigarh from which the samples were obtained was not associated with likelihood of contamination, fresh produce from supermarkets had heavier contamination with Cryptosporidium oocysts than fresh produce purchased through other sales outlets. The results are discussed in relation to the fresh produce chain and sales models in Chandigarh, both in terms of where contamination may occur and the potential importance of fresh produce as a transmission vehicle.
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Affiliation(s)
- Kjersti Selstad Utaaker
- Parasitology Lab, Department for Food Safety and Infection Biology, Faculty of Veterinary Medicine, Norwegian University of Life Sciences, Adamstuen Campus, PO Box 8146 Dep., 0033 Oslo, Norway.
| | - Anil Kumar
- Department of Medical Parasitology, Postgraduate Institute of Medical Education and Research, Chandigarh 16002, India
| | - Himanshu Joshi
- Department of Medical Parasitology, Postgraduate Institute of Medical Education and Research, Chandigarh 16002, India
| | - Suman Chaudhary
- Department of Medical Parasitology, Postgraduate Institute of Medical Education and Research, Chandigarh 16002, India; Nanomedicine-Laboratory of Immunology and Molecular Biomedical Research (NLIMBR), School of Medicine (SoM), Centre for Molecular and Medical Research (C-MMR), Strategic Research Centre, Faculty of Health, Deakin University, Waurn Ponds, Victoria 3216, Australia
| | - Lucy J Robertson
- Parasitology Lab, Department for Food Safety and Infection Biology, Faculty of Veterinary Medicine, Norwegian University of Life Sciences, Adamstuen Campus, PO Box 8146 Dep., 0033 Oslo, Norway
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28
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Utaaker KS, Skjerve E, Robertson LJ. Keeping it cool: Survival of Giardia cysts and Cryptosporidium oocysts on lettuce leaves. Int J Food Microbiol 2017; 255:51-57. [PMID: 28578228 DOI: 10.1016/j.ijfoodmicro.2017.05.009] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2017] [Revised: 05/03/2017] [Accepted: 05/13/2017] [Indexed: 10/19/2022]
Abstract
Fresh produce has been recognized as a vehicle for transmission of protozoan parasites for many years, and there are numerous publications regarding their occurrence on such foodstuffs, indicating their potential importance as foodborne parasites. Nevertheless, few studies have been published regarding the effectiveness of this transmission route, and whether contamination is likely to result in transmission. The purpose of this study was to assess the viability of Cryptosporidium oocysts and Giardia cysts, two protozoa associated with both waterborne and foodborne transmission, by spiking fresh produce (lettuce leaves) with viable transmission stages and determining changes in viability. These investigations were performed under different conditions and over time spans that may be used in a regular household; a fridge at 4°C, under ambient temperatures exposed to natural cycles of light during night and day, and inside a cupboard to ensure no light exposure, for a duration of up to two weeks, or as long as the produce remained visually palatable. The major finding from this study is that whereas both Cryptosporidium oocysts and Giardia cysts survive well when kept moist and refrigerated, survival of Giardia cysts was abrogated on lettuce at room temperature. Indeed, almost 50% die-off of Giardia cysts was recorded within the first 24h. Cryptosporidium oocysts had a stable viability throughout the experiment under all the conditions investigated, indicating that fresh produce is a suitable transmission vehicle for Cryptosporidium, even if contamination occurs on-farm and the parasites are exposed to non-favourable storage conditions, as may be common in developing countries. Giardia cysts were not as robust as Cryptosporidium oocysts, and would be probably unlikely to survive under ambient storage conditions on-farm, during sale, or at home. However, if kept refrigerated, then some contaminating Giardia cysts may remain viable and therefore may pose a threat to the consumer. Thus, as the cold chain for transport and storage of fresh produce improves, it is important that similar improvements are implemented to reduce the contamination of fresh produce with parasite transmission stages.
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Affiliation(s)
- Kjersti Selstad Utaaker
- Department for Food Safety and Infection Biology, Norwegian University of Life Sciences, Adamstuen Campus, PO Box 8146 Dep., 0033 Oslo, Norway.
| | - Eystein Skjerve
- Department for Food Safety and Infection Biology, Norwegian University of Life Sciences, Adamstuen Campus, PO Box 8146 Dep., 0033 Oslo, Norway
| | - Lucy J Robertson
- Department for Food Safety and Infection Biology, Norwegian University of Life Sciences, Adamstuen Campus, PO Box 8146 Dep., 0033 Oslo, Norway
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29
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Neonatal Rat; A Suitable Animal Model for Experimental Cryptosporidiosis. Jundishapur J Microbiol 2017. [DOI: 10.5812/jjm.13865] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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30
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PAINTER JE, GARGANO JW, YODER JS, COLLIER SA, HLAVSA MC. Evolving epidemiology of reported cryptosporidiosis cases in the United States, 1995-2012. Epidemiol Infect 2016; 144:1792-802. [PMID: 27125575 PMCID: PMC9150710 DOI: 10.1017/s0950268815003131] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2015] [Revised: 11/18/2015] [Accepted: 11/23/2015] [Indexed: 01/30/2023] Open
Abstract
Cryptosporidium is the leading aetiology of waterborne disease outbreaks in the United States. This report briefly describes the temporal and geographical distribution of US cryptosporidiosis cases and presents analyses of cryptosporidiosis case data reported in the United States for 1995-2012. The Cochran-Armitage test was used to assess changes in the proportions of cases by case status (confirmed vs. non-confirmed), sex, race, and ethnicity over the study period. Negative binomial regression models were used to estimate rate ratios (RR) and 95% confidence intervals (CI) for comparing rates across three time periods (1995-2004, 2005-2008, 2009-2012). The proportion of confirmed cases significantly decreased (P < 0·0001), and a crossover from male to female predominance in case-patients occurred (P < 0·0001). Overall, compared to 1995-2004, rates were higher in 2005-2008 (RR 2·92, 95% CI 2·08-4·09) and 2009-2012 (RR 2·66, 95% CI 1·90-3·73). However, rate changes from 2005-2008 to 2009-2012 varied by age group (P interaction < 0·0001): 0-14 years (RR 0·55, 95% CI 0·42-0·71), 15-44 years (RR 0·99, 95% CI 0·82-1·19), 45-64 years (RR 1·47, 95% CI 1·21-1·79) and ⩾65 years (RR 2·18, 95% CI 1·46-3·25). The evolving epidemiology of cryptosporidiosis necessitates further identification of risk factors in population subgroups. Adding systematic molecular typing of Cryptosporidium specimens to US national cryptosporidiosis surveillance would help further identify risk factors and markedly expand understanding of cryptosporidiosis epidemiology in the United States.
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Affiliation(s)
- J. E. PAINTER
- Epidemic Intelligence Service Officer, Division of Foodborne, Waterborne, and Environmental Diseases, National Center for Emerging Zoonotic and Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - J. W. GARGANO
- Division of Foodborne, Waterborne, and Environmental Diseases, National Center for Emerging Zoonotic and Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - J. S. YODER
- Division of Foodborne, Waterborne, and Environmental Diseases, National Center for Emerging Zoonotic and Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - S. A. COLLIER
- Division of Foodborne, Waterborne, and Environmental Diseases, National Center for Emerging Zoonotic and Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - M. C. HLAVSA
- Division of Foodborne, Waterborne, and Environmental Diseases, National Center for Emerging Zoonotic and Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
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31
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Jafari R, Mohaghegh MA, Ghomashlooyan M, Azimi Resketi M, Hejazi SH, Kalani H, Mirzaei F, Azami M, Falahati M. Title: Prevalence of Cryptosporidium spp. Oocysts in Soil Samples in Different Parts of Sari, North of Iran. INTERNATIONAL JOURNAL OF ENTERIC PATHOGENS 2016. [DOI: 10.17795/ijep37090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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32
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Cacciò SM, Chalmers RM. Human cryptosporidiosis in Europe. Clin Microbiol Infect 2016; 22:471-80. [PMID: 27172805 DOI: 10.1016/j.cmi.2016.04.021] [Citation(s) in RCA: 132] [Impact Index Per Article: 16.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2016] [Revised: 04/12/2016] [Accepted: 04/30/2016] [Indexed: 11/25/2022]
Abstract
Cryptosporidium has emerged as a significant cause of diarrhoeal disease worldwide, with severe health consequences for very young, malnourished children living in endemic areas and for individuals with highly impaired T-cell functions. In Europe, as elsewhere, the burden of disease has been difficult to measure as a result of the lack of appropriate, standardized surveillance and monitoring systems. The recent occurrence of large water- and foodborne outbreaks in several EU countries, as well as the results of many surveys of human and animal cryptosporidiosis, indicate that this parasite is widespread. Specific subtypes of the zoonotic Cryptosporidium parvum and the anthroponotic C. hominis are responsible for the majority of human cases in Europe. No treatment is currently available to clear the infection, but recent progress in genetic engineering of the parasite, coupled with advances in genomics, have opened important avenues for future research. Here we explore the possible reasons for underascertainment of cryptosporidiosis and the importance of accurate diagnosis in clinical management, the epidemiology of human cryptosporidiosis and key messages from recent outbreaks to highlight important interventions and emerging public health issues.
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Affiliation(s)
- S M Cacciò
- European Union Reference Laboratory for Parasites, Istituto Superiore di Sanità, Rome, Italy.
| | - R M Chalmers
- Cryptosporidium Reference Unit, Public Health Wales, Singleton Hospital, Swansea, UK
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33
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Parasitic illnesses associated with the consumption of fresh produce — an emerging issue in developed countries. Curr Opin Food Sci 2016. [DOI: 10.1016/j.cofs.2016.04.009] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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34
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Le Govic Y, Guyot K, Certad G, Deschildre A, Novo R, Mary C, Sendid B, Viscogliosi E, Favennec L, Dei-Cas E, Fréalle E, Dutoit E. Assessment of microscopic and molecular tools for the diagnosis and follow-up of cryptosporidiosis in patients at risk. Eur J Clin Microbiol Infect Dis 2015; 35:137-48. [PMID: 26610340 DOI: 10.1007/s10096-015-2519-2] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2015] [Accepted: 10/30/2015] [Indexed: 11/29/2022]
Abstract
Cryptosporidiosis is an important though underreported public health concern. Molecular tools might be helpful in improving its diagnosis. In this study, ZR Fecal DNA MiniPrep™ Kit (ZR) and NucliSens® easyMAG® (EM) were compared using four Cryptosporidium-seeded feces and 29 Cryptosporidium-positive stools. Thereafter, ZR was selected for prospective evaluation of Cryptosporidium detection by 18S rDNA and LAXER quantitative PCR (qPCR) in 69 stools from 56 patients after Cryptosporidium detection by glycerin, modified Ziehl-Neelsen (ZN) and auramine-phenol (AP) stainings. The combination of any of the two extraction methods with 18S qPCR yielded adequate detection of Cryptosporidium in seeded stools, but the ZR kit showed the best performance. All 29 Cryptosporidium-positive samples were positive with 18S qPCR, after both ZR and EM extraction. However, false-negative results were found with LAXER qPCR or nested PCR. Cryptosporidiosis was diagnosed in 7/56 patients. All the microscopic methods enabled the initial diagnosis, but Cryptosporidium was detected in 12, 13, and 14 samples from these seven patients after glycerin, ZN, and AP staining respectively. Among these samples, 14 and 12 were positive with 18S and LAXER qPCR respectively. In two patients, Cryptosporidium DNA loads were found to be correlated with clinical evolution. Although little known, glycerin is a sensitive method for the initial detection of Cryptosporidium. When combined with 18S qPCR, ZR extraction, which had not been evaluated so far for Cryptosporidium, was an accurate tool for detecting Cryptosporidium and estimating the oocyst shedding in the course of infection.
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Affiliation(s)
- Y Le Govic
- Laboratoire de Parasitologie-Mycologie, CHRU de Lille & Faculté de Médecine de Lille, Université de Lille, Villeneuve-d'Ascq, France.,Laboratoire de Parasitologie-Mycologie, Centre Hospitalier Universitaire d'Angers, France; Groupe d'Etude des Interactions Hôte-Pathogène, UPRES-EA 3142, UNAM Université, Université d'Angers, Angers, France
| | - K Guyot
- Univ. Lille, CNRS, INSERM, CHU Lille, Institut Pasteur de Lille, U1019 - UMR 8204 - CIIL - Center for Infection and Immunity of Lille, F-59000, Lille, France
| | - G Certad
- Univ. Lille, CNRS, INSERM, CHU Lille, Institut Pasteur de Lille, U1019 - UMR 8204 - CIIL - Center for Infection and Immunity of Lille, F-59000, Lille, France
| | - A Deschildre
- Unité de pneumologie-allergologie pédiatrique, pôle enfant, clinique de pédiatrie Jeanne de Flandre, CHRU de Lille, Université de Lille, Lille, France
| | - R Novo
- Unité de Néphrologie Pédiatrique, CHRU de Lille, Lille, France
| | - C Mary
- Aix-Marseille Université, Faculté de Médecine, UMR MD3, et APHM, Laboratoire de Parasitologie-Mycologie, Hôpital de la Timone, Marseille, France
| | - B Sendid
- Laboratoire de Parasitologie-Mycologie, CHRU de Lille & Faculté de Médecine de Lille, Université de Lille, Villeneuve-d'Ascq, France.,Inserm U995, Université de Lille, Lille, France
| | - E Viscogliosi
- Univ. Lille, CNRS, INSERM, CHU Lille, Institut Pasteur de Lille, U1019 - UMR 8204 - CIIL - Center for Infection and Immunity of Lille, F-59000, Lille, France
| | - L Favennec
- Laboratoire de Parasitologie, EA 3800-IRIB, CHRU de Rouen, Rouen, France
| | - E Dei-Cas
- Laboratoire de Parasitologie-Mycologie, CHRU de Lille & Faculté de Médecine de Lille, Université de Lille, Villeneuve-d'Ascq, France.,Univ. Lille, CNRS, INSERM, CHU Lille, Institut Pasteur de Lille, U1019 - UMR 8204 - CIIL - Center for Infection and Immunity of Lille, F-59000, Lille, France
| | - E Fréalle
- Laboratoire de Parasitologie-Mycologie, CHRU de Lille & Faculté de Médecine de Lille, Université de Lille, Villeneuve-d'Ascq, France. .,Univ. Lille, CNRS, INSERM, CHU Lille, Institut Pasteur de Lille, U1019 - UMR 8204 - CIIL - Center for Infection and Immunity of Lille, F-59000, Lille, France.
| | - E Dutoit
- Laboratoire de Parasitologie-Mycologie, CHRU de Lille & Faculté de Médecine de Lille, Université de Lille, Villeneuve-d'Ascq, France
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35
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A reduced-cost approach for analyzing fresh produce for contamination with Cryptosporidium oocysts and/or Giardia cysts. Food Res Int 2015. [DOI: 10.1016/j.foodres.2015.05.010] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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36
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Rehn M, Wallensten A, Widerström M, Lilja M, Grunewald M, Stenmark S, Kark M, Lindh J. Post-infection symptoms following two large waterborne outbreaks of Cryptosporidium hominis in Northern Sweden, 2010-2011. BMC Public Health 2015; 15:529. [PMID: 26041728 PMCID: PMC4454271 DOI: 10.1186/s12889-015-1871-6] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2015] [Accepted: 05/26/2015] [Indexed: 11/13/2022] Open
Abstract
Background In 2010–2011, two large waterborne outbreaks caused by Cryptosporidium hominis affected two cities in Sweden, Östersund and Skellefteå. We investigated potential post-infection health consequences in people who had reported symptoms compatible with cryptosporidiosis during the outbreaks using questionnaires. Methods We compared cases linked to these outbreaks with non-cases in terms of symptoms present up to eleven months after the initial infection. We examined if cases were more likely to report a list of symptoms at follow-up than non-cases, calculating odds ratios (OR) and 95 % confidence intervals (CI) obtained through logistic regression. Results A total of 872 (310 cases) and 743 (149 cases) individuals responded to the follow-up questionnaires in Östersund and Skellefteå respectively. Outbreak cases were more likely to report diarrhea (Östersund OR: 3.3, CI: 2.0-5.3. Skellefteå OR: 3.6, CI: 2.0-6.6), watery diarrhea (Östersund OR: 3.4, CI: 1.9-6.3. Skellefteå OR: 2.8, CI: 1.5-5.1) abdominal pain (Östersund OR: 2.1, CI: 1.4-3.3, Skellefteå OR: 2.7, CI: 1.5-4.6) and joint pain (Östersund OR: 2.0, CI: 1.2-3.3, Skellefteå OR: 2.0, CI: 1.1-3.6) at follow-up compared to non-cases. Conclusions Our findings suggest that gastrointestinal- and joint symptoms can persist several months after the initial infection with Cryptosporidium and should be regarded as a potential cause of unexplained symptoms in people who have suffered from the infection. Electronic supplementary material The online version of this article (doi:10.1186/s12889-015-1871-6) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Moa Rehn
- Public Health Agency of Sweden, Solna, Sweden. .,European Programme for Intervention Epidemiology Training (EPIET), European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden.
| | - Anders Wallensten
- Public Health Agency of Sweden, Solna, Sweden. .,Department of Medical Sciences, Infectious Diseases, Uppsala University, Uppsala, Sweden.
| | - Micael Widerström
- Department of Clinical Microbiology, Unit of Communicable Disease Control and Prevention- Östersund, Umeå University, Umeå, Sweden.
| | - Mikael Lilja
- Department of Public health and Clinical Medicine, Unit of Clinical Research Center - Östersund, Umeå University, Umeå, Sweden.
| | | | - Stephan Stenmark
- Department for Infectious Disease Control, Västerbotten County Council, Umeå, Sweden.
| | - Malin Kark
- Public Health Agency of Sweden, Solna, Sweden.
| | - Johan Lindh
- Department of Cell and Molecular Biology, Microbiology, Uppsala University, Box 256, 751 05, Uppsala, Sweden.
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37
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McKerr C, Adak GK, Nichols G, Gorton R, Chalmers RM, Kafatos G, Cosford P, Charlett A, Reacher M, Pollock KG, Alexander CL, Morton S. An Outbreak of Cryptosporidium parvum across England & Scotland Associated with Consumption of Fresh Pre-Cut Salad Leaves, May 2012. PLoS One 2015; 10:e0125955. [PMID: 26017538 PMCID: PMC4446264 DOI: 10.1371/journal.pone.0125955] [Citation(s) in RCA: 54] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2014] [Accepted: 03/28/2015] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND We report a widespread foodborne outbreak of Cryptosporidium parvum in England and Scotland in May 2012. Cases were more common in female adults, and had no history of foreign travel. Over 300 excess cases were identified during the period of the outbreak. Speciation and microbiological typing revealed the outbreak strain to be C. parvum gp60 subtype IIaA15G2R1. METHODS Hypothesis generation questionnaires were administered and an unmatched case control study was undertaken to test the hypotheses raised. Cases and controls were interviewed by telephone. Controls were selected using sequential digit dialling. Information was gathered on demographics, foods consumed and retailers where foods were purchased. RESULTS Seventy-four laboratory confirmed cases and 74 controls were included in analyses. Infection was found to be strongly associated with the consumption of pre-cut mixed salad leaves sold by a single retailer. This is the largest documented outbreak of cryptosporidiosis attributed to a food vehicle.
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Affiliation(s)
- Caoimhe McKerr
- Public Health England, Field Epidemiology Services, London, England, United Kingdom
- Field Epidemiology Training Programme, Public Health England, London, England, United Kingdom
| | - Goutam K. Adak
- Department of Gastrointestinal, Emerging & Zoonotic Infections, Public Health England, London, England, United Kingdom
| | - Gordon Nichols
- Department of Gastrointestinal, Emerging & Zoonotic Infections, Public Health England, London, England, United Kingdom
- Norwich Medical School, University of East Anglia, Norwich, England, United Kingdom
- Faculty of Medicine, University of Thessaly, Larissa, Greece
- European Centre for Environment and Human Health, University of Exeter, Exeter, England, United Kingdom
| | - Russell Gorton
- Public Health England, Field Epidemiology Services, London, England, United Kingdom
| | - Rachel M. Chalmers
- Cryptosporidium Reference Unit, Public Health Wales, Swansea, Wales, United Kingdom
| | - George Kafatos
- Statistics, Modelling and Economics Department, Public Health England, London, England, United Kingdom
| | - Paul Cosford
- Public Health England, London, England, United Kingdom
| | - Andre Charlett
- Statistics, Modelling and Economics Department, Public Health England, London, England, United Kingdom
| | - Mark Reacher
- Public Health England, Field Epidemiology Services, London, England, United Kingdom
| | | | | | - Stephen Morton
- Public Health England Centre, Yorkshire & Humber, England, United Kingdom
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Abeywardena H, Jex AR, Gasser RB. A perspective on Cryptosporidium and Giardia, with an emphasis on bovines and recent epidemiological findings. ADVANCES IN PARASITOLOGY 2015; 88:243-301. [PMID: 25911369 PMCID: PMC7103119 DOI: 10.1016/bs.apar.2015.02.001] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Cryptosporidium and Giardia are two common aetiological agents of infectious enteritis in humans and animals worldwide. These parasitic protists are usually transmitted by the faecal-oral route, following the ingestion of infective stages (oocysts or cysts). An essential component of the control of these parasitic infections, from a public health perspective, is an understanding of the sources and routes of transmission in different geographical regions. Bovines are considered potential sources of infection for humans, because species and genotypes of Cryptosporidium and Giardia infecting humans have also been isolated from cattle in molecular parasitological studies. However, species and genotypes of Cryptosporidium and Giardia of bovids, and the extent of zoonotic transmission in different geographical regions in the world, are still relatively poorly understood. The purpose of this article is to (1) provide a brief background on Cryptosporidium and Giardia, (2) review some key aspects of the molecular epidemiology of cryptosporidiosis and giardiasis in animals, with an emphasis on bovines, (3) summarize research of Cryptosporidium and Giardia from cattle and water buffaloes in parts of Australasia and Sri Lanka, considering public health aspects and (4) provide a perspective on future avenues of study. Recent studies reinforce that bovines harbour Cryptosporidium and Giardia that likely pose a human health risk and highlight the need for future investigations of the biology, population genetics and transmission dynamics of Cryptosporidium and Giardia in cattle, water buffaloes and other ruminants in different geographical regions, the fate and transport of infective stages following their release into the environment, as well as for improved strategies for the control and prevention of cryptosporidiosis and giardiasis, guided by molecular epidemiological studies.
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Affiliation(s)
- Harshanie Abeywardena
- Faculty of Veterinary and Agricultural Sciences, The University of Melbourne, Parkville, Victoria, Australia
| | - Aaron R. Jex
- Faculty of Veterinary and Agricultural Sciences, The University of Melbourne, Parkville, Victoria, Australia
| | - Robin B. Gasser
- Faculty of Veterinary and Agricultural Sciences, The University of Melbourne, Parkville, Victoria, Australia
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Åberg R, Sjöman M, Hemminki K, Pirnes A, Räsänen S, Kalanti A, Pohjanvirta T, Caccio SM, Pihlajasaari A, Toikkanen S, Huusko S, Rimhanen-Finne R. Cryptosporidium parvum Caused a Large Outbreak Linked to Frisée Salad in Finland, 2012. Zoonoses Public Health 2015; 62:618-24. [PMID: 25807859 DOI: 10.1111/zph.12190] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2014] [Indexed: 11/30/2022]
Abstract
Over 250 individuals fell ill in five outbreaks caused by Cryptosporidium parvum in Finland, October-November 2012. The cases were connected by lunch meals at restaurants in four different cities. In two outbreaks, the same C. parvumIIdA17G1 subtype was found in patients' stool samples which supports a single source of infection. Frisée salad was the only common food item served at the restaurants, and consumption of lunch salad containing the frisée salad was associated with the illness. Lunch customers who responded that they had eaten lunch salad were three times more likely to have become ill than those who had not answered whether they had eaten the salad or not (RR 2.66; 95% Cl 1.02-6.9, P-value <0.01). Cryptosporidiosis should be considered as a causal agent in long-lasting watery diarrhoea combined with abdominal cramps, and clinical samples should be tested for Cryptosporidium at the same time bacteria and viruses are tested. Measures to prevent contamination of 'ready-to-eat vegetables' with Cryptosporidium oocysts and methods to test frozen food samples should be developed.
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Affiliation(s)
- R Åberg
- Food Safety Department, Environment Centre, Helsinki, Finland
| | - M Sjöman
- Food Safety Department, Environment Centre, Helsinki, Finland
| | - K Hemminki
- Social and Health Services, Environmental Health, Espoo, Finland
| | - A Pirnes
- Social and Health Services, Environmental Health, Espoo, Finland
| | | | - A Kalanti
- Clinical Microbiology, Helsinki University Central Hospital, Hospital District of Helsinki and Uusimaa, Laboratory Services, HUSLAB, Helsinki, Finland
| | - T Pohjanvirta
- Veterinary Bacteriology Unit, Finnish Food Safety Authority Evira, Kuopio, Finland
| | - S M Caccio
- European Union Reference Laboratory for Parasites, Istituto Superiore di Sanità, Rome, Italy
| | - A Pihlajasaari
- Food Hygiene Unit, Finnish Food Safety Authority Evira, Helsinki, Finland
| | - S Toikkanen
- Department for Infectious Disease Surveillance and Control, National Institute for Health and Welfare, Helsinki, Finland
| | - S Huusko
- Department for Infectious Disease Surveillance and Control, National Institute for Health and Welfare, Helsinki, Finland
| | - R Rimhanen-Finne
- Department for Infectious Disease Surveillance and Control, National Institute for Health and Welfare, Helsinki, Finland
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40
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Widerström M, Schönning C, Lilja M, Lebbad M, Ljung T, Allestam G, Ferm M, Björkholm B, Hansen A, Hiltula J, Långmark J, Löfdahl M, Omberg M, Reuterwall C, Samuelsson E, Widgren K, Wallensten A, Lindh J. Large outbreak of Cryptosporidium hominis infection transmitted through the public water supply, Sweden. Emerg Infect Dis 2014; 20:581-9. [PMID: 24655474 PMCID: PMC3966397 DOI: 10.3201/eid2004.121415] [Citation(s) in RCA: 99] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
In November 2010, ≈27,000 (≈45%) inhabitants of Östersund, Sweden, were affected by a waterborne outbreak of cryptosporidiosis. The outbreak was characterized by a rapid onset and high attack rate, especially among young and middle-aged persons. Young age, number of infected family members, amount of water consumed daily, and gluten intolerance were identified as risk factors for acquiring cryptosporidiosis. Also, chronic intestinal disease and young age were significantly associated with prolonged diarrhea. Identification of Cryptosporidium hominis subtype IbA10G2 in human and environmental samples and consistently low numbers of oocysts in drinking water confirmed insufficient reduction of parasites by the municipal water treatment plant. The current outbreak shows that use of inadequate microbial barriers at water treatment plants can have serious consequences for public health. This risk can be minimized by optimizing control of raw water quality and employing multiple barriers that remove or inactivate all groups of pathogens.
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41
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Cui Z, Wang R, Huang J, Wang H, Zhao J, Luo N, Li J, Zhang Z, Zhang L. Cryptosporidiosis caused by Cryptosporidium parvum subtype IIdA15G1 at a dairy farm in Northwestern China. Parasit Vectors 2014; 7:529. [PMID: 25430474 PMCID: PMC4254006 DOI: 10.1186/s13071-014-0529-z] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2014] [Accepted: 11/07/2014] [Indexed: 11/25/2022] Open
Abstract
Background Cryptosporidium spp. are zoonotic parasites responsible for diarrhoeal diseases in animals and humans worldwide. Cattle are the most common mammalian species in which Cryptosporidium is detected, with pre-weaned calves considered to be reservoirs for zoonotic C. parvum. In October 2013, severe diarrhoea was observed in 396 pre-weaned calves at a farm in the Ningxia Autonomous Region of Northwestern China. 356 of the infected calves died despite antibiotic therapy. Findings 252 faecal samples were collected from the investigated farm. The identity of Cryptosporidium species was determined by polymerase chain reaction (PCR) restriction fragment length polymorphism (RFLP) analysis, and by DNA sequence analysis of the small subunit (SSU) rRNA gene. C. parvum was subtyped using sequence analysis of the 60 kDa glycoprotein (gp60) gene. The highest infection rate of 83.3% (40/48) was seen in 2–3-week-old calves with diarrhoea, corresponding to the age at which animals died. Three Cryptosporidium species were identified, including C. parvum (n = 51), C. bovis (n = 1), and C. ryanae (n = 1). All C. parvum isolates were further identified as subtype IIdA15G1. Conclusions Cryptosporidium parvum was likely to be most responsible for diarrhoea and death. This is the first report of a cryptosporidiosis outbreak caused by C. parvum IIdA15G1 in Chinese dairy cattle.
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Affiliation(s)
- Zhaohui Cui
- College of Animal Science and Veterinary Medicine, Henan Agricultural University, Zhengzhou, 450002, China. .,International Joint Research Laboratory for Zoonotic Diseases of Henan, Zhengzhou, 450002, China.
| | - Rongjun Wang
- College of Animal Science and Veterinary Medicine, Henan Agricultural University, Zhengzhou, 450002, China. .,International Joint Research Laboratory for Zoonotic Diseases of Henan, Zhengzhou, 450002, China.
| | - Jianying Huang
- College of Animal Science and Veterinary Medicine, Henan Agricultural University, Zhengzhou, 450002, China. .,International Joint Research Laboratory for Zoonotic Diseases of Henan, Zhengzhou, 450002, China.
| | - Haiyan Wang
- College of Animal Science and Veterinary Medicine, Henan Agricultural University, Zhengzhou, 450002, China. .,International Joint Research Laboratory for Zoonotic Diseases of Henan, Zhengzhou, 450002, China.
| | - Jinfeng Zhao
- College of Animal Science and Veterinary Medicine, Henan Agricultural University, Zhengzhou, 450002, China. .,International Joint Research Laboratory for Zoonotic Diseases of Henan, Zhengzhou, 450002, China.
| | - Nannan Luo
- College of Animal Science and Veterinary Medicine, Henan Agricultural University, Zhengzhou, 450002, China. .,International Joint Research Laboratory for Zoonotic Diseases of Henan, Zhengzhou, 450002, China.
| | - Junqiang Li
- College of Animal Science and Veterinary Medicine, Henan Agricultural University, Zhengzhou, 450002, China. .,International Joint Research Laboratory for Zoonotic Diseases of Henan, Zhengzhou, 450002, China.
| | - Zhenjie Zhang
- College of Animal Science and Veterinary Medicine, Henan Agricultural University, Zhengzhou, 450002, China. .,International Joint Research Laboratory for Zoonotic Diseases of Henan, Zhengzhou, 450002, China.
| | - Longxian Zhang
- College of Animal Science and Veterinary Medicine, Henan Agricultural University, Zhengzhou, 450002, China. .,International Joint Research Laboratory for Zoonotic Diseases of Henan, Zhengzhou, 450002, China.
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Hong S, Kim K, Yoon S, Park WY, Sim S, Yu JR. Detection of Cryptosporidium parvum in environmental soil and vegetables. J Korean Med Sci 2014; 29:1367-71. [PMID: 25368489 PMCID: PMC4214936 DOI: 10.3346/jkms.2014.29.10.1367] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2014] [Accepted: 07/18/2014] [Indexed: 12/31/2022] Open
Abstract
Cryptosporidium parvum is a zoonotic protozoan parasite that causes cryptosporidial enteritis. Numerous outbreaks of cryptosporidiosis have been reported worldwide. Cryptosporidium is transmitted to hosts via consumption of contaminated water and food but also by direct contact with contaminated soil or infected hosts. The present study investigated farm soil collected from 34 locations along the western Korean peninsula and 24 vegetables purchased from local grocery markets in Seoul. The soil and vegetable samples were examined by real-time polymerase chain reaction (qPCR) to estimate the risk of infection. Eleven of 34 locations (32.4%) and 3 of 24 vegetable samples (12.5%) were contaminated with Cryptosporidium parvum, as confirmed by TaqI enzyme digestion of qPCR products and DNA sequencing. It is suggested that Cryptosporidium infection can be mediated via farm soil and vegetables. Therefore, it is necessary to reduce contamination of this organism in view of public health.
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Affiliation(s)
- Semie Hong
- Department of Radiation Oncology & Research Institute of Medical Science, Konkuk University School of Medicine, Seoul, Korea
| | - Kyungjin Kim
- Department of Environmental and Tropical Medicine & Research Institute of Medical Science, Konkuk University School of Medicine, Seoul, Korea
| | - Sejoung Yoon
- Department of Environmental and Tropical Medicine & Research Institute of Medical Science, Konkuk University School of Medicine, Seoul, Korea
| | - Woo-Yoon Park
- Department of Radiation Oncology, College of Medicine, Chungbuk National University, Cheongju, Korea
| | - Seobo Sim
- Department of Environmental and Tropical Medicine & Research Institute of Medical Science, Konkuk University School of Medicine, Seoul, Korea
| | - Jae-Ran Yu
- Department of Environmental and Tropical Medicine & Research Institute of Medical Science, Konkuk University School of Medicine, Seoul, Korea
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43
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Impacts of globalisation on foodborne parasites. Trends Parasitol 2014; 30:37-52. [DOI: 10.1016/j.pt.2013.09.005] [Citation(s) in RCA: 83] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2013] [Revised: 09/18/2013] [Accepted: 09/19/2013] [Indexed: 11/21/2022]
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Second outbreak of infection with a rare Cryptosporidium parvum genotype in schoolchildren associated with contact with lambs/goat kids at a holiday farm in Norway. Epidemiol Infect 2013; 142:2105-13. [PMID: 24308502 DOI: 10.1017/s0950268813003002] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
In March 2012, a second outbreak of Cryptosporidium parvum affected children following a stay at a holiday farm in Norway; the first outbreak occurred in 2009. We studied a cohort of 145 schoolchildren who had visited the farm, of which 40 (28%) were cases. Cryptosporidium oocysts were detected in faecal samples from humans, goat kids and lambs. Molecular studies revealed C. parvum subtype IIa A19G1R1 in all samples including human samples from the 2009 outbreak. A dose-response relationship was found between the number of optional sessions with animals and illness, increasing from two sessions [risk ratio (RR) 2·7, 95% confidence interval (CI) 0·6-11·5] to six sessions (RR 8·0, 95% CI 1·7-37·7). The occurrence of two outbreaks 3 years apart, with the same subtype of C. parvum, suggests that the parasite is established in the farm's environment. We recommend greater emphasis on hand hygiene and routines related to animal contact.
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45
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Webber MA, Sari I, Hoefel D, Monis PT, King BJ. PCR Slippage Across the ML-2 Microsatellite of theCryptosporidiumMIC1 Locus Enables Development of a PCR Assay Capable of Distinguishing the ZoonoticCryptosporidium parvumFrom Other Human InfectiousCryptosporidiumSpecies. Zoonoses Public Health 2013; 61:324-37. [DOI: 10.1111/zph.12074] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2013] [Indexed: 12/01/2022]
Affiliation(s)
- M. A. Webber
- Department of Medical Biotechnology; School of Medicine; Flinders University; Bedford Park SA Australia
| | - I. Sari
- School of Pharmacy and Medical Sciences; University of South Australia; Adelaide SA Australia
| | - D. Hoefel
- Australian Water Quality Centre; South Australian Water Corporation; Adelaide SA Australia
| | - P. T. Monis
- Department of Medical Biotechnology; School of Medicine; Flinders University; Bedford Park SA Australia
- School of Pharmacy and Medical Sciences; University of South Australia; Adelaide SA Australia
- Australian Water Quality Centre; South Australian Water Corporation; Adelaide SA Australia
| | - B. J. King
- Department of Medical Biotechnology; School of Medicine; Flinders University; Bedford Park SA Australia
- Australian Water Quality Centre; South Australian Water Corporation; Adelaide SA Australia
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46
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Cacciò SM, Widmer G, Axén C, Fayer R. Cryptosporidiosis in Farmed Animals. CRYPTOSPORIDIUM: PARASITE AND DISEASE 2013. [PMCID: PMC7122230 DOI: 10.1007/978-3-7091-1562-6_4] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
Cryptosporidiosis was first identified as a disease of veterinary, rather than human medical, importance, and infection of farmed animals with different species of Cryptosporidium continues to be of veterinary clinical concern. This chapter provides insights into Cryptosporidium infection in a range of farmed animals – cattle, sheep, goats, pigs, cervids, camelids, rabbits, water buffalo and poultry – presenting not only an updated overview of the infection in these animals, but also information on clinical disease, infection dynamics and zoonotic potential. Although extensive data have been accrued on, for example, Cryptosporidium parvum infection in calves, and calf cryptosporidiosis continues to be a major veterinary concern especially in temperate regions, there remains a paucity of data for other farmed animals, despite Cryptosporidium infection causing significant clinical disease and also, for some species, with the potential for transmission of infection to people, either directly or indirectly.
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Affiliation(s)
- Simone M. Cacciò
- Department of Infectious, Parasitic and Immunomediated Diseases, Istituto Superiore di Sanità, Rome, Italy
| | - Giovanni Widmer
- Tufts Cummings School of Veterinary Medicine Division of Infectious Diseases, North Grafton, Massachusetts USA
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47
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Chalmers RM, Katzer F. Looking for Cryptosporidium: the application of advances in detection and diagnosis. Trends Parasitol 2013; 29:237-51. [PMID: 23566713 PMCID: PMC7106352 DOI: 10.1016/j.pt.2013.03.001] [Citation(s) in RCA: 109] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2013] [Revised: 02/27/2013] [Accepted: 03/01/2013] [Indexed: 01/18/2023]
Abstract
The protozoan Cryptosporidium is a major public and animal health concern. Young children, immunocompromised people, and pre-weaning animals are especially vulnerable, but treatment options are limited and there is no vaccine. A laboratory diagnosis is required to confirm cases of cryptosporidiosis, and species and genotype determination is essential in distinguishing human from non-human sources, understanding transmission, and strengthening the epidemiological evidence for causative links in outbreaks. However, testing is not consistent, as demonstrated by investigation of a significant increase in cases in some European countries during 2012. Many methods employed are laborious and time-consuming; recent advances, translated into diagnostic assays, can improve testing and facilitate typing to support clinical and environmental investigations.
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Affiliation(s)
- Rachel M Chalmers
- Cryptosporidium Reference Unit, Public Health Wales Microbiology, Singleton Hospital, Swansea, UK.
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48
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Have foodborne parasites finally become a global concern? Trends Parasitol 2013; 29:101-3. [DOI: 10.1016/j.pt.2012.12.004] [Citation(s) in RCA: 69] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2012] [Accepted: 12/20/2012] [Indexed: 11/17/2022]
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