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Bujila I, Troell K, Ögren J, Hansen A, Killander G, Agudelo L, Lebbad M, Beser J. Cryptosporidium species and subtypes identified in human domestic cases through the national microbiological surveillance programme in Sweden from 2018 to 2022. BMC Infect Dis 2024; 24:146. [PMID: 38291399 PMCID: PMC10826111 DOI: 10.1186/s12879-024-09049-x] [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] [Received: 11/14/2023] [Accepted: 01/23/2024] [Indexed: 02/01/2024] Open
Abstract
BACKGROUND The intestinal protozoan parasite Cryptosporidium is an important cause of diarrheal disease worldwide. A national microbiological surveillance programme was implemented in Sweden in 2018 in order to increase knowledge of the molecular epidemiology of human cryptosporidiosis to better understand transmission patterns and potential zoonotic sources. This article summarises the results of the first five years of the surveillance programme. METHODS Cryptosporidium-positive faecal and DNA samples from domestically acquired infections were collected from clinical microbiological laboratories in Sweden. Species and subtype determination was performed using 60 kDa glycoprotein and/or small subunit ribosomal RNA gene analysis. RESULTS Between 2018 and 2022, 1654 samples were analysed and 11 different species were identified: C. parvum (n = 1412), C. mortiferum (n = 59), C. hominis (n = 56), C. erinacei (n = 11), C. cuniculus (n = 5), C. meleagridis (n = 3), C. equi (n = 2), C. ubiquitum (n = 2), and one each of C. canis, C. ditrichi and C. felis. Subtyping revealed seven subtype families of C. parvum (new subtype families IIy and IIz) and 69 different subtypes (11 new subtypes). The most common C. parvum subtypes were IIdA22G1c, IIdA24G1, IIdA15G2R1 and IIaA16G1R1b. For C. hominis, four different subtype families and nine different subtypes (two new subtypes) were identified. For additional species, two new subtype families (IIIk and VId) and nine new subtypes were identified. All successfully subtyped C. mortiferum cases were subtype XIVaA20G2T1, confirming previous findings in Sweden. Several outbreaks were identified of which the majority were foodborne and a few were due to direct contact with infected animals. CONCLUSION Infection with C. parvum is the leading cause of human cryptosporidiosis acquired in Sweden, where more than 90% of domestic cases are caused by this zoonotic species and only a small proportion of cases are due to infection with other species. The rodent-associated C. mortiferum is considered an emerging zoonotic species in Sweden and the number of domestically acquired human cases has surpassed that of infection with C. hominis. A high diversity of species and subtypes, as well as diversity within the same subtype, was detected. Also, cryptosporidiosis appears to affect adults to a great extent in Sweden.
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Affiliation(s)
- Ioana Bujila
- Department of Microbiology, Unit of Parasitology, Public Health Agency of Sweden, Solna, Sweden.
| | - Karin Troell
- Department of Microbiology, National Veterinary Agency, Uppsala, Sweden
- Norwegian Veterinary Institute, Ås, Norway
| | - Jessica Ögren
- Division of Clinical Microbiology, Laboratory Medicine, Jönköping County, Jönköping, Sweden
- Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden
| | - Anette Hansen
- Department of Communicable Disease Control and Health Protection, Unit of Zoonoses and Antibiotic Resistance, Public Health Agency of Sweden, Solna, Sweden
| | - Gustav Killander
- Department of Microbiology, Unit of Parasitology, Public Health Agency of Sweden, Solna, Sweden
| | - Lady Agudelo
- Department of Microbiology, Unit of Parasitology, Public Health Agency of Sweden, Solna, Sweden
| | - Marianne Lebbad
- Department of Microbiology, Unit of Parasitology, Public Health Agency of Sweden, Solna, Sweden
| | - Jessica Beser
- Department of Microbiology, Unit of Parasitology, Public Health Agency of Sweden, Solna, Sweden
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Molecular identification of Cryptosporidium species from domestic ruminants and wild reptiles in Cyprus. Parasitol Res 2022; 121:2193-2198. [PMID: 35488924 PMCID: PMC9055218 DOI: 10.1007/s00436-022-07527-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2021] [Accepted: 04/18/2022] [Indexed: 11/14/2022]
Abstract
The presence of Cryptosporidium species in faecal samples of 32 sheep (Aries bovis), 10 goats (Capra circus), 1 blunt nose viper (Macrovipera lebetina lebetina), 3 Kotschy’s geckos (Mediodactylus kotschyi) and 6 wild stellagamas (Stellagama stellio cypriaca) in Cyprus were investigated by polymerase chain reaction (PCR) and sequencing. Cryptosporidium species were found in 9/32 sheep, 5/10 goats, 2/3 Kotschy’s geckos and 2/6 stellagamas faecal samples based on the sequencing of the 18S rRNA gene. Subtyping was achieved based on the sequencing of the gp60 gene. Four different species have been identified: Cryptosporidium parvum in goats (subtype IIaA15G1R1), C. xiaoi (subtypes XXIIId and XXIIIl) and C. ubiquitum (subtype XIIa) in sheep and C. varanii and C. parvum in lizards; the viper snake sample was negative. This is the first report on the molecular identification of a variety of Cryptosporidium species from domestic ruminants and wild reptiles in the Republic of Cyprus.
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Zhang K, Wu Y, Jing B, Xu C, Chen Y, Yu F, Wei Z, Zhang Y, Cui Z, Qi M, Zhang L. Seasonal monitoring of Cryptosporidium species and their genetic diversity in neonatal calves on two large-scale farms in Xinjiang, China. J Eukaryot Microbiol 2021; 69:e12878. [PMID: 34877732 DOI: 10.1111/jeu.12878] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
To find out whether and how the prevalence and genetic diversity of Cryptosporidium in neonatal calves vary with the season, 380 fecal samples from neonatal calves on two large-scale farms in Xinjiang (Alar and Wensu) were studied using molecular biology techniques. Cryptosporidium was detected in 48.7% (185/380) of the samples and was most frequent in summer (56.8%), followed by spring (50.0%), winter (46.8%), and autumn (41.7%; p > 0.05). Calves with diarrhea seem to be more likely infected by Cryptosporidium than those without diarrhea (p < 0.01). We also found that C. parvum (n = 173), C. bovis (n = 7), and C. ryanae (n = 3) were the Cryptosporidium species detected in this study, and co-infections of these three species (n = 2) were also identified. Two subtypes (IIdA14G1 and IIdA15G1) of C. parvum were identified, and both can infect human. These results also show that neonatal calves commonly suffer diarrhea caused by C. parvum throughout the year.
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Affiliation(s)
- Kuankuan Zhang
- College of Animal Science, Tarim University, Alar, China
| | - Yayun Wu
- College of Veterinary Medicine, Henan Agricultural University, Zhengzhou, China
| | - Bo Jing
- College of Animal Science, Tarim University, Alar, China
| | - Chunyan Xu
- College of Animal Science, Tarim University, Alar, China
| | - Yuancai Chen
- College of Veterinary Medicine, Henan Agricultural University, Zhengzhou, China
| | - Fuchang Yu
- College of Animal Science, Tarim University, Alar, China
| | - Zilin Wei
- College of Animal Science, Tarim University, Alar, China
| | - Ying Zhang
- College of Animal Science, Tarim University, Alar, China
| | - Zhaohui Cui
- College of Veterinary Medicine, Henan Agricultural University, Zhengzhou, China
| | - Meng Qi
- College of Animal Science, Tarim University, Alar, China.,College of Veterinary Medicine, Henan Agricultural University, Zhengzhou, China
| | - Longxian Zhang
- College of Veterinary Medicine, Henan Agricultural University, Zhengzhou, China
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Lebbad M, Winiecka-Krusnell J, Stensvold CR, Beser J. High Diversity of Cryptosporidium Species and Subtypes Identified in Cryptosporidiosis Acquired in Sweden and Abroad. Pathogens 2021; 10:pathogens10050523. [PMID: 33926039 PMCID: PMC8147002 DOI: 10.3390/pathogens10050523] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Revised: 04/23/2021] [Accepted: 04/23/2021] [Indexed: 11/16/2022] Open
Abstract
The intestinal protozoan parasite Cryptosporidium is an important cause of diarrheal disease worldwide. The aim of this study was to expand the knowledge on the molecular epidemiology of human cryptosporidiosis in Sweden to better understand transmission patterns and potential zoonotic sources. Cryptosporidium-positive fecal samples were collected between January 2013 and December 2014 from 12 regional clinical microbiology laboratories in Sweden. Species and subtype determination was achieved using small subunit ribosomal RNA and 60 kDa glycoprotein gene analysis. Samples were available for 398 patients, of whom 250 (63%) and 138 (35%) had acquired the infection in Sweden and abroad, respectively. Species identification was successful for 95% (379/398) of the samples, revealing 12 species/genotypes: Cryptosporidium parvum (n = 299), C. hominis (n = 49), C. meleagridis (n = 8), C. cuniculus (n = 5), Cryptosporidium chipmunk genotype I (n = 5), C. felis (n = 4), C. erinacei (n = 2), C. ubiquitum (n = 2), and one each of C. suis, C. viatorum, C. ditrichi, and Cryptosporidium horse genotype. One patient was co-infected with C. parvum and C. hominis. Subtyping was successful for all species/genotypes, except for C. ditrichi, and revealed large diversity, with 29 subtype families (including 4 novel ones: C. parvum IIr, IIs, IIt, and Cryptosporidium horse genotype Vic) and 81 different subtypes. The most common subtype families were IIa (n = 164) and IId (n = 118) for C. parvum and Ib (n = 26) and Ia (n = 12) for C. hominis. Infections caused by the zoonotic C. parvum subtype families IIa and IId dominated both in patients infected in Sweden and abroad, while most C. hominis cases were travel-related. Infections caused by non-hominis and non-parvum species were quite common (8%) and equally represented in cases infected in Sweden and abroad.
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Affiliation(s)
- Marianne Lebbad
- Department of Microbiology, Public Health Agency of Sweden, 171 82 Solna, Sweden; (M.L.); (J.W.-K.)
| | | | - Christen Rune Stensvold
- Department of Bacteria, Parasites and Fungi, Statens Serum Institut, DK-2300 Copenhagen S, Denmark;
| | - Jessica Beser
- Department of Microbiology, Public Health Agency of Sweden, 171 82 Solna, Sweden; (M.L.); (J.W.-K.)
- Correspondence:
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Comparison of three diagnostic methods in the diagnosis of cryptosporidiosis and gp60 subtyping of Cryptosporidium parvum in diarrheic calves in Central Anatolia Region of Turkey. THE EUROBIOTECH JOURNAL 2021. [DOI: 10.2478/ebtj-2021-0010] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
Abstract
The aim of this study was to compare three diagnostic methods for the diagnosis of cryptosporidiosis and to detect subtypes ofCryptosporidium parvum by sequences analyses of gp60 gene in diarrheic calves in several herds in Konya province located in Central Anatolia Region of Turkey. Fecal samples were collected from a total of 194 pre-weaned calves (n=158, ≤15 days old, and n=36, 15 to 40 days old), with diarrhoea. For comparative diagnosis, all samples were examined by modified Ziehl-Neelsen staining of fecal smears for the presence of oocyst, nested PCR-RFLP of SSU rRNA and TaqMan qPCR for the detection of Cryptosporidium DNA. A total of 92 (47.4%) and 104 (53.6%) out of the examined samples were found positive by microscopic examination and molecular tools, respectively. The diagnostic sensitivity and specificity of microscopic identification were determined as 88.5% and 100.0%, respectively compared to molecular assays. Cryptosporidium parvum was the only detected species in all positive samples by species-specific qPCR and nested PCR-RFLP assays. Species identifications were further confirmed by sequence analyses of the SSU rRNA PCR products. There was no statistically significant difference in C. parvum prevalence between early pre-weaned calves and calves older than 15 days. The sequence analyses of the gp60 gene of C. parvum isolates revealed a one subtype IIaA13G2R1 belonging to zoonotic family IIa in diarrheic calves
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Small ruminants and zoonotic cryptosporidiosis. Parasitol Res 2021; 120:4189-4198. [PMID: 33712929 DOI: 10.1007/s00436-021-07116-9] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2021] [Accepted: 03/04/2021] [Indexed: 12/19/2022]
Abstract
Sheep and goats are commonly infected with three Cryptosporidium species, including Cryptosporidium parvum, Cryptosporidium ubiquitum, and Cryptosporidium xiaoi, which differ from each in prevalence, geographic distribution, and public health importance. While C. parvum appears to be a dominant species in small ruminants in European countries, its occurrence in most African, Asian, and American countries appear to be limited. As a result, zoonotic infections due to contact with lambs and goat kids are common in European countries, leading to frequent reports of outbreaks of cryptosporidiosis on petting farms. In contrast, C. xiaoi is the dominant species elsewhere, and mostly does not infect humans. While C. ubiquitum is another zoonotic species, it occurs in sheep and goats at much lower frequency. Host adaptation appears to be present in both C. parvum and C. ubiquitum, consisting of several subtype families with different host preference. The host-adapted nature of C. parvum and C. ubiquitum has allowed the use of subtyping tools in tracking infection sources. This has led to the identification of geographic differences in the importance of small ruminants in epidemiology of human cryptosporidiosis. These tools have also been used effectively in linking zoonotic transmission of C. parvum between outbreak cases and the suspected animals. Further studies should be directly elucidating the reasons for differences in the distribution and public health importance of major Cryptosporidium species in sheep and goats.
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Yanta CA, Bessonov K, Robinson G, Troell K, Guy RA. CryptoGenotyper: A new bioinformatics tool for rapid Cryptosporidium identification. Food Waterborne Parasitol 2021; 23:e00115. [PMID: 33748443 PMCID: PMC7966988 DOI: 10.1016/j.fawpar.2021.e00115] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2020] [Revised: 02/09/2021] [Accepted: 02/15/2021] [Indexed: 01/09/2023] Open
Abstract
Cryptosporidium is a protozoan parasite that is transmitted to both humans and animals through zoonotic or anthroponotic means. When a host is infected with this parasite, it causes a gastrointestinal disease known as cryptosporidiosis. To understand the transmission dynamics of Cryptosporidium, the small subunit (SSU or 18S) rRNA and gp60 genes are commonly studied through PCR analysis and conventional Sanger sequencing. However, analyzing sequence chromatograms manually is both time consuming and prone to human error, especially in the presence of poorly resolved, heterozygous peaks and the absence of a validated database. For this study, we developed a Cryptosporidium genotyping tool, called CryptoGenotyper, which has the capability to read raw Sanger sequencing data for the two common Cryptosporidium gene targets (SSU rRNA and gp60) and classify the sequence data into standard nomenclature. The CryptoGenotyper has the capacity to perform quality control and properly classify sequences using a high quality, manually curated reference database, saving users' time and removing bias during data analysis. The incorporated heterozygous base calling algorithms for the SSU rRNA gene target resolves double peaks, therefore recovering data previously classified as inconclusive. The CryptoGenotyper successfully genotyped 99.3% (428/431) and 95.1% (154/162) of SSU rRNA chromatograms containing single and mixed sequences, respectively, and correctly subtyped 95.6% (947/991) of gp60 chromatograms without manual intervention. This new, user-friendly tool can provide both fast and reproducible analyses of Sanger sequencing data for the two most common Cryptosporidium gene targets.
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Affiliation(s)
- Christine A Yanta
- National Microbiology Laboratory, Public Health Agency of Canada, 110 Stone Road West, Guelph, ON N1G 3W4, Canada
| | - Kyrylo Bessonov
- National Microbiology Laboratory, Public Health Agency of Canada, 110 Stone Road West, Guelph, ON N1G 3W4, Canada
| | - Guy Robinson
- Cryptosporidium Reference Unit, Public Health Wales, Microbiology and Health Protection, Singleton Hospital, Swansea SA2 8QA, UK.,Swansea University Medical School, Singleton Park, Swansea SA2 8PP, UK
| | - Karin Troell
- National Veterinary Institute, 751 89 Uppsala, Sweden.,Department of Medical Biochemistry and Microbiology, Uppsala University, Sweden
| | - Rebecca A Guy
- National Microbiology Laboratory, Public Health Agency of Canada, 110 Stone Road West, Guelph, ON N1G 3W4, Canada
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Caffarena RD, Meireles MV, Carrasco-Letelier L, Picasso-Risso C, Santana BN, Riet-Correa F, Giannitti F. Dairy Calves in Uruguay Are Reservoirs of Zoonotic Subtypes of Cryptosporidium parvum and Pose a Potential Risk of Surface Water Contamination. Front Vet Sci 2020; 7:562. [PMID: 32974408 PMCID: PMC7473207 DOI: 10.3389/fvets.2020.00562] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2020] [Accepted: 07/15/2020] [Indexed: 12/19/2022] Open
Abstract
Cryptosporidium parvum, a major cause of diarrhea in calves, is of concern given its zoonotic potential. Numerous outbreaks of human cryptosporidiosis caused by C. parvum genetic subtypes are reported yearly worldwide, with livestock or water being frequently identified sources of infection. Although cryptosporidiosis has been reported from human patients in Uruguay, particularly children, epidemiologic information is scant and the role of cattle as reservoirs of zoonotic subtypes of C. parvum has not been explored. In this study, we aimed to (a)-identify C. parvum subtypes infecting dairy calves in Uruguay (including potentially zoonotic subtypes), (b)-assess their association with calf diarrhea, (c)-evaluate their spatial clustering, and (d)-assess the distance of infected calves to surface watercourses draining the farmlands and determine whether these watercourses flow into public water treatment plants. Feces of 255 calves that had tested positive for Cryptosporidium spp. by antigen ELISA were selected. Samples had been collected from 29 dairy farms in seven Uruguayan departments where dairy farming is concentrated and represented 170 diarrheic and 85 non-diarrheic calves. Selected samples were processed by nested PCRs targeting the 18S rRNA and gp60 genes followed by sequencing to identify C. parvum subtypes. Of seven C. parvum subtypes detected in 166 calves, five (identified in 143 calves on 28/29 farms) had been identified in humans elsewhere and have zoonotic potential. Subtype IIaA15G2R1 was the most frequent (53.6%; 89/166), followed by IIaA20G1R1 (24.1%; 40/166), IIaA22G1R1 (11.4%; 19/166), IIaA23G1R1 (3.6%; 6/166), IIaA17G2R1 (3%; 5/166), IIaA21G1R1 (2.4%; 4/166), and IIaA16G1R1 (1.8%; 3/166). There were no significant differences in the proportions of diarrheic and non-diarrheic calves infected with any of the C. parvum subtypes. Two spatial clusters were detected, one of which overlapped with Uruguay's capital city and its main water treatment plant (Aguas Corrientes), harvesting surface water to supply ~1,700,000 people. Infected calves on all farms were within 20–900 m of a natural surface watercourse draining the farmland, 10 of which flowed into six water treatment plants located 9–108 km downstream. Four watercourses flowed downstream into Aguas Corrientes. Calves are reservoirs of zoonotic C. parvum subtypes in Uruguay and pose a public health risk.
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Affiliation(s)
- Rubén Darío Caffarena
- Instituto Nacional de Investigación Agropecuaria (INIA), Plataforma de Investigación en Salud Animal, Estación Experimental INIA La Estanzuela, Colonia, Uruguay.,Facultad de Veterinaria, Universidad de la República, Montevideo, Uruguay
| | | | - Leonidas Carrasco-Letelier
- Instituto Nacional de Investigación Agropecuaria (INIA), Programa de Producción y Sustentabilidad Ambiental, Estación Experimental INIA La Estanzuela, Colonia, Uruguay
| | - Catalina Picasso-Risso
- Facultad de Veterinaria, Universidad de la República, Montevideo, Uruguay.,Department of Veterinary Population Medicine, College of Veterinary Medicine, University of Minnesota, Saint Paul, MN, United States
| | | | - Franklin Riet-Correa
- Instituto Nacional de Investigación Agropecuaria (INIA), Plataforma de Investigación en Salud Animal, Estación Experimental INIA La Estanzuela, Colonia, Uruguay
| | - Federico Giannitti
- Instituto Nacional de Investigación Agropecuaria (INIA), Plataforma de Investigación en Salud Animal, Estación Experimental INIA La Estanzuela, Colonia, Uruguay
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Firoozi Z, Sazmand A, Zahedi A, Astani A, Fattahi-Bafghi A, Kiani-Salmi N, Ebrahimi B, Dehghani-Tafti A, Ryan U, Akrami-Mohajeri F. Prevalence and genotyping identification of Cryptosporidium in adult ruminants in central Iran. Parasit Vectors 2019; 12:510. [PMID: 31666095 PMCID: PMC6822396 DOI: 10.1186/s13071-019-3759-2] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2019] [Accepted: 10/22/2019] [Indexed: 12/22/2022] Open
Abstract
Background Apicomplexan parasites of the genus Cryptosporidium infect a wide range of animal species as well as humans. Cryptosporidium spp. can cause life threatening diarrhea especially in young animals, children, immunocompromised patients and malnourished individuals. Asymptomatic cryptosporidial infections in animals can also occur, making these animals potential reservoirs of infection. Methods In the present study, a molecular survey of Cryptosporidium spp. in ruminants that were slaughtered for human consumption in Yazd Province, located in central Iran was conducted. Faeces were collected per-rectum from 484 animals including 192 cattle, 192 sheep and 100 goats. DNA was extracted from all samples and screened for Cryptosporidium by PCR amplification of the 18S rRNA gene. Positives were Sanger sequenced and further subtyped by sequence analysis of the 60 kDa glycoprotein (gp60) locus. Results In total, Cryptosporidium spp. were detected in 22 animals: C. andersoni and C. bovis in seven and two cattle faecal samples, respectively, C. ubiquitum in five sheep, and C. xiaoi in six sheep and two goat samples, respectively. To our knowledge, this study provides for the first time, molecular information concerning Cryptosporidium species infecting goats in Iran, and is also the first report of C. ubiquitum and C. xiaoi from ruminants in Iran. Conclusion The presence of potentially zoonotic species of Cryptosporidium in ruminants in this region may suggest that livestock could potentially contribute to human cryptosporidiosis, in particular among farmers and slaughterhouse workers, in the area. Further molecular studies on local human populations are required to more accurately understand the epidemiology and transmission dynamics of Cryptosporidium spp. in this region.
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Affiliation(s)
- Zohre Firoozi
- Zoonotic Diseases Research Center, School of Public Health, Shahid Sadoughi University of Medical Sciences and Health Services, Yazd, Iran.,Department of Food Hygiene and Safety, School of Public Health, Shahid Sadoughi University of Medical Sciences and Health Services, Yazd, Iran
| | - Alireza Sazmand
- Department of Pathobiology, Faculty of Veterinary Sciences, Bu-Ali Sina University, Hamedan, Iran
| | - Alireza Zahedi
- Vector and Water-Borne Pathogens Research Group, College of Science, Health, Engineering and Education, Murdoch University, Murdoch, WA, 6150, Australia
| | - Akram Astani
- Zoonotic Diseases Research Center, School of Public Health, Shahid Sadoughi University of Medical Sciences and Health Services, Yazd, Iran.,Department of Microbiology Sciences, School of Medicine, Shahid Sadoughi University of Medical Sciences and Health Services, Yazd, Iran
| | - Ali Fattahi-Bafghi
- Department of Parasitology, School of Medicine, Shahid Sadoughi University of Medical Sciences and Health Services, Yazd, Iran
| | - Narges Kiani-Salmi
- Zoonotic Diseases Research Center, School of Public Health, Shahid Sadoughi University of Medical Sciences and Health Services, Yazd, Iran.,Department of Food Hygiene and Safety, School of Public Health, Shahid Sadoughi University of Medical Sciences and Health Services, Yazd, Iran
| | - Behnam Ebrahimi
- Yazd Cardiovascular Research Center, Shahid Sadoughi University of Medical Sciences and Health Services, Yazd, Iran
| | - Arefeh Dehghani-Tafti
- Department of Biostatics and Epidemiology, School of Public Health, Shahid Sadoughi University of Medical Sciences and Health Services, Yazd, Iran
| | - Una Ryan
- Vector and Water-Borne Pathogens Research Group, College of Science, Health, Engineering and Education, Murdoch University, Murdoch, WA, 6150, Australia
| | - Fateme Akrami-Mohajeri
- Zoonotic Diseases Research Center, School of Public Health, Shahid Sadoughi University of Medical Sciences and Health Services, Yazd, Iran. .,Department of Food Hygiene and Safety, School of Public Health, Shahid Sadoughi University of Medical Sciences and Health Services, Yazd, Iran.
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