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Have Diarrhoea And Diagnosed With Cryptosporidiosis. Anything Serious?

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Posted on Fri, 22 Nov 2013
Question: I sure hope so! I am a RN working with group and CBRF homes. Recently several residents within one setting developed serious diarrhea and were eventually diagnosed with Cryptosporidia. At about that same time, there was a new outbreak of Cyclospora in several states, including our own. I understand a special test need be ordered by the PCP in order to test for Cyclospora within the same symptoms. How does the CCD obtain their statistics for something of this sort(Cyclospora) if most PCP's were not aware of this potential and were not ordering the extra testing? Our residents did regain their health after about a month or more of treatment. Could we have done better had the additional test been ordered? Also, is it true that the Cryptospora sample may contain or mask the Cyclospora? Several questions within one! Can you advise me? Our local health department had contacted the State Health Dept. regarding this question but had no information to share. They would be interested in your reply. Thanks.
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Answered by Dr. Dr.Albana Sejdini (7 hours later)
Brief Answer: Please refer to the following suggestions... Detailed Answer: Hi, Usually, outbreaks of such infectious diseases such as Cryptosporidiosis and Cyclospora have the same clinical feature as : diarrhea (including of serious type as in your setting case). It is true that the real diagnosis is done through microscopical examination of feces for ova/parasites where the oocysts/cysts of Cyclospora and the Cryptosporidium are seen. Other tests include ELISA or molecular testing for respective parasites. Usually, Cryposporidium outbreaks are noticed in various care settings where proper hygiene and sanitary measures are not followed. Cryptosporidium itself is very resistant to chlorine or other sanitizers which makes the outbreaks very easily to develop and difficult to manage. I am currently working at the Public Health sector in my country, and the very first thing to do in such cases is to take the emergency measures by putting our patients' life safe. The second thing (at the same time too) is to take samples and further investigate to come out with the final report. Feces, water, foods, etc. are taken as sample for further investigation. For both diseases, contaminated water and food could be to blame although the real transmission chain is not established yet for cyclospora infection. We also evaluate if the cases were in a caring settings as yours or sporadic cases or more. We also evaluate the medical history and recent travelling of the patients. At the end, to my knowledge, CDC is being in touch with the public health officials of each states together with FDA with regards to managing and confirmatory testing for such infectious diseases. Could be that both infections had happened at the same time, but without any lab report, cannot tell for sure. Hope it answered to your questions! p.s. if you have more questions, do not hesitate to write me back!
Above answer was peer-reviewed by : Dr. Prasad
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Follow up: Dr. Dr.Albana Sejdini (2 days later)
Thank you, Dr. Sejdini, for your reply. I read you information with interest. Do I understand correctly, if the State Health Dept. has not been in direct contact with the local Health Dept. requesting additional tests be run on the crypto. stool samples, it would remain that the if said samples had contained cyclospora, these numbers would not become part of the statistic? Thank you. XXXXXXX XXXX
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Answered by Dr. Dr.Albana Sejdini (16 hours later)
Brief Answer: Please refer to the answer below... Detailed Answer: Hi XXXXXXX Thank you for writing back. Usually, when such examination of stool for ova/parasites are done in such emergency or outbreak situations, the stool samples are stored for future tests. In addition, the final report will include all parasites seen and not only crypto. Based on those reports, a statistical analysis is carried out to determine whether it is an outbreak of crypto only or cyclospora only or a both of them. Hope it answered to your question! Dr.Sejdini p.s. If you still have more inquiries, feel free to write back to me! I'd be happy to assist you further.
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Above answer was peer-reviewed by : Dr. Yogesh D
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Dr. Dr.Albana Sejdini

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Have Diarrhoea And Diagnosed With Cryptosporidiosis. Anything Serious?

Brief Answer: Please refer to the following suggestions... Detailed Answer: Hi, Usually, outbreaks of such infectious diseases such as Cryptosporidiosis and Cyclospora have the same clinical feature as : diarrhea (including of serious type as in your setting case). It is true that the real diagnosis is done through microscopical examination of feces for ova/parasites where the oocysts/cysts of Cyclospora and the Cryptosporidium are seen. Other tests include ELISA or molecular testing for respective parasites. Usually, Cryposporidium outbreaks are noticed in various care settings where proper hygiene and sanitary measures are not followed. Cryptosporidium itself is very resistant to chlorine or other sanitizers which makes the outbreaks very easily to develop and difficult to manage. I am currently working at the Public Health sector in my country, and the very first thing to do in such cases is to take the emergency measures by putting our patients' life safe. The second thing (at the same time too) is to take samples and further investigate to come out with the final report. Feces, water, foods, etc. are taken as sample for further investigation. For both diseases, contaminated water and food could be to blame although the real transmission chain is not established yet for cyclospora infection. We also evaluate if the cases were in a caring settings as yours or sporadic cases or more. We also evaluate the medical history and recent travelling of the patients. At the end, to my knowledge, CDC is being in touch with the public health officials of each states together with FDA with regards to managing and confirmatory testing for such infectious diseases. Could be that both infections had happened at the same time, but without any lab report, cannot tell for sure. Hope it answered to your questions! p.s. if you have more questions, do not hesitate to write me back!