Skip to main content

Introduction to Cryptosporidium: The Parasite and the Disease

  • Chapter
  • First Online:
Cryptosporidium as a Foodborne Pathogen

Part of the book series: SpringerBriefs in Food, Health, and Nutrition ((BRIEFSFOOD))

  • 728 Accesses

Abstract

Cryptosporidium is an Apicomplexan parasite, of which around 25 species and several genotypes are recognised, several of which are infectious to humans. The majority of human infections are due to the species Cryptosporidium hominis and C. parvum. The latter parasite is also a common pathogen of a range of animals, particularly young calves and small ruminants. Cryptosporidium is globally distributed and is considered to be one of the four pathogens most associated serious childhood diarrhoea in developing countries; effective chemotherapy in the most vulnerable patient groups is lacking.

The life cycle of Cryptosporidium is relatively complicated, consisting of both asexual and sexual cycles, the latter of which results in the production of oocysts, the environmentally robust transmission stages that are excreted in the faeces of infected hosts. This chapter provides an overview of the parasite, the various species, establishment of infection and details of the life cycle and also describes the disease, cryptosporidiosis, that is associated with infection, with focus on symptoms and diagnosis.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

eBook
USD 16.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 16.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  • Adl SM, Simpson AG, Farmer MA, Andersen RA, Anderson OR, Barta JR, Bowser SS, Brugerolle G, Fensome RA, Fredericq S, James TY, Karpov S, Kugrens P, Krug J, Lane CE, Lewis LA, Lodge J, Lynn DH, Mann DG, McCourt RM, Mendoza L, Moestrup O, Mozley-Standridge SE, Nerad TA, Shearer CA, Smirnov AV, Spiegel FW, Taylor MF (2005) The new higher level classification of eukaryotes with emphasis on the taxonomy of protists. J Eukaryot Microbiol 52(5):399–451

    Article  Google Scholar 

  • Adl SM, Leander BS, Simpson AG, Archibald JM, Anderson OR, Bass D, Bowser SS, Brugerolle G, Farmer MA, Karpov S, Kolisko M, Lane CE, Lodge DJ, Mann DG, Meisterfeld R, Mendoza L, Moestrup Ø, Mozley-Standridge SE, Smirnov AV, Spiegel F (2007) Diversity, nomenclature, and taxonomy of protists. Syst Biol 56(4):684–689

    Article  Google Scholar 

  • Adl SM, Simpson AG, Lane CE, LukeÅ¡ J, Bass D, Bowser SS, Brown MW, Burki F, Dunthorn M, Hampl V, Heiss A, Hoppenrath M, Lara E, Le Gall L, Lynn DH, McManus H, Mitchell EA, Mozley-Stanridge SE, Parfrey LW, Pawlowski J, Rueckert S, Shadwick RS, Schoch CL, Smirnov A, Spiegel FW (2012) The revised classification of eukaryotes. J Eukaryot Microbiol 59(5):429–493

    Article  Google Scholar 

  • Al-Brikan FA, Salem HS, Beeching N, Hilal N (2008) Multilocus genetic analysis of Cryptosporidium isolates from Saudi Arabia. J Egypt Soc Parasitol 38(2):645–658

    Google Scholar 

  • Azami M, Moghadam DD, Salehi R, Salehi M (2007) The identification of Cryptosporidium species (protozoa) in Isfahan, Iran by PCR-RFLP analysis of the 18s rRNA gene. Mol Biol (Mosk) 41:851–856

    Article  CAS  Google Scholar 

  • Bouzid M, Hunter PR, Chalmers RM, Tyler KM (2013) Cryptosporidium pathogenicity and virulence. Clin Microbiol Rev 26(1):115–134

    Article  CAS  Google Scholar 

  • Cama VA, Bern C, Sulaiman IM, Gilman RH, Ticona E, Vivar A, Kawai V, Vargas D, Zhou L, Xiao L (2003) Cryptosporidium species and genotypes in HIV-positive patients in Lima, Peru. J Eukaryot Microbiol 50(Suppl):531–533

    Article  Google Scholar 

  • Cama VA, Ross JM, Crawford S, Kawai V, Chavez-Valdez R, Vargas D, Vivar A, Ticona E, Navincopa M, Williamson J, Ortega Y, Gilman RH, Bern C, Xiao L (2007) Differences in clinical manifestations among Cryptosporidium species and subtypes in HIV-infected persons. J Infect Dis 196(5):684–691

    Article  Google Scholar 

  • Cama VA, Bern C, Roberts J, Cabrera L, Sterling CR, Ortega Y, Gilman RH, Xiao L (2008) Cryptosporidium species and subtypes and clinical manifestations in children, Peru. Emerg Infect Dis 14(10):1567–1574

    Article  Google Scholar 

  • Chalmers RM, Elwin K, Thomas AL, Guy EC, Mason B (2009) Long-term Cryptosporidium typing reveals the aetiology and species-specific epidemiology of human cryptosporidiosis in England and Wales, 2000 to 2003. Euro Surveill 14(2)

    Google Scholar 

  • Chalmers RM, Elwin K, Hadfield SJ, Robinson G (2011) Sporadic human cryptosporidiosis caused by Cryptosporidium cuniculus, United Kingdom, 2007–2008. Emerg Infect Dis 17(3):536–538

    Article  Google Scholar 

  • Chang’a JS, Robertson LJ, Mtambo MM, Mdegela RH, Løken T, Reksen O (2011) Unexpected results from large-scale cryptosporidiosis screening study in calves in Tanzania. Ann Trop Med Parasitol 105(7):513–519. doi:10.1179/2047773211Y.0000000007

    Article  Google Scholar 

  • Chappell CL, Okhuysen PC, Sterling CR, DuPont HL (1996) Cryptosporidium parvum: intensity of infection and oocyst excretion patterns in healthy volunteers. J Infect Dis 173(1):232–236

    Article  CAS  Google Scholar 

  • Chappell CL, Okhuysen PC, Sterling CR, Wang C, Jakubowski W, Dupont HL (1999) Infectivity of Cryptosporidium parvum in healthy adults with pre-existing anti-C. Parvum serum immunoglobulin G. Am J Trop Med Hyg 60(1):157–164

    CAS  Google Scholar 

  • Chappell CL, Okhuysen PC, Langer-Curry R, Widmer G, Akiyoshi DE, Tanriverdi S, Tzipori S (2006) Cryptosporidium hominis: experimental challenge of healthy adults. Am J Trop Med Hyg 75(5):851–857

    CAS  Google Scholar 

  • Chappell CL, Okhuysen PC, Langer-Curry RC, Akiyoshi DE, Widmer G, Tzipori S (2011) Cryptosporidium meleagridis: infectivity in healthy adult volunteers. Am J Trop Med Hyg 85(2):238–242

    Article  Google Scholar 

  • Checkley W, Epstein LD, Gilman RH, Black RE, Cabrera L, Sterling CR (1998) Effects of Cryptosporidium parvum infection in Peruvian children: growth faltering and subsequent catch-up growth. Am J Epidemiol 148(5):497–506

    Article  CAS  Google Scholar 

  • Cieloszyk J, Goñi P, García A, Remacha MA, Sánchez E, Clavel A (2012) Two cases of zoonotic cryptosporidiosis in Spain by the unusual species Cryptosporidium ubiquitum and Cryptosporidium felis. Enferm Infecc Microbiol Clin 30(9):549–551

    Article  Google Scholar 

  • Ditrich O, Palkovic L, StÄ•rba J, Prokopic J, Loudová J, Giboda M (1991) The first finding of Cryptosporidium baileyi in man. Parasitol Res 77(1):44–47

    Article  CAS  Google Scholar 

  • DuPont HL, Chappell CL, Sterling CR, Okhuysen PC, Rose JB, Jakubowski W (1995) The infectivity of Cryptosporidium parvum in healthy volunteers. N Engl J Med 332(13):855–859

    Article  CAS  Google Scholar 

  • ECDC (2013) European Centre for Disease Prevention and Control. Cryptosporidium. Annual epidemiological report 2012. Reporting on 2010 surveillance data and 2011 epidemic intelligence data. ECDC, Stockholm. pp 72–74. http://www.ecdc.europa.eu/en/publications/Publications/Annual-Epidemiological-Report-2012.pdf

  • Elwin K, Hadfield SJ, Robinson G, Chalmers RM (2012a) The epidemiology of sporadic human infections with unusual cryptosporidia detected during routine typing in England and Wales, 2000–2008. Epidemiol Infect 140(4):673–683

    Article  CAS  Google Scholar 

  • Elwin K, Hadfield SJ, Robinson G, Crouch ND, Chalmers RM (2012b) Cryptosporidium viatorum n. sp. (Apicomplexa: Cryptosporidiidae) among travellers returning to Great Britain from the Indian subcontinent, 2007–2011. Int J Parasitol 42(7):675–682

    Article  Google Scholar 

  • Fayer R (2008) Biology. In: Faryer R, Xiao L (eds) Cryptosporidium and cryptosporidiosis, 2nd edn. CRC Press/IWA Publishing, Boca Raton, FL, pp 1–42

    Google Scholar 

  • Fayer R, Santín M, Macarisin D (2010) Cryptosporidium ubiquitum n. sp. in animals and humans. Vet Parasitol 172(1–2):23–32

    Article  Google Scholar 

  • Gatei W, Suputtamongkol Y, Waywa D, Ashford RW, Bailey JW, Greensill J, Beeching NJ, Hart CA (2002) Zoonotic species of Cryptosporidium are as prevalent as the anthroponotic in HIV-infected patients in Thailand. Ann Trop Med Parasitol 96(8):797–802

    Article  CAS  Google Scholar 

  • Gatei W, Barrett D, Lindo JF, Eldemire-Shearer D, Cama V, Xiao L (2008) Unique Cryptosporidium population in HIV-infected persons, Jamaica. Emerg Infect Dis 14(5):841–843

    Article  CAS  Google Scholar 

  • Goodgame RW, Genta RM, White AC, Chappell CL (1993) Intensity of infection in AIDS-associated cryptosporidiosis. J Infect Dis 167:704–709

    Article  CAS  Google Scholar 

  • Guerrant DI, Moore SR, Lima AA, Patrick PD, Schorling JB, Guerrant RL (1999) Association of early childhood diarrhea and cryptosporidiosis with impaired physical fitness and cognitive function four-seven years later in a poor urban community in northeast Brazil. Am J Trop Med Hyg 61(5):707–713

    CAS  Google Scholar 

  • Hunter PR, Hughes S, Woodhouse S, Raj N, Syed Q, Chalmers RM, Verlander NQ, Goodacre J (2004a) Health sequelae of human cryptosporidiosis in immunocompetent patients. Clin Infect Dis 39:504–510

    Article  Google Scholar 

  • Insulander M, SilverlÃ¥s C, Lebbad M, Karlsson L, Mattsson JG, Svenungsson B (2013) Molecular epidemiology and clinical manifestations of human cryptosporidiosis in Sweden. Epidemiol Infect 141(5):1009–1020

    Article  CAS  Google Scholar 

  • Jenkins MB, Eaglesham BS, Anthony LC, Kachlany SC, Bowman DD, Ghiorse WC (2010) Significance of wall structure, macromolecular composition, and surface polymers to the survival and transport of Cryptosporidium parvum oocysts. Appl Environ Microbiol 76(6):1926–1934

    Article  CAS  Google Scholar 

  • Johnston SP, Ballard MM, Beach MJ, Causer L, Wilkins PP (2003) Evaluation of three commercial assays for detection of Giardia and Cryptosporidium organisms in fecal specimens. J Clin Microbiol 41:623–626

    Article  Google Scholar 

  • Khan SM, Debnath C, Pramanik AK, Xiao L, Nozaki T, Ganguly S (2010) Molecular characterization and assessment of zoonotic transmission of Cryptosporidium from dairy cattle in West Bengal, India. Vet Parasitol 171(1–2):41–47

    Article  CAS  Google Scholar 

  • Kotloff KL, Nataro JP, Blackwelder WC, Nasrin D, Farag TH, Panchalingam S, Wu Y, Sow SO, Sur D, Breiman RF, Faruque AS, Zaidi AK, Saha D, Alonso PL, Tamboura B, Sanogo D, Onwuchekwa U, Manna B, Ramamurthy T, Kanungo S, Ochieng JB, Omore R, Oundo JO, Hossain A, Das SK, Ahmed S, Qureshi S, Quadri F, Adegbola RA, Antonio M, Hossain MJ, Akinsola A, Mandomando I, Nhampossa T, Acácio S, Biswas K, O’Reilly CE, Mintz ED, Berkeley LY, Muhsen K, Sommerfelt H, Robins-Browne RM, Levine MM (2013) Burden and aetiology of diarrhoeal disease in infants and young children in developing countries (the Global Enteric Multicenter Study, GEMS): a prospective, case-control study. Lancet 382(9888):209–222. doi:10.1016/S0140-6736(13)60844-2

    Article  Google Scholar 

  • Kvác M, Kvetonová D, Sak B, Ditrich O (2009) Cryptosporidium pig genotype II in immunocompetent man. Emerg Infect Dis 15(6):982–983

    Google Scholar 

  • Leander BS, Clopton R, Keeling P (2003) Phylogeny of gregarines (Apicomplexa) as inferred from small-subunit rDNA and beta-tubulin. Int J Syst Evol Microbiol 53:345–354

    Article  CAS  Google Scholar 

  • Lorntz B, Soares AM, Moore SR, Pinkerton R, Gansneder B, Bovbjerg VE, Guyatt H, Lima AM, Guerrant RL (2006) Early childhood diarrhea predicts impaired school performance. Pediatr Infect Dis J 25(6):513–520

    Article  Google Scholar 

  • Mac Kenzie WR, Hoxie NJ, Proctor ME, Gradus MS, Blair KA, Peterson DE, Kazmierczak JJ, Addiss DG, Fox KR, Rose JB, Davis JP (1994) A massive outbreak in Milwaukee of Cryptosporidium infection transmitted through the public water supply. N Engl J Med 331(3):161–167

    Article  CAS  Google Scholar 

  • McDonald V (2008) Immune responses. In: Fayer R, Xiao L (eds) Cryptosporidium and Cryptosporidiosis, 2nd edn. CRC Press/IWA Publishing, Boca Raton, FL, pp 209–233

    Google Scholar 

  • Morrison DA (2009) Evolution of the Apicomplexa: where are we now? Trends Parasitol 25(8):375–382

    Article  Google Scholar 

  • Morse TD, Nichols RA, Grimason AM, Campbell BM, Tembo KC, Smith HV (2007) Incidence of cryptosporidiosis species in paediatric patients in Malawi. Epidemiol Infect 135(8):1307–1315

    Article  CAS  Google Scholar 

  • Mosier DA, Oberst RD (2000) Cryptosporidiosis. A global challenge. Ann N Y Acad Sci 916:102–111

    Article  CAS  Google Scholar 

  • Muthusamy D, Rao SS, Ramani S, Monica B, Banerjee I, Abraham OC, Mathai DC, Primrose B, Muliyil J, Wanke CA, Ward HD, Kang G (2006) Multilocus genotyping of Cryptosporidium sp. isolates from human immunodeficiency virus-infected individuals in South India. J Clin Microbiol 44(2):632–634

    Article  CAS  Google Scholar 

  • Ng-Hublin JS, Combs B, Mackenzie B, Ryan U (2013) Human cryptosporidiosis diagnosed in Western Australia: a mixed infection with Cryptosporidium meleagridis, the Cryptosporidium mink genotype, and an unknown Cryptosporidium species. J Clin Microbiol 51(7):2463–2465

    Article  Google Scholar 

  • Niehaus MD, Moore SR, Patrick PD, Derr LL, Lorntz B, Lima AA, Guerrant RL (2002) Early childhood diarrhea is associated with diminished cognitive function 4 to 7 years later in children in a northeast Brazilian shantytown. Am J Trop Med Hyg 66(5):590–593

    Google Scholar 

  • Okhuysen PC, Chappell CL, Crabb JH, Sterling CR, DuPont HL (1999) Virulence of three distinct Cryptosporidium parvum isolates for healthy adults. J Infect Dis 180(4):1275–1281

    Article  CAS  Google Scholar 

  • Okhuysen PC, Rich SM, Chappell CL, Grimes KA, Widmer G, Feng X, Tzipori S (2002) Infectivity of a Cryptosporidium parvum isolate of cervine origin for healthy adults and interferon-gamma knockout mice. J Infect Dis 185(9):1320–1325

    Article  Google Scholar 

  • Palmer CJ, Xiao L, Terashima A, Guerra H, Gotuzzo E, Saldías G, Bonilla JA, Zhou L, Lindquist A, Upton SJ (2003) Cryptosporidium muris, a rodent pathogen, recovered from a human in Perú. Emerg Infect Dis 9(9):1174–1176

    Article  Google Scholar 

  • Raccurt CP (2007) Worldwide human zoonotic cryptosporidiosis caused by Cryptosporidium felis. Parasite 14(1):15–20

    Article  CAS  Google Scholar 

  • Rasková V, Kvetonová D, Sak B, McEvoy J, Edwinson A, Stenger B, Kvác M (2013) Human cryptosporidiosis caused by Cryptosporidium tyzzeri and C. parvum isolates presumably transmitted from wild mice. J Clin Microbiol 51(1):360–362

    Article  Google Scholar 

  • RimÅ¡elienÄ— G, Vold L, Robertson L, Nelke C, Søli K, Johansen ØH, Thrana FS, NygÃ¥rd K (2011) An outbreak of gastroenteritis among schoolchildren staying in a wildlife reserve: thorough investigation reveals Norway’s largest cryptosporidiosis outbreak. Scand J Public Health 39:287–295

    Article  Google Scholar 

  • Robertson LJ, Fayer R (2012) Cryptosporidium. In: Robertson LJ, Smith HV (eds) Foodborne protozoan parasite. Nova Publishers, Hauppauge, NY

    Google Scholar 

  • Robertson LJ, Gjerde BK (2007) Cryptosporidium oocysts: challenging adversaries? Trends Parasitol 23(8):344–347

    Article  Google Scholar 

  • Robertson LJ, Forberg T, Hermansen L, Gjerde BK, AlvsvÃ¥g JO, Langeland N (2006) Cryptosporidium parvum infections in Bergen, Norway, during an extensive outbreak of waterborne giardiasis in autumn and winter 2004. Appl Environ Microbiol 72(3):2218–2220

    Article  CAS  Google Scholar 

  • Robinson G, Chalmers RM (2010) The European rabbit (Oryctolagus cuniculus), a source of zoonotic cryptosporidiosis. Zoonoses Public Health 57(7–8):e1–e13

    Article  CAS  Google Scholar 

  • Robinson G, Chalmers RM (2012) Assessment of polymorphic genetic markers for multi-locus typing of Cryptosporidium parvum and Cryptosporidium hominis. Exp Parasitol 132(2):200–215

    Article  CAS  Google Scholar 

  • Ryan U, Power M (2012) Cryptosporidium species in Australian wildlife and domestic animals. Parasitology 139(13):1673–1688

    Article  Google Scholar 

  • Savioli L, Smith H, Thompson A (2006) Giardia and Cryptosporidium join the ‘Neglected Diseases Initiative’. Trends Parasitol 22(5):203–208

    Article  CAS  Google Scholar 

  • Shirley DA, Moonah SN, Kotloff KL (2012) Burden of disease from cryptosporidiosis. Curr Opin Infect Dis 25(5):555–563

    Article  Google Scholar 

  • SilverlÃ¥s C, Mattsson JG, Insulander M, Lebbad M (2012) Zoonotic transmission of Cryptosporidium meleagridis on an organic Swedish farm. Int J Parasitol 42(11):963–967

    Article  Google Scholar 

  • Stensvold CR, Lebbad M, Verweij JJ (2011) The impact of genetic diversity in protozoa on molecular diagnostics. Trends Parasitol 27(2):53–58. doi:10.1016/j.pt.2010.11.005

    Article  CAS  Google Scholar 

  • Sulaiman IM, Xiao L, Yang C, Escalante L, Moore A, Beard CB, Arrowood MJ, Lal AA (1998) Differentiating human from animal isolates of Cryptosporidium parvum. Emerg Infect Dis 4:681–685

    Article  CAS  Google Scholar 

  • Teunis PF, Chappell CL, Okhuysen PC (2002a) Cryptosporidium dose response studies: variation between isolates. Risk Anal 22:175–183

    Article  Google Scholar 

  • Teunis PF, Chappell CL, Okhuysen PC (2002b) Cryptosporidium dose-response studies: variation between hosts. Risk Anal 22:475–485

    Article  Google Scholar 

  • Wang L, Zhang H, Zhao X, Zhang L, Zhang G, Guo M, Liu L, Feng Y, Xiao L (2013) Zoonotic Cryptosporidium species and Enterocytozoon bieneusi genotypes in HIV-positive patients on antiretroviral therapy. J Clin Microbiol 51(2):557–563

    Article  CAS  Google Scholar 

  • Weitzel T, Dittrich S, Möhl I, Adusu E, Jelinek T (2006) Evaluation of seven commercial antigen detection tests for Giardia and Cryptosporidium in stool samples. Clin Microbiol Infect 12(7):656–659

    Article  CAS  Google Scholar 

  • Xiao L (2010) Molecular epidemiology of cryptosporidiosis: an update. Exp Parasitol 124(1):80–89

    Article  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Rights and permissions

Reprints and permissions

Copyright information

© 2014 Lucy J. Robertson

About this chapter

Cite this chapter

Robertson, L.J. (2014). Introduction to Cryptosporidium: The Parasite and the Disease. In: Cryptosporidium as a Foodborne Pathogen. SpringerBriefs in Food, Health, and Nutrition. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-9378-5_1

Download citation

Publish with us

Policies and ethics