Cryptosporidia

Pathogen

Cryptosporidia (C. parvum, C. muris); protozoa

Occurrence

Worldwide occurrence in humans and numerous mammals (cattle, goats, sheep and horses, but also dogs, cats and birds).

Transmission routes

The pathogens are excreted in the stool of infected animals and humans.

Infection (contagion) can occur via various routes:

• contaminated water (e.g., drinking water, ice cubes, water from running waters, bathing water)
• human-to-human contact (usually via hands that have not been adequately cleaned after using the toilet, especially in young children)
• direct animal contact contaminated (polluted) food, e.g. contaminated meat

Risk groups

Immunocompromised people are particularly at risk of infection. In addition, children aged 6 - 24 months are particularly susceptible.

Disease pattern and course

After infection with Cryptosporidium, the time to onset of the disease is 1 - 12 days, usually 7 - 10 days. The clinical picture varies from symptom-free courses to considerable watery diarrhea, which can be accompanied by a large loss of fluids. Other symptoms (signs of illness) include abdominal pain, nausea, fever and/or weight loss. In persons with immunodeficiency, the courses are often more severe, with prolonged (chronic) diarrhea and pathogen excretion, severe cramps, significant weight and fluid loss, and low-grade fever. Excretion of the pathogens in the stool may continue for several weeks after symptoms have subsided. Contagiousness persists during this phase.

Treatment measures

There is no targeted treatment that reliably kills the parasites. Therefore, treatment is generally through adequate intake of fluids and electrolytes. Please consult your family physician for advice.

Hygiene measures

Sick persons should avoid close contact with immunocompromised persons and infants. Do not visit public swimming pools for two weeks if diarrhea is present and after symptoms have subsided. Careful hygiene is the most effective measure. In the domestic sphere, this concerns in particular regular hand washing. Drink only water that you are sure is not contaminated. Wash raw vegetables, leafy salads and fruit thoroughly under warm running water before eating them, and peel them if necessary. Wash hands thoroughly after every trip to the toilet, after contact with diapers as well as sewage, after contact with animals, before preparing food or before eating! Use liquid soap (no bar soap!) and personal towels, washcloths.

When taking in new pets (see occurrence), especially puppies, a veterinary examination for cryptosporidia should be carried out if necessary.

• Use a household cleaner daily to clean the toilet in use (seat, flush button, toilet brush handle, faucet, door handle).
• Cryptosporidia (more precisely the oocysts) are resistant to all disinfectants, including chlorine.
• Washing: the pathogens are safely killed at a temperature above 60 °C for at least 30 minutes.
• All objects and surfaces that may have come into contact with excreta from the sick person must be thoroughly cleaned.

Regulations for community facilities

Children under 6 years of age who are ill with or suspected of having infectious gastroenteritis (gastrointestinal infection) may not attend community facilities (§ 34 Infection Protection Act). The facility may only be visited again after the clinical symptoms have subsided (formed stools). However, even then, increased attention should be paid to hygiene. A written medical certificate is not required.

Regulations for work in food areas

People who are ill or suspected of being ill must not work or be employed in the production, handling or marketing of certain foodstuffs if they come into contact with them in the process (Section 42 of the Infection Protection Act). This also applies to employees in kitchens of restaurants and other facilities with or for communal catering.

These foods include:

• Meat, poultry meat and products thereof
• Milk and milk-based products
• fish, crustaceans or molluscs and products thereof
• Egg products
• Infant and young child food
• Ice cream and ice cream semi-products
• Baked products with fillings or toppings that are not baked through or heated through
• Delicatessen, raw vegetable and potato salads, marinades, mayonnaises, other emulsified sauces, nutritional yeasts

Obligation to report

Notification is obligatory according to §§ 6 to 9, 34 and 42 of the Infection Protection Act: - For community facilities: the illness of infectious gastroenteritis if children under 6 years of age are affected who attend a community facility (kindergarten, etc.). There is an obligation for parents to notify the community facility of their children. For physicians: the suspicion of or illness from acute infectious gastroenteritis, if persons are affected who work in the food sector or if several cases of illness occur that suggest a temporal and/or local connection. For laboratories: the direct detection of human pathogenic Cryptosporidium sp.