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Cryptosporidiosis - Causes, Symptoms, Diagnosis, and Treatment

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Cryptosporidiosis is a parasitic infection. Read this article to know more about the causes, symptoms, diagnosis, and treatment.

Written byDr. Lochana. K

Medically reviewed by

Dr. Sandeep V. Nair

Published At November 26, 2020
Reviewed AtFebruary 17, 2023

What Is Cryptosporidiosis?

Cryptosporidiosis is a condition caused by a parasite called cryptosporidium. This parasite lives in water, soil, and food. It can be seen on the surfaces that have been contaminated with feces. Cryptosporidium is a worldwide parasite and can be found in poor sanitation areas.

What Are the Symptoms?

The most characteristic symptom of cryptosporidiosis is watery diarrhea. Other symptoms include:

If you have watery diarrhea that is lasting for more than two days, you should contact your doctor immediately. The symptoms usually last for 30 days. Some patients are known to have a recurrence. Some people with cryptosporidiosis will not have any symptoms.

What Are the Risk Factors?

The risk factors of cryptosporidiosis are:

  • Weaken immune response.

  • HIV (human immunodeficiency virus) positive patients.

  • Cancer.

  • Patients who are under immunosuppressive drugs.

  • Any genetic disorders.

What Are the Causes and How Is It Transmitted?

Cryptosporidium species are known to reside in the infected individual’s intestine. It can also live in the intestine of animals. An infected animal or human excretes the parasite in the stools in the form of oocysts. In these stools, many oocysts are known to be released. Transmission occurs by swallowing the food or water which is contaminated with oocysts. Cryptosporidium oocysts are Chlorine-resistant and have resulted in several waterborne outbreaks. Even as low as 1 to 10 oocysts can lead to infection. Swallowing contaminated food and drinking water that is unhygienic can be the cause of transmission. The other reasons and routes of transmission are:

  • By consuming aerated drinks and water that are contaminated with cryptosporidium.

  • By accidentally drinking recreational water. Recreational water is the water found in swimming pools, lakes, hot tubs, rivers, and fountains. Since these recreational waters are the public source of supply and it can be contaminated with feces from humans and animals. Contamination of recreational water can happen with sewage systems.

  • Fruits and vegetables purchased from shops have a high risk of contamination. But we cannot ignore these as they are very healthy. But we can make it clean by thoroughly washing them before consumption. Peel off the skin before eating them.

  • Sexual practice can also cause transmission of feces. Cryptosporidiosis cannot be spread through blood.

  • Traveling to rural areas where sanitation is very poor can cause you to become prone to this infection.

  • In rural areas, transmission from farm animals have been reported.

How Is It Diagnosed?

The doctor needs to observe the symptoms after an incubation period of one to 12 days. The doctor will ask you to take a sample of the stool. After the sample is collected, it is sent to the laboratory. The results of stool examination with modified AFB (acid-fast bacillus) staining can reveal whether the parasite is present or not. The other tests that are useful to diagnosis are:

  • Enzyme-Linked Immunosorbent Assay: This test identifies antigens, antibodies, glycoproteins, and proteins. This method is trusted more in other branches of science like biotechnology and plant technology. This assay can be used as a diagnostic tool for dengue, malaria, HIV. This method efficiently detects the presence of an analyte. The analyte is the substance that is analyzed both by quantitative and qualitative analysis.
  • Immunochromatographic Assay: This is also called a lateral flow test. It uses a small amount of liquid to detect a particular agent. It is carried out with the help of chromatographic paper. This test has the potential to test a vast number of samples like urine, sweat, saliva, and serum. The immunochromatographic assay has done extensive miracles in veterinary science, food safety departments.
  • Immunofluorescent Assay: This technique is used to detect and visualize the filaments of the parasite. It uses light microscopy with a fluorescence microscope. It is used mainly on microbiological samples.
  • Ultrasound Imaging: Ultrasound scan of the intestine can reveal any inflammatory conditions of the intestine. There may be any dilation in the gallbladder or any irregularities in bile ducts.
  • Endoscopy and biopsy can reveal cryptosporidium in intestinal mucosal cells.

What Are the Treatment Options?

The treatment for cryptosporidiosis requires medications and certain lifestyle modifications.

Medications:

  • Anti-Parasitic Drugs - Nitazoxanide is the only drug with proven efficacy in treating cryptosporidiosis. It relieves diarrhea by attacking the parasites. Patients may experience yellow urine and eyes due to this drug, but the discoloration is harmless. Paromomycin with Azithromycinare other drugs that are prescribed for immuno-compromised patients.

  • Antimotility Agents - These drugs help in the slow movement of the food. The food remains in the gut for a long period. More liquids get absorbed with the help of these medications, and the stools become firmer. Loperamide is a highly effective antimotility drug. You should follow your doctor’s instructions while taking these drugs.

Lifestyle Modification:

  • Fluid Replacement - Persistent diarrhea can cause a heavy loss of fluids and will leave you dehydrated. Oral or intravenous supplementation of fluids and electrolytes such as potassium, sodium, and calcium. Restoration of these fluids will help to maintain the balance of your body and keep you healthy.

What Are the Preventative Measures?

There is no vaccination found to prevent cryptosporidiosis. The following are the ways to prevent it:

  • Wash your hands thoroughly with soap and water after using the restrooms and changing diapers for your baby. Disposal of diapers should be done in a hygienic manner because the feces is the source of infection. Parents should take care of the child. If you are using cotton clothes instead of diapers, make sure you wash them well with hot soapy water.

  • Wash your hands before and after eating.

  • People who are cooking should wash their hands before cutting vegetables and cooking.

  • Wash all the raw fruits and vegetables before consuming them. The skin or peel of fruits and vegetables should be removed as they are the places where the parasites can be present.

  • Do not drink water from fountains, lakes, rivers, and ponds. These water sources are prone to contamination. Always drink boiled and purified water. Many water filters at home can remove cryptosporidium.

  • Avoid junk foods and roadside foods. We do not know whether they followed proper handwashing techniques while handling the food items. So to stay in the safe zone, kindly avoid eating in open food spots.

  • When you are traveling or going to picnics, carry sufficient quantities of water. The water we carry from home will be purified and good for drinking. Do not randomly drink water from taps.

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Frequently Asked Questions

Cryptosporidiosis can be caused due to the parasite called cryptosporidium. This cryptosporidium can be present in food, water, soil, or on the surfaces or hands, contaminated with feces of animals or humans infected with the parasite.
The symptoms of cryptosporidiosis can start within 2 to 10 days after being infected by the parasite cryptosporidium. The common symptoms of cryptosporidiosis are:
1. Watery diarrhea.
2. Stomach pain or cramps.
3. Nausea.
4. Vomiting.
5. Fever.
6. Dehydration.
7. Weight loss.
Cryptosporidium can cause watery diarrhea, even in healthy humans. The cryptosporidium infection will usually go away within a week or two. But in patients with a compromised immune system, this infection can cause life-threatening complications without treatment.
Cryptosporidium infection symptoms, if present, can last for about two weeks and maybe longer sometimes. But even if you do not have any symptoms, the parasite can be passed in your stools for about 2 months, which has the risk of spreading the infection to others.
Cryptosporidium can be seen in vegetables, contaminated drinking water, irrigation water, fruit juices, raw meat, swimming pools, and unpasteurized milk. Cryptosporidiosis can also be seen in recreational water contaminated with humans and animals' feces and uncooked food contaminated with cryptosporidium.
Infected people can recover from cryptosporidium infection within two weeks without any treatment. But in the case of immune-compromised patients, it can stay longer than that and cause life-threatening complications.
People with a healthy immune system can recover from cryptosporidiosis within two weeks without treatment, if they maintain a proper fluid level in the body by drinking plenty of water and avoiding dehydration. If the appropriate fluid level is not maintained, it can lead to severe health complications. People with a weakened immune system should also concentrate on getting back their immunity.
Acid staining test is done to diagnose cryptosporidiosis in stool samples. This cryptosporidium can be very difficult to detect, so that the doctor may ask for several stool samples at several days. Otherwise, a biopsy can be done by taking a tissue sample from the intestine.
The recurrence rate of cryptosporidiosis is high in patients with a weakened immune system and low in people with a normal immune system. Cryptosporidiosis can recur due to reinfection with the parasite.
Cryptosporidiosis cannot be contracted from an infected person directly through the blood. It can be contracted by touching the surfaces contaminated with cryptosporidium or accidentally swallowing the contaminated water. They can also be seen in the water, soil, and food contaminated with cryptosporidium.
Cryptosporidium can get into the surface water sources like lakes and rivers from animals or human stools and contaminate it. The public water system which gets water from these resources can be contaminated and contain oocysts (an egg-like form of the parasite). Water can also be contaminated by sewage overflow or sewage that is not working properly.
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Dr. Sandeep V. Nair from iCliniq

Dr. Sandeep V. Nair

Medical Gastroenterology

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