Background Small numbers of Cryptosporidium parvum oocysts cancontaminate even treated drinking water, and ingestion of oocystscan cause diarrheal disease in normal as well as immunocompromisedhosts. Since the number of organisms necessary to cause infectionin humans is unknown, we performed a study to determine theinfective dose of the parasite in healthy adults.
Methods After providing informed consent, 29 healthy volunteerswithout evidence of previous C. parvum infection, as determinedby the absence of anti-cryptosporidium–specific antibodies,were given a single dose of 30 to 1 million C. parvum oocystsobtained from a calf. They were then monitored for oocyst excretionand clinical illness for eight weeks. Household contacts weremonitored for secondary spread.
Results Of the 16 subjects who received an intended dose of300 or more oocysts, 14 (88 percent) became infected. Aftera dose of 30 oocysts, one of five subjects (20 percent) becameinfected, whereas at a dose of 1000 or more oocysts, seven ofseven became infected. The median infective dose, calculatedby linear regression, was 132 oocysts. Of the 18 subjects whoexcreted oocysts after the challenge dose, 11 had enteric symptomsand 7 (39 percent) had clinical cryptosporidiosis, consistingof diarrhea plus at least one other enteric symptom. All recovered,and there were no secondary cases of diarrhea among householdcontacts.
Conclusions In healthy adults with no serologic evidence ofpast infection with C. parvum, a low dose of C. parvum oocystsis sufficient to cause infection.
Source Information
From the University of Texas Medical School (H.L.D., P.C.O.) and the University of Texas School of Public Health (H.L.D., C.L.C.), Houston; the University of Arizona, Tucson (C.R.S.); the University of South Florida, Tampa (J.B.R.); and the Environmental Protection Agency, Cincinnati (W.J.). Portions of the study were presented at the Clinical Research Meetings, Baltimore, May 1, 1994; the Society of Protozoologists Meeting, Cleveland, June 24, 1994; and the Workshop on Prevention and Control of Waterborne Cryptosporidiosis, Centers for Disease Control and Prevention, Atlanta, September 22, 1994.
Address reprint requests to Dr. DuPont at St. Luke's Episcopal Hospital, 6720 Bertner Ave., MCI-164, Rm. P153, Houston, TX 77030.
Nair, P., Mohamed, J. A., DuPont, H. L., Figueroa, J. F., Carlin, L. G., Jiang, Z.-D., Belkind-Gerson, J., Martinez-Sandoval, F. G., Okhuysen, P. C.
(2008). Epidemiology of Cryptosporidiosis in North American Travelers to Mexico. Am J Trop Med Hyg
79: 210-214
[Abstract][Full Text]
Liu, J., Enomoto, S., Lancto, C. A., Abrahamsen, M. S., Rutherford, M. S.
(2008). Inhibition of Apoptosis in Cryptosporidium parvum-Infected Intestinal Epithelial Cells Is Dependent on Survivin. Infect. Immun.
76: 3784-3792
[Abstract][Full Text]
Ives, R. L., Kamarainen, A. M., John, D. E., Rose, J. B.
(2007). Use of Cell Culture To Assess Cryptosporidium parvum Survival Rates in Natural Groundwaters and Surface Waters. Appl. Environ. Microbiol.
73: 5968-5970
[Abstract][Full Text]
Priest, J. W., Bern, C., Xiao, L., Roberts, J. M., Kwon, J. P., Lescano, A. G., Checkley, W., Cabrera, L., Moss, D. M., Arrowood, M. J., Sterling, C. R., Gilman, R. H., Lammie, P. J.
(2006). Longitudinal Analysis of Cryptosporidium Species-Specific Immunoglobulin G Antibody Responses in Peruvian Children. CVI
13: 123-131
[Abstract][Full Text]
Lagunas-Solar, M. C., Cullor, J. S., Zeng, N. X., Truong, T. D., Essert, T. K., Smith, W. L., Pina, C.
(2005). Disinfection of Dairy and Animal Farm Wastewater with Radiofrequency Power. J DAIRY SCI
88: 4120-4131
[Abstract][Full Text]
Baishanbo, A., Gargala, G., Delaunay, A., Francois, A., Ballet, J.-J., Favennec, L.
(2005). Infectivity of Cryptosporidium hominis and Cryptosporidium parvum Genotype 2 Isolates in Immunosuppressed Mongolian Gerbils. Infect. Immun.
73: 5252-5255
[Abstract][Full Text]
ONG, C. S., LI, A. S., PRIEST, J. W., COPES, R., KHAN, M., FYFE, M. W., MARION, S. A., ROBERTS, J. M., LAMMIE, P. J., ISAAC-RENTON, J. L.
(2005). ENZYME IMMUNOASSAY OF CRYPTOSPORIDIUM-SPECIFIC IMMUNOGLOBULIN G ANTIBODIES TO ASSESS LONGITUDINAL INFECTION TRENDS IN SIX COMMUNITIES IN BRITISH COLUMBIA, CANADA. Am J Trop Med Hyg
73: 288-295
[Abstract][Full Text]
Di Giovanni, G. D., LeChevallier, M. W.
(2005). Quantitative-PCR Assessment of Cryptosporidium parvum Cell Culture Infection. Appl. Environ. Microbiol.
71: 1495-1500
[Abstract][Full Text]
Ochiai, Y., Takada, C., Hosaka, M.
(2005). Detection and Discrimination of Cryptosporidium parvum and C. hominis in Water Samples by Immunomagnetic Separation-PCR. Appl. Environ. Microbiol.
71: 898-903
[Abstract][Full Text]
Musher, D. M., Musher, B. L.
(2004). Contagious Acute Gastrointestinal Infections. NEJM
351: 2417-2427
[Full Text]
MATHIEU, E., LEVY, D. A., VEVERKA, F., PARRISH, M.-K., SARISKY, J., SHAPIRO, N., JOHNSTON, S., HANDZEL, T., HIGHTOWER, A., XIAO, L., LEE, Y.-M., YORK, S., ARROWOOD, M., LEE, R., JONES, J. L.
(2004). EPIDEMIOLOGIC AND ENVIRONMENTAL INVESTIGATION OF A RECREATIONAL WATER OUTBREAK CAUSED BY TWO GENOTYPES OF CRYPTOSPORIDIUM PARVUM IN OHIO IN 2000. Am J Trop Med Hyg
71: 582-589
[Abstract][Full Text]
Umejiego, N. N., Li, C., Riera, T., Hedstrom, L., Striepen, B.
(2004). Cryptosporidium parvum IMP Dehydrogenase: IDENTIFICATION OF FUNCTIONAL, STRUCTURAL, AND DYNAMIC PROPERTIES THAT CAN BE EXPLOITED FOR DRUG DESIGN. J. Biol. Chem.
279: 40320-40327
[Abstract][Full Text]
Striepen, B., Pruijssers, A. J. P., Huang, J., Li, C., Gubbels, M.-J., Umejiego, N. N., Hedstrom, L., Kissinger, J. C.
(2004). Gene transfer in the evolution of parasite nucleotide biosynthesis. Proc. Natl. Acad. Sci. USA
101: 3154-3159
[Abstract][Full Text]
Okhuysen, P. C., Rogers, G. A., Crisanti, A., Spano, F., Huang, D. B., Chappell, C. L., Tzipori, S.
(2004). Antibody Response of Healthy Adults to Recombinant Thrombospondin-Related Adhesive Protein of Cryptosporidium 1 after Experimental Exposure to Cryptosporidium Oocysts. CVI
11: 235-238
[Abstract][Full Text]
Caccio, S. M., De Giacomo, M., Aulicino, F. A., Pozio, E.
(2003). Giardia Cysts in Wastewater Treatment Plants in Italy. Appl. Environ. Microbiol.
69: 3393-3398
[Abstract][Full Text]
Dalle, F., Roz, P., Dautin, G., Di-Palma, M., Kohli, E., Sire-Bidault, C., Fleischmann, M. G., Gallay, A., Carbonel, S., Bon, F., Tillier, C., Beaudeau, P., Bonnin, A.
(2003). Molecular Characterization of Isolates of Waterborne Cryptosporidium spp. Collected during an Outbreak of Gastroenteritis in South Burgundy, France. J. Clin. Microbiol.
41: 2690-2693
[Abstract][Full Text]
ALCANTARA, C. S., YANG, C.-H., STEINER, T. S., BARRETT, L. J., LIMA, A. A. M., CHAPPELL, C. L., OKHUYSEN, P. C., WHITE, A. C. JR., GUERRANT, R. L.
(2003). INTERLEUKIN-8, TUMOR NECROSIS FACTOR-{alpha}, AND LACTOFERRIN IN IMMUNOCOMPETENT HOSTS WITH EXPERIMENTAL AND BRAZILIAN CHILDREN WITH ACQUIRED CRYPTOSPORIDIOSIS. Am J Trop Med Hyg
68: 325-328
[Abstract][Full Text]
Garcia, L. S., Shimizu, R. Y., Novak, S., Carroll, M., Chan, F.
(2003). Commercial Assay for Detection of Giardia lamblia and Cryptosporidium parvum Antigens in Human Fecal Specimens by Rapid Solid-Phase Qualitative Immunochromatography. J. Clin. Microbiol.
41: 209-212
[Abstract][Full Text]
Rochelle, P. A., Marshall, M. M., Mead, J. R., Johnson, A. M., Korich, D. G., Rosen, J. S., De Leon, R.
(2002). Comparison of In Vitro Cell Culture and a Mouse Assay for Measuring Infectivity of Cryptosporidium parvum. Appl. Environ. Microbiol.
68: 3809-3817
[Abstract][Full Text]
Sturbaum, G. D., Klonicki, P. T., Marshall, M. M., Jost, B. H., Clay, B. L., Sterling, C. R.
(2002). Immunomagnetic Separation (IMS)-Fluorescent Antibody Detection and IMS-PCR Detection of Seeded Cryptosporidium parvum Oocysts in Natural Waters and Their Limitations. Appl. Environ. Microbiol.
68: 2991-2996
[Abstract][Full Text]
Chen, X.-M., Keithly, J. S., Paya, C. V., LaRusso, N. F.
(2002). Cryptosporidiosis. NEJM
346: 1723-1731
[Full Text]
Weir, S. C., Pokorny, N. J., Carreno, R. A., Trevors, J. T., Lee, H.
(2002). Efficacy of Common Laboratory Disinfectants on the Infectivity of Cryptosporidium parvum Oocysts in Cell Culture. Appl. Environ. Microbiol.
68: 2576-2579
[Abstract][Full Text]
Lacroix-Lamande, S., Mancassola, R., Naciri, M., Laurent, F.
(2002). Role of Gamma Interferon in Chemokine Expression in the Ileum of Mice and in a Murine Intestinal Epithelial Cell Line after Cryptosporidium parvum Infection. Infect. Immun.
70: 2090-2099
[Abstract][Full Text]
Jellison, K. L., Hemond, H. F., Schauer, D. B.
(2002). Sources and Species of Cryptosporidium Oocysts in the Wachusett Reservoir Watershed. Appl. Environ. Microbiol.
68: 569-575
[Abstract][Full Text]
Walker, M., Leddy, K., Hagar, E.
(2001). Effects of Combined Water Potential and Temperature Stresses on Cryptosporidium parvum Oocysts. Appl. Environ. Microbiol.
67: 5526-5529
[Abstract][Full Text]
Katanik, M. T., Schneider, S. K., Rosenblatt, J. E., Hall, G. S., Procop, G. W.
(2001). Evaluation of ColorPAC Giardia/Cryptosporidium Rapid Assay and ProSpecT Giardia/Cryptosporidium Microplate Assay for Detection of Giardia and Cryptosporidium in Fecal Specimens. J. Clin. Microbiol.
39: 4523-4525
[Abstract][Full Text]
Carreno, R. A., Pokorny, N. J., Weir, S. C., Lee, H., Trevors, J. T.
(2001). Decrease in Cryptosporidium parvum Oocyst Infectivity In Vitro by Using the Membrane Filter Dissolution Method for Recovering Oocysts from Water Samples. Appl. Environ. Microbiol.
67: 3309-3313
[Abstract][Full Text]
(2001). Protracted Outbreaks of Cryptosporidiosis Associated With Swimming Pool Use--Ohio and Nebraska, 2000. JAMA
285: 2967-2969
[Full Text]
Priest, J. W., Li, A., Khan, M., Arrowood, M. J., Lammie, P. J., Ong, C. S., Roberts, J. M., Isaac-Renton, J.
(2001). Enzyme Immunoassay Detection of Antigen-Specific Immunoglobulin G Antibodies in Longitudinal Serum Samples from Patients with Cryptosporidiosis. CVI
8: 415-423
[Abstract][Full Text]
Hayward, A. R., Cosyns, M., Jones, M., Ponnuraj, E. M.
(2001). Marrow-Derived CD40-Positive Cells Are Required for Mice To Clear Cryptosporidium parvum Infection. Infect. Immun.
69: 1630-1634
[Abstract][Full Text]
Robinson, P., Okhuysen, P. C., Chappell, C. L., Lewis, D. E., Shahab, I., Janecki, A., White, A. C. Jr.
(2001). Expression of Tumor Necrosis Factor Alpha and Interleukin 1{beta} in Jejuna of Volunteers after Experimental Challenge with Cryptosporidium parvum Correlates with Exposure but Not with Symptoms. Infect. Immun.
69: 1172-1174
[Abstract][Full Text]
Robin, G., Fraser, D., Orr, N., Sela, T., Slepon, R., Ambar, R., Dagan, R., Le Blancq, S., Deckelbaum, R. J., Cohen, D.
(2001). Cryptosporidium Infection in Bedouin Infants Assessed by Prospective Evaluation of Anticryptosporidial Antibodies and Stool Examination. Am J Epidemiol
153: 194-201
[Abstract][Full Text]
Weir, C., Vesey, G., Slade, M., Ferrari, B., Veal, D. A., Williams, K.
(2000). An Immunoglobulin G1 Monoclonal Antibody Highly Specific to the Wall of Cryptosporidium Oocysts. CVI
7: 745-750
[Abstract][Full Text]
Dann, S. M., Okhuysen, P. C., Salameh, B. M., DuPont, H. L., Chappell, C. L.
(2000). Fecal Antibodies to Cryptosporidium parvum in Healthy Volunteers. Infect. Immun.
68: 5068-5074
[Abstract][Full Text]
Robinson, P., Okhuysen, P. C., Chappell, C. L., Lewis, D. E., Shahab, I., Lahoti, S., White, A. C. Jr.
(2000). Transforming Growth Factor beta 1 Is Expressed in the Jejunum after Experimental Cryptosporidium parvum Infection in Humans. Infect. Immun.
68: 5405-5407
[Abstract][Full Text]
Garcia, L. S., Shimizu, R. Y., Bernard, C. N.
(2000). Detection of Giardia lamblia, Entamoeba histolytica/Entamoeba dispar, and Cryptosporidium parvum Antigens in Human Fecal Specimens Using the Triage Parasite Panel Enzyme Immunoassay. J. Clin. Microbiol.
38: 3337-3340
[Abstract][Full Text]
LOWERY, C.J., MOORE, J.E., MILLAR, B.C., BURKE, D.P., McCORRY, K.A. J., CROTHERS, E., DOOLEY, J.S. G.
(2000). Detection and speciation of Cryptosporidium spp. in environmental water samples by immunomagnetic separation, PCR and endonuclease restriction. J Med Microbiol
49: 779-785
[Abstract][Full Text]
Strong, W. B., Gut, J., Nelson, R. G.
(2000). Cloning and Sequence Analysis of a Highly Polymorphic Cryptosporidium parvum Gene Encoding a 60-Kilodalton Glycoprotein and Characterization of Its 15- and 45-Kilodalton Zoite Surface Antigen Products. Infect. Immun.
68: 4117-4134
[Abstract][Full Text]
Gomez-Bautista, M., Ortega-Mora, L. M., Tabares, E., Lopez-Rodas, V., Costas, E.
(2000). Detection of Infectious Cryptosporidium parvum Oocysts in Mussels (Mytilus galloprovincialis) and Cockles (Cerastoderma edule). Appl. Environ. Microbiol.
66: 1866-1870
[Abstract][Full Text]
Lukin, K., Cosyns, M., Mitchell, T., Saffry, M., Hayward, A.
(2000). Eradication of Cryptosporidium parvum Infection by Mice with Ovalbumin-Specific T Cells. Infect. Immun.
68: 2663-2670
[Abstract][Full Text]
Garcia, L. S., Shimizu, R. Y.
(2000). Detection of Giardia lamblia and Cryptosporidium parvum Antigens in Human Fecal Specimens Using the ColorPAC Combination Rapid Solid-Phase Qualitative Immunochromatographic Assay. J. Clin. Microbiol.
38: 1267-1268
[Abstract][Full Text]
Clark, D. P.
(1999). New Insights into Human Cryptosporidiosis. Clin. Microbiol. Rev.
12: 554-563
[Abstract][Full Text]
Slifko, T. R., Huffman, D. E., Rose, J. B.
(1999). A Most-Probable-Number Assay for Enumeration of Infectious Cryptosporidium parvum Oocysts. Appl. Environ. Microbiol.
65: 3936-3941
[Abstract][Full Text]
Priest, J. W., Kwon, J. P., Moss, D. M., Roberts, J. M., Arrowood, M. J., Dworkin, M. S., Juranek, D. D., Lammie, P. J.
(1999). Detection by Enzyme Immunoassay of Serum Immunoglobulin G Antibodies That Recognize Specific Cryptosporidium parvum Antigens. J. Clin. Microbiol.
37: 1385-1392
[Abstract][Full Text]
Griffiths, J. K., Theodos, C., Paris, M., Tzipori, S.
(1998). The Gamma Interferon Gene Knockout Mouse: a Highly Sensitive Model for Evaluation of Therapeutic Agents against Cryptosporidium parvum. J. Clin. Microbiol.
36: 2503-2508
[Abstract][Full Text]
Frost, F. J., Craun;, G. F., Okhuysen, P. C., Chappell, C. L., DuPont, H. L., Sterling, C. R., Jakubowski, W.
(1998). Serologic Response to Human Cryptosporidium Infections. Infect. Immun.
66: 4008-4009
[Full Text]
Deng, M. Q., Cliver, D. O.
(1998). Differentiation of Cryptosporidium parvum Isolates by a Simplified Randomly Amplified Polymorphic DNA Technique. Appl. Environ. Microbiol.
64: 1954-1957
[Abstract][Full Text]
Champliaud, D., Gobet, P., Naciri, M., Vagner, O., Lopez, J., Buisson, J. C., Varga, I., Harly, G., Mancassola, R., Bonnin, A.
(1998). Failure To Differentiate Cryptosporidium parvum from C. meleagridis Based on PCR Amplification of Eight DNA Sequences. Appl. Environ. Microbiol.
64: 1454-1458
[Abstract][Full Text]
Okhuysen, P. C., Chappell, C. L., Sterling, C. R., Jakubowski, W., DuPont, H. L.
(1998). Susceptibility and Serologic Response of Healthy Adults to Reinfection with Cryptosporidium parvum. Infect. Immun.
66: 441-443
[Abstract][Full Text]
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