Chapter 13 – Cryptosporidium as a Public Health Challenge

Publisher Summary This chapter is designed to study Cryptosporidium as a public health challenge. It addresses recent findings that impact public health aspects of Cryptosporidium and cryptosporidiosis, particularly taxonomy and epidemiology; diagnosis; at-risk populations and clinical aspects; sources, prevention, and control; and regulatory approaches. Cryptosporidium appears high on the list of public health concerns, particularly in developed countries. This is largely because its resistance to disinfectants commonly used in the drinking and recreational water industries, which control most other waterborne pathogens, has led to ample outbreaks of waterborne diseases. Cryptosporidiosis can cause prolonged diarrhea, resulting distress for individuals and families, absence from work or education, or exclusion from day-care centers. The lack of effective chemotherapy has significant implications for dissemination of infection and complications in immunocompromised hosts. Difficulties in detection and poor correlation with conventional indicator organisms pose challenges for the water industry. There are multiple sources and routes of transmission of Cryptosporidium, and the load of disease attributable to each is mainly unknown. Therefore, it is difficult to evaluate effective interventions. Despite concerns within the water and other industries and the public health challenges of cryptosporidiosis, awareness is low among primary care physicians and requests for screening seldom made, particularly in otherwise healthy patients.