Cryptosporidium species a "new" human pathogen.

D P Casemore, R L Sands, A Curry

Publications describing aspects of the coccidian protozoan parasite Cryptosporidium, increased greatly during 1983 and 1984 as a result of not only increasing veterinary interest but also in the role of the parasite in the newly recognised acquired immune deficiency syndrome (AIDS). The reports reflected widespread collaboration, not only between clinicians, microbiologists, and histopathologists, but also between veterinary and human health care workers. Cryptosporidium was first described in mice in 1907 and subsequently in various other species; it was not described in man until 1976. Several likely putative species have been described, but there is probably little host specificity. Experimental and clinical studies have greatly increased the knowledge about the organism's biology. The parasite undergoes its complete life cycle within the intestine, although it may occasionally occur in other sites. The main symptom produced is a non-inflammatory diarrhoea, which, in patients with AIDS and children in Third World countries, may be life threatening: even in immunocompetent subjects this symptom is usually protracted. Attempts to find effective chemotherapeutic agents have been unsuccessful. Epidemiologically the infection was thought to be zoonotic in origin, but there is increasing evidence of person to person transmission. Diagnosis has depended upon histological examination, but simple methods of detection have now been described: more invasive methods need no longer be used. The parasite, which is found more commonly in children, occurs in about 2% of faecal specimens examined and seems to be closely associated with production of symptoms. A serological response has been shown. Much remains to be learned about its epidemiology and pathogenic mechanisms, while the expected increase in incidence of AIDS makes an effective form of treatment essential.

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