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Epidemiology of Cryptosporidiosis and Giardiasis: What Pediatricians Need to Know

  • Protozoa (R Mejia, Section Editor)
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Abstract

Diarrheal illness in the USA is a significant contributor to adverse morbidity in children and has a major impact economically, including the utilization of healthcare resources. Viral and bacterial pathogens account for the majority of cases that have an infectious cause; however, intestinal protozoan parasites are important but often under-recognized etiologic agents for infectious diarrhea. Cryptosporidium spp. and Giardia lamblia are the most common intestinal protozoal infections in both resource-limited and resource-abundant countries and predominately affect children, usually those between ages 1–9 years and most often in children less than 4 years of age. Both Cryptosporidium and Giardia are ubiquitous in the environment and transmit primarily through the fecal-oral route after ingestion of oocysts/cysts in contaminated water or food or direct person-to-person contact. Both are environmentally hardy. The chlorine-tolerant Cryptosporidium oocysts in particular have led to more diarrheal outbreaks due to treated recreational water exposure than any other pathogen. Despite notifiable diseases in the USA, reporting is very low and thus general awareness of epidemiology and clinical manifestations is limited. Underdiagnosis can further contribute to under-reporting, especially in asymptomatic patients and where specialty consultation and reliable diagnostics are absent. Once a diagnosis of cryptosporidiosis or giardiasis has been confirmed, in addition to appropriate case reporting and treatment considerations, it is essential to provide educational support to children and their parents or caregivers to prevent further transmission of the disease within the household and throughout the community.

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Acknowledgments

Medical writing assistance provided by Peter Todd, PhD, of Tajut Ltd. (Kaiapoi, New Zealand) was supported financially by Lupin Pharmaceuticals, Inc., during the preparation of this manuscript.

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  1. Division of Infectious Diseases and International Health, University of Virginia, Charlottesville, VA, USA

    Luther A. Bartelt

  2. Atom Strategic Consulting, 40 Market Street, Suite 423, Morristown, NJ, 07960, USA

    Elizabeth Attias & Jimmy Black

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Lupin Pharmaceuticals, Inc., Baltimore, MD, USA, facilitated this article by providing financial support. Luther A. Bartelt, Elizabeth Attias, and Jimmy Black declare that they have no other conflicts of interest.

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Bartelt, L.A., Attias, E. & Black, J. Epidemiology of Cryptosporidiosis and Giardiasis: What Pediatricians Need to Know. Curr Trop Med Rep 3, 108–114 (2016). https://doi.org/10.1007/s40475-016-0081-3

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