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General issues of Vaccine
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General issues of Tropical med.
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Trematode (fluke, distoma)
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Cryptosporidium spp.
- especially C. paravum, C. hominis
epidemiology
- worldwide
- 2nd important pathogen for moderate-severe diarrhea before 1 year of life
- repeated outbreaks even in developed countries with huge number of cases
- human excretes 100 mil. cysts per day
- calf excretes 10 bil. cysts per day
- water chlorination does not prevent tap water borne infection
life cycle
- calf is reservoir of C. hominis
- resistant to chlorinated water
- auto-infection in host intestine
- survive >1 year in 4-6℃ cold water
- vulnerable to dry environment
morphology
- oocyst contains 4 sporozoites
clinical features
- incubation 1-12 days
- symptoms 1-2 weeks
- watery diarrhea
- abd cramps
- bloating
- fever, malaise
- weight loss
- often self-limiting
- problemable in children in developing countries, immunocompromised
diagnosis
- fecal microscopy
- Ziehl-Neelsen stain
- Auramine stain
treatment
- nitazoxianide
- paromomycin