(ATDN) Cryptosporidiosis


(ATDN) Cryptosporidiosis

Treatment Review No. 13; August 1994

Cryptosporidiosis is caused by a small organism that usually infects the gastrointestinal tract (the stomach and intestine). In people whose immune systems aren't compromised, infection is either without symptoms or symptoms go away on their own, usually in 30 days. However, in young children and immunocompromised adults, infection can cause severe and lengthy illness. The most common symptoms are diarrhea, nausea, and cramping abdominal pain, especially in the right side. The diarrhea can be profuse and watery and last a long time. Infection can also cause loss of appetite and vomiting. The primary way of getting infected is person to person via the fecal-oral route. Those at highest risk are young children, especially those in day care, those who engage in oral-anal sex, and close personal contacts of an infected person. Some outbreaks have been traced to water supply systems. Diagnosis is made by the identification of the parasite in stool samples or by intestinal biopsy (taking a small piece of tissue from the intestine).

At one time cryptosporidium were thought to only infect animals. Around 1983, a number of human cases began to be reported. Cryptosporidiosis has recently been added to the list of infections that must be reported by doctors and other health-care providers to the New York City Department of Health.

Increases in HIV infection have led to a rise in cryptosporidiosis infection. For a person living with HIV, cryptosporidiosis may cause dangerous dehydration and malnutrition. Diarhea leads to dehydration, and your body can't function without maintaining adequate levels of water.

There are two approaches to treatment for cryptosporidiosis: kill the parasites, and treat the symptoms. Current treatments include paromomycin (Humatin) and azithromycin. Humatin is currently in an ongoing double-blind placebo- controlled study. Participants are divided into two groups. One group will take humatin, the other group will take placebo. Neither the doctor nor the participant will know which treatment is being given. Treatment is for three weeks. Humatin is also available through prescription.

Azithromycin is available from the drug company through a treatment IND for people who have failed or can't take conventional treatments. Azithromycin is a pill. Call The Network for more information on this program. A new drug for cryptosporidiosis called Immuno-C is being considered by the U.S. Food and Drug Administration for human studies. The drug Diclazuril is no longer available for the treatment of cryptosporidiosis, as studies indicate that it does not work.

Treatment of symptoms can include Immodium which slows down the movement of the stomach, and octreotides or opiates for the diarrhea. Hyperimmune bovine collostrum is being tested as a means to increase the body's production of natural immunoglobulins used in fighting the disease. Total parenteral nutrition, or intravenous feeding is sometimes recommended to replace nutrients, but isn't often used because it is invasive and expensive. It is important to address the symptoms as soon as they occur. Recovery from severe weight loss can take a long time.

High fat foods should be avoided as they are hard to digest and increase diarrhea. Foods containing lactose - dairy products such as cheeses, milk, ice cream - produce similar effects.

Handwashing, especially after using the bathroom and during food preparation, is crucial in preventing the spread of crypto, as well as hepatitis and other infectons. Safe sex practices reduce the risk of crypto.

During a water alert in Washington, DC, Whitman-Walker Clinic recommended that people with HIV/AIDS boil their water for 20-25 minutes. Boiling all drinking water is recommended for people with less than 200 T4 cells. This is thought to kill the parasite that causes cryptosporidiosis.


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This information is designed to support, not replace, the relationship that exists between you and your doctor.
©1994. AEGIS.