title: Epidemiology of cryptosporidiosis in North American travelers to Mexico.
abstract: We studied 1,179 North American travelers who visited Mexico from 2005 to 2007. Travelers' diarrhea (TD) was reported by 521 (44%) participants. Among subjects with TD, 218 cases were examined for cryptosporidiosis by polymerase chain reaction (PCR) and enzyme-linked immunoassays (ELISA). There were 14 (6%) cases of cryptosporidiosis and 141 cases (64%) of bacterial diarrhea. Compared with bacterial diarrhea, a longer stay in Mexico was a risk factor for cryptosporidiosis. Additionally, Cryptosporidium cases passed greater number of watery stools (P < 0.05), suffered more episodes of diarrhea (P < or = 0.05), and were more likely to experience tenesmus (P < or = 0.05) compared with bacterial causes of TD. ELISA detected seven (3%) cases of Cryptosporidium, whereas PCR identified an additional seven cases (6%). Speciation by 18SrRNA sequencing showed that 13 cases were caused by C. parvum and only 1 case was caused by C. hominis. ELISA showed a sensitivity of 50% and specificity of 100% compared with PCR.
authors.affiliation: The University of Texas Health Science Center at Houston Medical School and School of Public Health, Houston, Texas, USA.
authors.forename: Parvathy
authors.initials: P
authors.lastname: Nair
authors.forename: Jamal A
authors.initials: JA
authors.lastname: Mohamed
authors.forename: Herbert L
authors.initials: HL
authors.lastname: DuPont
authors.forename: Jose Flores
authors.initials: JF
authors.lastname: Figueroa
authors.forename: Lily G
authors.initials: LG
authors.lastname: Carlin
authors.forename: Zhi-Dong
authors.initials: ZD
authors.lastname: Jiang
authors.forename: Jaime
authors.initials: J
authors.lastname: Belkind-Gerson
authors.forename: Francisco G
authors.initials: FG
authors.lastname: Martinez-Sandoval
authors.forename: Pablo C
authors.initials: PC
authors.lastname: Okhuysen
mesh_terms: D000293:Adolescent; D000328:Adult; D000818:Animals; D002170:Canada / Q000453:epidemiology; D003457:Cryptosporidiosis / Q000453:epidemiology*; D003458:Cryptosporidium / Q000145:classification; D003967:Diarrhea / Q000453:epidemiology* / Q000469:parasitology*; D004797:Enzyme-Linked Immunosorbent Assay; D006801:Humans; D008800:Mexico / Q000453:epidemiology; D016017:Odds Ratio; D016133:Polymerase Chain Reaction; D012307:Risk Factors; D012680:Sensitivity and Specificity; D013997:Time Factors; D014195:Travel; D014481:United States / Q000453:epidemiology