Epidemiology of cryptosporidiosis in North American travelers to Mexico.
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.
Nair
Parvathy
P
The University of Texas Health Science Center at Houston Medical School and School of Public Health, Houston, Texas, USA.
Mohamed
Jamal A
JA
DuPont
Herbert L
HL
Figueroa
Jose Flores
JF
Carlin
Lily G
LG
Jiang
Zhi-Dong
ZD
Belkind-Gerson
Jaime
J
Martinez-Sandoval
Francisco G
FG
Okhuysen
Pablo C
PC
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