Frequency of Cryptosporidium spp. as cause of human gastrointestinal disease in Switzerland and possible sources of infection.

A Baumgartner, H P Marder, J Munzinger, H H Siegrist
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Abstract

Detection of Cryptosporidium parvum is not routinely done in laboratories of clinical microbiology and there is no obligation to communicate isolations of this pathogen to health authorities. For these reasons, frequency of cryptosporidiosis and sources of infection are only poorly known in Switzerland. To obtain more concise information in this field, feces from 5179 hospitalized and 1256 ambulatory patients with suspected gastrointestinal infections were screened for Cryptosporidium spp. over the period of one year in two laboratories. In toto, 13 patients with cryptosporidiosis were detected which results a frequency of 0.2%. Furthermore, it was shown by a projection that about 340 cases of cryptosporidiosis have to expected yearly in Switzerland, resulting an estimated morbidity of 4.85 cases per 100,000 persons. With regard to risk factors, the available patient data did not allow solid statistical conclusions. However, known risk factors such as immunosuppression, travelling abroad (33.3%) and contact to symptomatic persons were unquestionably demonstrated. Oysters, raw milk and cream from raw milk had to be strongly taken into consideration as food vehicles of transmission. Tap water from municipal nets has not to be considered as relevant source of sporadic infections. The obtained data indicate that cryptosporidiosis is a disease of low epidemiological significance in Switzerland. To a great extent, cryptosporidiosis could be prevented by best known measures of personal hygiene, avoiding certain raw food-stuffs and being aware of safe catering on travels.

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瑞士隐孢子虫引起人类胃肠道疾病的频率和可能的感染源。
细小隐孢子虫的检测不是临床微生物学实验室的常规工作,也没有义务向卫生当局通报这种病原体的分离情况。由于这些原因,瑞士对隐孢子虫病的发病率和感染来源知之甚少。为了获得这方面更简明的信息,我们在两个实验室对5179例住院和1256例疑似胃肠道感染患者的粪便进行了为期一年的隐孢子虫筛查。共检出隐孢子虫病13例,检出率0.2%。此外,一项预测表明,预计瑞士每年约有340例隐孢子虫病,估计发病率为每10万人4.85例。至于危险因素,现有的患者资料并没有得出可靠的统计结论。然而,已知的危险因素如免疫抑制、出国旅行(33.3%)和接触有症状的人无疑得到了证实。生蚝、生奶和生奶制成的奶油必须强烈考虑作为食品传播媒介。来自市政管网的自来水不应被视为散发感染的相关来源。所获得的数据表明,隐孢子虫病在瑞士是一种低流行病学意义的疾病。在很大程度上,隐孢子虫病可以通过最著名的个人卫生措施来预防,避免食用某些生食,并注意旅行时的安全饮食。
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