Complex epidemiology and zoonotic potential for Cryptosporidium suis in rural Madagascar

Cryptosporidium spp. is the most important parasitic diarrheal agent in the world, is among the top four causes of moderate-to-severe diarrheal disease in young children in developing nations, and is problematic as an opportunistic co-infection with HIV. In addition, Cryptosporidium is a persistent challenge for livestock production. Despite its zoonotic potential, few studies have examined the ecology and epidemiology of this pathogen in rural systems characterized by high rates of overlap among humans, domesticated animals, and wildlife. To improve our understanding of the zoonotic potential of Cryptosporidium species in the rural tropics, we screened humans, livestock, peridomestic rodents, and wildlife using PCR-RFLP and sequencing-based approaches to distinguish species of Cryptosporidium in rural southeastern Madagascar. Cryptosporidium of multiple species/genotypes were apparent in this study system. Interestingly, C. suis was the dominant species of Cryptosporidium in the region, infecting humans (n = 1), cattle (n =  18), pigs (n= 3), and rodents (n = 1). The broad species range of C. suis and the lack of common cattle Cryptosporidium species (Cryptosporidium parvum and Cryptosporidium andersoni) in this system are unique. This report represents the fifth confirmed case of C. suis infection in humans, and the first case in Africa. Few rural human and livestock populations have been screened for Cryptosporidium using genus-specific genotyping methods. Consequently, C. suis may be more widespread in human and cattle populations than previously believed.     

Determining the zoonotic significance of Giardia and Cryptosporidium in Australian dogs and cats

In a recent study of intestinal parasites in dogs and cats in Australia, Giardia was found to be the most prevalent parasite in dogs. The aim of the current study through the use of molecular tools was to determine the zoonotic significance of the Giardia and Cryptosporidium isolates recovered from dogs and cats during the Australian study. Of the isolates successfully amplified all but one of the Giardia from dogs was either Assemblage C and/or D, with one Assemblage A. Of the cat samples amplified all but one were Assemblage F, with one Assemblage D. We hypothesize that the lack of zoonotic Giardia Assemblages recovered is a result of their being a low prevalence of Giardia in the human population. The Cryptosporidium recovered from dogs and cats was determined to be C. canis and C. felis, respectively, a finding which supports growing evidence that Cryptosporidiumin companion animals is of limited public health significance to healthy people.     

A rare Cryptosporidium parvum genotype associated with infection of lambs and zoonotic transmission in Italy

An outbreak of cryptosporidiosis occurred in a mixed sheep/cattle farm of Central Italy in October 2011. A total of 450 ovines (250 sheep and 200 lambs) and 140 bovines (130 cows and 10 calves) were housed in two separated units, at the time of the outbreak. About half of the lambs had diarrhea due to Cryptosporidium sp. with a mortality rate of 80%; calves were not infected. Genomic DNA was extracted from an archived slide and from fecal specimens, and the parasite was identified as Cryptosporidium parvum by PCR and sequence analysis at the CpA135 gene. Genotyping at the GP60 gene showed the presence of a very rare genotype, IIaA20G2R1. Shortly after the outbreak was identified, the son of the farm's owner, aged 18 months, experienced an acute gastroenteritis and was hospitalized due to recurrent episodes of diarrhea, fever, vomiting and lack of appetite. The feces tested negative for bacteria and viruses, whereas cryptosporidiosis was diagnosed by microscopy and an immunochromatographic test. Molecular typing identified the C. parvum genotype IIaA20G2R1 in the feces of the child. This is the first case of transmission of cryptosporidiosis in Italy involving lambs as source of oocysts infectious to humans.     

Natural infection with zoonotic subtype of Cryptosporidium parvum in Capybara (Hydrochoerus hydrochaeris) from Brazil

A total of 145 capybara (Hydrochoerus hydrochaeris) fecal samples from the state of S?o Paulo, Brazil, were screened for Cryptosporidium spp. oocysts using the malachite green method. Eight samples (5.52%) showed positive results and were further submitted to nested PCR reaction for amplification of fragments of 18S rRNA gene and 60-kDa glycoprotein gene for determination of species, alleles and subtypes of Cryptosporidium. Sequencing of the PCR products of the 18S rRNA gene fragments and 60-kDa glycoprotein gene fragments showed that for both genes all Cryptosporidium isolates from capybara were respectively 100% genetically similar to a bovine isolate of C. parvum and to C. parvum subtype IIaA15G2R1. To the best of our knowledge this is the first report of Cryptosporidium infection in this rodent. The finding of zoonotic C. parvum infection in a semi-aquatic mammal that inhabits anthroponotic habitats raises the concern that human water supplies may be contaminated with zoonotic Cryptosporidium oocysts from wildlife.     

Quality assurance considerations for detection of waterborne zoonotic parasites using Cryptosporidium oocyst detection as the main example

A laboratory quality assurance (QA) program can minimize errors and provide confidence in the validity of laboratory test results. The structure of a QA program varies somewhat among laboratories but usually requires addressing a QA manual, QA goals, quality of resources, standard operating procedures, internal quality control, and external QA procedures. This paper reviews these general components and discusses some of the more particular QA considerations specific to filtration, immunomagnetic separation (IMS), immunofluorescence microscopy (FA), vital dye staining, differential interference contrast (DIC) microscopy, and molecular methods, which are involved in the detection and enumeration of Cryptosporidium oocysts.     

Cryptosporidium spp. and other zoonotic enteric parasites in a sample of domestic dogs and cats in the Niagara region of Ontario

To determine the prevalence of Cryptosporidium spp. and other zoonotic enteric parasites in a sample of domestic dogs and cats in the Niagara region, Ontario, 5 of 26 clinics invited by mail survey reported their parasitological findings over 24 months. Stool samples collected by 1 clinic over 68 days were investigated for parasites by using several techniques (fecal concentration, acid-fast staining, and a Cryptosporidium immunoassay). The 5 clinics that provided data indicated Toxocara spp. as the most frequent finding. Parasitological study of 111 stool samples showed a high overall positivity rate in samples from both dogs (40%) and cats (36.6%). Cryptosporidium spp. antigen was detected in 7.4% and 7.3%, Toxocara spp. in 14.2% and 12.2%, and Giardia spp. 7.1% and 2.4% of dog and cat samples, respectively. The high prevalence of zoonotic parasites in the Niagara region is important, and increased awareness of their potential threat to human health is necessary. Additionally, further research into the zoonotic capacity of Cryptosporidium spp. and Giardia spp. is necessary.     

Borna disease virus: a mystery as an emerging zoonotic pathogen

For Central European veterinarians, Borna disease (BD) has been known for a long time as a sporadically occurring, progressive viral polioencephalomyelitis predominantly affecting horses and sheep and-as discovered in the last decade-an increasing number of domestic and zoo animals. The aetiological agent, the Borna disease virus (BDV), a negative-sense, single-stranded RNA virus classified in the new virus family Bornaviridae within the order Mononegavirales, can induce severe clinical signs typically of a viral encephalitis with striking behavioural disturbances. After an incubation period lasting a few weeks to several months, BDV-infection causes locomotor and sensory dysfunctions followed by paralysis and death. Natural infections seem to be subclinical in most cases. BD received world-wide attention when it was reported that sera and/or cerebrospinal fluids from neuro-psychiatric patients can contain BDV-specific antibodies. Since infected animals produce BDV-specific antibodies only after virus replication, it was assumed that the broad spectrum of BDV-susceptible species also includes man. However, reports describing the presence of other BDV-markers, i.e. BDV-RNA or BDV-antigen, in peripheral blood leukocytes or brain tissue of neuro-psychiatric patients are highly controversial and, therefore, the role of BDV in human neuro-psychiatric disorders is questionable. (c) 2001 Harcourt Publishers Ltd.     

The potential for zoonotic transmission of Giardia duodenalis and Cryptosporidium spp. from beef and dairy cattle in Ontario, Canada

The objective of this study was to compare the occurrence and the genotypes and species of Giardia duodenalis and Cryptosporidium spp. in beef and dairy cattle from farms in the Regional Municipality of Waterloo, Ontario, in an effort to determine the potential for zoonotic transmission from these animals. Pooled manure samples were collected from 45 dairy cattle farms and 30 beef cattle farms. The presence of Giardia cysts and Cryptosporidium oocysts was determined by immunofluorescence microscopy, while nested-PCR and DNA sequencing were used to determine genotypes and species. The overall farm prevalence was very high for both Giardia and Cryptosporidium, and was similar for dairy cattle farms (96 and 64%, respectively) and beef cattle farms (97 and 63%, respectively). However, on dairy cattle farms, G. duodenalis and Cryptosporidium spp. were detected in 44% and 6% of total pooled pen manure samples, respectively, with the occurrence of both parasites being generally higher in calves than in older animals. Most Giardia isolates were identified as either the host-adapted genotype G. duodenalis Assemblage E or the zoonotic Assemblage B. Cryptosporidium parvum and Cryptosporidium andersoni were the most frequently identified species in dairy cattle, while the non-zoonotic species Cryptosporidium ryanae and Cryptosporidium bovis were also found. On beef cattle farms, 72% and 27% of the total pooled pen manure samples were positive for Giardia and Cryptosporidium, respectively, with no obvious correlation with age. All Giardia isolates in beef cattle were identified as G. duodenalis Assemblage E, while all Cryptosporidium isolates were identified by sequence analysis as C. andersoni, although microscopic analyses, and subsequent restriction fragment length polymorphism analyses, indicated that other Cryptosporidium species were also present. The results of this study indicate that although Giardia and Cryptosporidium were identified in a higher overall percentage of the pooled beef cattle manure samples than in dairy cattle, firmly established zoonotic genotypes and species were much more common in dairy cattle than in beef cattle in this region. Dairy cattle, and especially dairy calves, may, therefore, pose a greater risk of infection to humans than beef cattle. However, these results may also provide evidence of potential zooanthroponotic transmission (human to animal).     

One Health as a moral dilemma: Towards a socially responsible zoonotic disease control

During the last decade, the concept of One Health has become the international standard for zoonotic disease control. This call for transdisciplinary collaboration between professionals in human, animal and environmental health has produced several successes in zoonotic disease control, surveillance and research. Despite the lack of a clear definition, a shared agenda or institutional governance, One Health has proven to be a fruitful idea. Due to its ambiguity, the One Health concept functions as a boundary object: by leaving room for interpretation to fit different purposes, it facilitates cooperation. In many cases, this results in the promotion of health of humans, animals and the environment. However, there are also situations in which this mutual benefit of a One Health approach is not that evident, for instance, when healthy animals are culled to protect public health. Although such a strategy could well be part of a One Health approach, it is hard to understand how this contributes to the health of concerning animals. Consequently, these practices often lead to public debate. This raises questions on how we should understand the One Health concept in zoonotic disease control. Is it really about equally improving the health of humans, animals and the environment and is this even possible? Or is it ultimately just public health that counts? In cases of conflict between different values, the lack of a universal definition of the One Health concept contributes to this complexity. Although boundary objects have many positive aspects, in the context of One Health and zoonotic disease control, this conception seems to conceal underlying normative differences. To address moral dilemmas related to a One Health approach in zoonotic disease control, it is important to reflect on moral status and the meaning of health for humans, animals and the environment.     

Waterborne zoonotic helminthiases

This review deals with waterborne zoonotic helminths, many of which are opportunistic parasites spreading directly from animals to man or man to animals through water that is either ingested or that contains forms capable of skin penetration. Disease severity ranges from being rapidly fatal to low-grade chronic infections that may be asymptomatic for many years. The most significant zoonotic waterborne helminthic diseases are either snail-mediated, copepod-mediated or transmitted by faecal-contaminated water. Snail-mediated helminthiases described here are caused by digenetic trematodes that undergo complex life cycles involving various species of aquatic snails. These diseases include schistosomiasis, cercarial dermatitis, fascioliasis and fasciolopsiasis. The primary copepod-mediated helminthiases are sparganosis, gnathostomiasis and dracunculiasis, and the major faecal-contaminated water helminthiases are cysticercosis, hydatid disease and larva migrans. Generally, only parasites whose infective stages can be transmitted directly by water are discussed in this article. Although many do not require a water environment in which to complete their life cycle, their infective stages can certainly be distributed and acquired directly through water. Transmission via the external environment is necessary for many helminth parasites, with water and faecal contamination being important considerations. Human behaviour, particularly poor hygiene, is a major factor in the re-emergence, and spread of parasitic infections. Also important in assessing the risk of infection by water transmission are human habits and population density, the prevalence of infection in them and in alternate animal hosts, methods of treating sewage and drinking water, and climate. Disease prevention methods, including disease surveillance, education and improved drinking water treatment are described.     

Morphological and molecular characterisation of a mixed Cryptosporidium muris/Cryptosporidium felis infection in a cat

To date Cryptosporidium muris has been identified by microscopy and genotyping in cats in two studies. We report morphological and genetic evidence of a mixed C. muris and C. felis infection in a cat and provide the first histological, immunohistochemical, in situ hybridisation and genetic confirmation of a C. muris infection in the stomach of a cat. The cat suffered persistent diarrhoea after the initial consultation, which remained unresolved, despite several medical interventions. Further studies are required to determine the range, prevalence and clinical impact of Cryptosporidium species infecting cats.     

Rotaviruses: diversity and zoonotic potential--a brief review

Rotaviruses, a genus within the family Reoviridae, are among the most important etiological agents of severe diarrhoeal illness in humans and animals worldwide. Their genome, consisting of 11 segments of double-stranded RNA, is characterized by genetic variability including (i) point mutations, (ii) genomic reassortment, and (iii) genome rearrangements, thus leading to the considerable diversity of rotaviruses. Animal rotaviruses are regarded as a potential reservoir for genetic exchange with human rotaviruses.There is now increasing evidence that animal rotaviruses can infect humans, either by direct transmission of the virus or by contributing one or several genes to reassortants with essentially a human strain genetic background. As mixed infections are a prerequisite for reassortment events, cosurveillance of animal and human rotavirus strains will be vital to gain a better understanding of the relationships between cocirculating viruses, as well as assessing any relevant vaccination programs.     

Hepatitis E virus: Animal reservoirs and zoonotic risk

Hepatitis E virus (HEV) is a small, non-enveloped, single-strand, positive-sense RNA virus of approximately 7.2 kb in size. HEV is classified in the family Hepeviridae consisting of four recognized major genotypes that infect humans and other animals. Genotypes 1 and 2 HEV are restricted to humans and often associated with large outbreaks and epidemics in developing countries with poor sanitation conditions, whereas genotypes 3 and 4 HEV infect humans, pigs and other animal species and are responsible for sporadic cases of hepatitis E in both developing and industrialized countries. The avian HEV associated with Hepatitis-Splenomegaly syndrome in chickens is genetically and antigenically related to mammalian HEV, and likely represents a new genus in the family. There exist three open reading frames in HEV genome: ORF1 encodes non-structural proteins, ORF2 encodes the capsid protein, and the ORF3 encodes a small phosphoprotein. ORF2 and ORF3 are translated from a single bicistronic mRNA, and overlap each other but neither overlaps ORF1. Due to the lack of an efficient cell culture system and a practical animal model for HEV, the mechanisms of HEV replication and pathogenesis are poorly understood. The recent identification and characterization of animal strains of HEV from pigs and chickens and the demonstrated ability of cross-species infection by these animal strains raise potential public health concerns for zoonotic HEV transmission. It has been shown that the genotypes 3 and 4 HEV strains from pigs can infect humans, and vice versa. Accumulating evidence indicated that hepatitis E is a zoonotic disease, and swine and perhaps other animal species are reservoirs for HEV. A vaccine against HEV is not yet available.     

Cattle industry and zoonotic risk

The intensive farming of dairy and beef cattle has elicited a decrease in the herds and an increase in the number of animals per herd. The high concentration of cattle and the movement of the animals among herds has led to an increase in the health risks. In this context we have to consider the role of microbial agents of zoonoses, such as bacteria, parasites, and in some cases viruses. Notably, foodstuffs, such as meat, milk and dairy products, are the main sources of zoonoses of bovine origin. In particular, raw milk must be considered at high risk for trasmission of pathogens from cattle to humans. The European Regulation concerning food safety provides specific requirements for animal products and in bovine health management. Given the direct responsibility of the producer, the adoption of a self-regulation regimen on animal health, dairy and meat products must be planned by farmers.     

(Highly pathogenic) avian influenza as a zoonotic agent

Zoonotic agents challenging the world every year afresh are influenza A viruses. In the past, human pandemics caused by influenza A viruses had been occurring periodically. Wild aquatic birds are carriers of the full variety of influenza virus A subtypes, and thus, most probably constitute the natural reservoir of all influenza A viruses. Whereas avian influenza viruses in their natural avian reservoir are generally of low pathogenicity (LPAIV), some have gained virulence by mutation after transmission and adaptation to susceptible gallinaceous poultry. Those so-called highly pathogenic avian influenza viruses (HPAIV) then cause mass die-offs in susceptible birds and lead to tremendous economical losses when poultry is affected. Besides a number of avian influenza virus subtypes that have sporadically infected mammals, the HPAIV H5N1 Asia shows strong zoonotic characteristics and it was transmitted from birds to different mammalian species including humans. Theoretically, pandemic viruses might derive directly from avian influenza viruses or arise after genetic reassortment between viruses of avian and mammalian origin. So far, HPAIV H5N1 already meets two conditions for a pandemic virus: as a new subtype it has been hitherto unseen in the human population and it has infected at least 438 people, and caused severe illness and high lethality in 262 humans to date (August 2009). The acquisition of efficient human-to-human transmission would complete the emergence of a new pandemic virus. Therefore, fighting H5N1 at its source is the prerequisite to reduce pandemic risks posed by this virus. Other influenza viruses regarded as pandemic candidates derive from subtypes H2, H7, and H9 all of which have infected humans in the past. Here, we will give a comprehensive overview on avian influenza viruses in concern to their zoonotic potential.