Cryptosporidiosis outbreak in Amazonia, French Guiana, 2018.

Estelle Menu,Loic Favennec,Emilie Mosnier,Romy Razakandrainibe,Arnaud Cotrel,Denis Blanchet,Stéphane Valot,Damien Costa,Mélanie Gaillet,Franck De Laval,Frédéric Dalle,Magalie Demar,Maria Angeles Gómez-Morales

doi:10.1371/journal.pntd.0010068

Abstract

BackgroundCryptosporidiosis outbreaks in South America are poorly documented. In March 2018, 51 cases of cryptosporidiosis were reported in Maripasoula, a village located in a remote forest area along the border between Surinam and French Guiana.MethodTo identify the origin of the epidemic, we performed epidemiological, microbiological, and environmental investigations. Only the cases involving diarrhoea and Cryptosporidium-positive stool were considered as bona fide, while cases involving diarrhoea and close contact with a confirmed case were classified as “possible”.ResultsWe identified 16 confirmed cases and 35 possible ones. Confirmed cases comprised nine children (median age of 18 months, range: 6–21), one immunocompromised adult and six soldiers. One child required a hospitalisation for rehydration. All 16 Cryptosporidium stools were PCR positive, and sequencing of the gp60 gene confirmed only one Cryptosporidium hominis subtype IbA10G2. Tap water consumption was the only common risk factor identified. Contamination of the water network with Cryptosporidium parvum subtype IIdA19G2 was found.ConclusionWater quality is a major public health issue in Amazonian French Guiana, especially for population at risk (children, people with comorbidity, travelers). For them, alternative water supply or treatment should be implemented.

Highlights

The apicomplexan protozoan Cryptosporidium is distributed worldwide and is one of the most common waterborne pathogens [1]
Symptoms may be protracted and severe in immunocompromised patients and in children–for whom they are frequently associated with severe watery diarrhoea and dehydration [7]
The study was approved by the ethics committee of the Andree Rosemon Hospital, Cayenne (French Guiana)

Summary

Introduction

The apicomplexan protozoan Cryptosporidium is distributed worldwide and is one of the most common waterborne pathogens [1]. It is the second leading cause of diarrheal death for children under the age of five, causing 12% of the total diarrhoea mortality burden [2]. Its transmission is fecal-oral and can occur through the ingestion of oocysts from untreated water (drinking or recreational) or food and by contact with infected persons or animals [3], with an incubation period of 5 to 7 days [4]. Ingestion of faecally-contaminated water has been responsible for large outbreaks [4,5]. Cryptosporidiosis outbreaks in South America are poorly documented. In March 2018, 51 cases of cryptosporidiosis were reported in Maripasoula, a village located in a remote forest area along the border between Surinam and French Guiana

Methods

Results

Conclusion