Abstract
Cryptosporidiosis is increasingly recognized to be a major cause of diarrheal disease in the United States. Cryptosporidiosis is a self-limited disease in immunocompetent persons, although symptoms may be prolonged, with an average duration of 2 weeks in patients who seek medical attention. In persons infected with the human immunodeficiency virus (HIV),<i>Cryptosporidium</i>causes a severe, unremitting diarrhea, often associated with biliary disease. The agent,<i>Cryptosporidium parvum</i>, is a protozoan parasite that is transmitted by fecally contaminated water and food and from person to person. The importance of cryptosporidiosis was dramatically highlighted in 1993 by a massive outbreak in Milwaukee, Wis, where an estimated 400 000 persons developed diarrheal disease due to contamination of the public water supply.<sup>1</sup>Cryptosporidial infection is endemic among domestic and wild animals, and the Milwaukee outbreak appeared to be due to spring runoff from livestock grazing areas into the municipal watershed. The cryptosporidial cysts are
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