Molecular typing of Cryptosporidium in Israel.

Tamar Grossman,Yael Glazer,Vered Agmon,Shifra Ken-Dror,Esther Marva,Lea Valinsky,Orli Sagi,Elsa Pavlotzky,Julia Vainer,Avi Peretz,Ana Paula Arez

doi:10.1371/journal.pone.0219977

Abstract

Cryptosporidium is a protozoan parasite associated with gastrointestinal illness. In immune-compromised individuals, the infection may become life-threatening. Cryptosporidiosis is a mandatory-reported disease but little was known about its prevalence and associated morbidity in Israel. Currently, laboratory diagnosis is based on microscopy or copro-antigen tests and the disease is underreported. Molecular assays, which are more sensitive and specific, are now increasingly used for identification and screening. Here, the molecular epidemiology of cryptosporidiosis is explored for the first time. Samples from 33 patients infected during an outbreak of 146 laboratory confirmed cases that occurred in Haifa and Western Galilee in 2015 were genotyped, as well as samples from 36 patients sporadically infected during 2014–2018 in different regions. The results suggest that Cryptosporidium subtypes found in Israel are more similar to those reported in the neighboring countries Jordan and Egypt than in European countries. C. hominis was the predominant species in the center and the north of Israel, implicating human-to-human transmission. C. hominis IeA11G3T3 was the most prevalent subtype contributing to morbidity.

Highlights

Cryptosporidium infection commonly causes self-limiting 2–3 week diarrhea
Between August and December 2015, the Haifa and West Galilee health-maintenance organization (HMO) identified an increase in Cryptosporidium infection rates, constituting an outbreak of 146 laboratory confirmed cases in the district (Fig 3)
Analysis of the 18S rRNA gene revealed that all positive samples contained Cryptosporidium of the species C. hominis

Summary

Introduction

Cryptosporidium infection commonly causes self-limiting 2–3 week diarrhea. In the immunecompromised or malnourished, the infection may develop into a prolonged life-threatening disease [1,2,3,4]. Young children are more frequently and severely affected. In sub-Saharan Africa and Southeast Asia, Cryptosporidium is the second cause (after rotavirus) of diarrheal disease and death in children under five.[4,5,6,7]. Cryptosporidiosis was added to the list of notifiable diseases in Israel in 2001. Practitioners are required to notify all new cases to the local health districts.

Methods

Results

Conclusion