Cyclospora cayetanensis
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: João André Alves Silva, M.D. [2]
Overview
Cyclospora cayetanensis is a protozoan that causes disease in humans, and perhaps other primates. It is sometimes referred to as the “yuppie disease” due to outbreaks in the United States from fecally-contaminated imported raspberries and was virtually unknown before about 1990, but has been on the rise since. The health risk associated with the disease is usually confined to adult foreigners visiting endemic regions and acquiring the infection: this is why C. cayetanensis has been labeled as causing “traveler’s diarrhea.” Given the recent rise of this protozoan menace, it is important to be able to characterize, recognize, and give proper treatment for C. cayetanensis.
This species was placed in the Cyclospora genus because of the spherical shape of its sporocysts. The species name refers to the Universidad Peruana Cayetano Heredia in Lima, Peru, where early epidemiological and taxonomic work was done.[3]
Taxonomy
Eukaryota; Alveolata; Apicomplexa; Conoidasida; Coccidia; Eucoccidiorida; Eimeriorina; Eimeriidae; Cyclospora[1]
Biology
Cyclospora cayetanensis is apicomplexan, cyst-forming coccidian protozoan, of the family of Eimeriidae, that causes a self-limiting diarrhea. Morphologically C. cayetanensis has spherical oocysts that are between 7.5 and 10 micrometers in diameter that also have a 50 nanometer thick bilayered wall with an outer threadlike coat that has been called a wrinkle by some researchers.[2][3][4]
Tropism
Natural Reservoir
The only hosts C. cayentanensis uses are humans.[2]
Treatment
Though the diarrhea caused by C. cayetanensis is self-limiting, relapses can and do occur. To date, the most effective drug for the treatment of the protozoan is a seven-day course of oral trimethoprim-sulfamethoxazole (TMP-SMX). Effects of the drug include significant decrease in the duration of oocyst excretion and cessation of diarrhea and stool samples negative for oocysts between two and three days. Relapse patients respond promptly to the therapy, and there has been talk of using TMP-SMX as a prophylaxis for HIV/AIDS patients.
Since infection occurs via fecally contaminated food and water in endemic environments, there are several simple solutions to suggest for the prevention of C. cayetanensis infections. The simplest one is to warn travelers not to visit regions where the protozoan is endemic (generally tropical and sub-tropical regions such as Peru, Brazil, and Haiti), especially when the disease is in its best season for spreading: such was the reason behind the first reported case of cyclosporiasis in Korea. This is not to say that natives of a region are completely free from possible infection: a middle-aged Turkish lawyer living in an urban area with water sanitized by the local government and with no travel history recently became Turkey’s first autochthonous case. This woman most likely received the infection from consuming some infected foodstuffs (possibly raspberries) that were not thoroughly washed before consumption. Thus, better health practices in the originating agricultural setting—such as ensuring produce is fully washed and kept away from human feces—and in the individual’s environment—taking an extra few seconds to wash that produce as well—would lead to a lower incidence of infection.
References
- Ak, Mucide, Berrin Karaayak, Turan Kaya, Meral Turk, and Metin Turker. "Cyclosporiasis associated with diarrhoea in an immunocompetent patient in Turkey." Journal of Medical Microbiology 53 (2004): 255-251.
- Belosevic, Miodrag, Yoshinobu Ishibashi, Masato Kawabata, Kenji Kimura, Shiba-Kumar Rai, Kaoru Takemasa, and Shoji Uga. "Comparison of three microscopic techniques for diagnosis of Cyclospora cayetanensis". FEMS Microbiology Letters 238 (2004): 263-266.
- Gajadhar, Alvin A. and Mansfield, Linda S.; "Cyclospora cayetanensis, a food- and waterborne coccidian parasite." Veterinary Parasitology 126 (2004): 73-90.
- Sohn, Woon-Mok and Jae-Ran Yu. "A case of human cyclosporiasis causing traveler's diarrhea after visiting Indonesia." Journal of Korean Medical Science 18 (2003): 738-741.
- ↑ "Cyclospora cayetanensis".
- ↑ 2.0 2.1 "Cyclosporiasis".
- ↑ Ortega YR, Sanchez R (2010). "Update on Cyclospora cayetanensis, a food-borne and waterborne parasite". Clin Microbiol Rev. 23 (1): 218–34. doi:10.1128/CMR.00026-09. PMC 2806662. PMID 20065331.
- ↑ Ortega YR, Gilman RH, Sterling CR (1994). "A new coccidian parasite (Apicomplexa: Eimeriidae) from humans". J Parasitol. 80 (4): 625–9. PMID 8064531.