REPLY
Cryptosporidium Spread in a Group Residential Home
Cynthia L. Sears, MD;
Robert D. Newman, MD; and
Richard L. Guerrant, MD
15 September 1994 | Volume 121 Issue 6 | Pages 467-468
IN RESPONSE:
The letter by Drs. Heald and Bartlett further suggests that C. parvum should be regarded as a highly infectious enteric pathogen. The 50% rate of secondary transmission they observed in the first group residential home is similar to the rate of potential person-to-person transmission observed in our studies in an urban slum in northeast Brazil [1]. Further evidence of the ease with which cryptosporidia are spread comes from the apparent nosocomial acquisition of cryptosporidial infection by 45% of nurses, housestaff, and students caring for patients with AIDS and cryptosporidiosis [2]. Given the recently reported low infectious inoculum for C. parvum infection in humans [3] and the hardy nature of the oocyst of this parasite, the sources of environmental transmission suggested by Heald and Bartlett seem plausible. In the future, the development of molecular diagnostic methods for C. parvum infections will enable studies to determine whether clusters of patients infected with C. parvum carry the same parasite strain. These studies should also allow reservoirs of infection to be clearly identified. We concur that to limit the spread of C. parvum, strict infection control measures are necessary, particularly in crowded living conditions and for immunocompromised patients.
1. Newman RD, Zu SX, Wuhib T, Lima AA, Guerrant RL, Sears CL. Household epidemiology of Cryptosporidium parvum infection in an urban community in northeast Brazil. Ann Intern Med. 1994; 120:500-5.
2. Koch KL, Phillips DJ, Aber RC, Current WL. Cryptosporidiosis in hospital personnel. Ann Intern Med. 1985; 102:593-6.
3. DuPont HL, Chappell CL, Sterling CR, Okhuysen PC, Rose JB, Jakubowski W. Infectivity of Cryptosporidium parvum for adult humans (Abstract) Clin Res. 1994; 42:285A.
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