Occurrence Of Cryptosporidium Oocysts And Giardia Cysts In Raw Water From The Atibaia River, Campinas, Brazil

Cryptosporidium parvum and Giardia duodenalis are waterborne parasites that have caused several outbreaks of gastrointestinal disease associated with drinking water. Due to the lack of studies about the occurrence of these protozoa in water in the Southeast of Brazil, an investigation was conducted to verify the presence of cysts and oocysts in superficial raw water of the Atibaia River. The water samples were submitted to membrane filtration (3.0 μm) and clution was processed by (1) scraping and rinsing of membrane (RM method) and (2) acetone-dissolution (ADM method). Microbiologic and chemical parameters were analyzed. Aliquots of the pellets were examined by immunofluorescence (Merifluor, Meridian Diagnostics, Cincinnati, Ohio). All water samples were positive for Cryptosporidium and Giardia, in spite of the high turbidity. Higher recovery rates occurred in samples treated by the RM method than by the ADM technique. The goal for future work is the assessment of viability of cysts and oocysts to determine the public health significance of this finding.432109111Aldom, J.E., Chagla, A.H., Recovery of Cryptosparidium oocysts from water by a membrane filter dissolution method (1995) Lett. Appl. Microbiol., 20, pp. 186-187Coombs, G.H., Biochemical peculiarities and drug targets in Cryptosporidium parvum: Lessons from other coccidian parasites (1999) Parasit. Today, 15, pp. 333-338Dawson, D.J., Maddocks, M., Roberts, J., Vidler, J.S., Evaluation of recovery of Cryptosporidium parvum oocysts using membrane filtration (1993) Lett. Appl. Microbiol., 17, pp. 276-279Franco, R.M.B., Cordeiro, N.D.S., Giardiose e criptosporidiose em creches no município de Campinas, SP (1996) Rev. Soc. Bras. Med. Trop., 29, pp. 585-591Fricker, C.R., Crabb, J.H., Water-borne cryptosporidiosis: Detection methods and treatment options (1998) Advanc. Parasit., 40, pp. 241-278Graczyk, T.K., Fayer, R., Cranfield, M.R., Owens, R., Cryptosporidium parvum oocysts recovered from water by the membrane filter dissolution method retain their infectivity (1997) J. Parasit., 83, pp. 111-114Griffiths, J.K., Human cryptosporidiosis: Epidemiology, transmission, clinical disease, treatment, and diagnosis (1998) Advanc. Parasit., 40, pp. 37-85Hayes, E.B., Matte, T.D., O'Bryen, T.R., Large community outbreak of cryptosporidiosis due to contamination of a filtered public water supply (1989) New Engl. J. Med., 320, pp. 1372-1376Hoffman, R., Chauret, C., Standridge, J., Peterson, L., Evaluation of four commercial antibodies (1999) J. Amer. Water Works Ass., 91, pp. 69-78Le Chevallier, M.W., Norton, W.D., Giardia and Cryptosporidium in raw and finished drinking water (1995) J. Amer. Water Works Ass., 87, pp. 54-63Meisel, J.L., Perera, D.R., Meligro, C., Rubin, C.E., Overwhelming watery diarrhea associated with a Cryptosporidium in an immunosuppressed patient (1976) Gastroenterology, 70, pp. 1156-1160O'Donoghue, P.J., Cryptosporidium and cryptosporidiosis in man and animals (1995) Int. J. Parasit., 25, pp. 139-195Pickering, L.K., Engelkirk, P.G., Giardia lamblia (1988) Pediat. Clin. N. Amer., 35, pp. 565-577Shepherd, K.M., Wyn-Jones, A.P., An evaluation of methods for the simultaneous detection of Cryptosporidium oocysts and Giardia cysts from water (1996) Appl. Environ. Microbiol., 62, pp. 1317-1322Smith, J.L., Cryptosporidium and Giardia as agent of foodborne disease (1993) J. Food Protect., 56, pp. 451-461States, S., Stadterman, K., Amon, L., Protozoa in river water: Sources, occurrence, and treatment (1997) J. Amer. Water Works Ass., 89, pp. 74-8

Detecção De Cistos De Giardia Spp. E Oocistos De Cryptosporidium Spp. Na água Bruta Das Estações De Tratamento No Município De Blumenau, Sc, Brasil

Giardia spp. and Cryptosporidium spp. are water-borne pathogenic protozoans spread through fecal-oral transmission which cause several health problems, to include gastrointestinal diseases associated with the consumption of contaminated water. There are limited data regarding the occurrence of these protozoans in surface waters in southern Brazil. The aim of this study was therefore to investigate the presence of cysts and oocysts in untreated water collected from water treatment plants in Blumenau, Santa Catarina State, Brazil. The methodology employed to study the protozoans was filtration through mixed cellulose ester membranes followed by the immunofluorescence reaction using the Merifluor® kit. Microbiological analysis was conducted using the Standard Methods for the Examination of Water and Wastewater and multi-parameter probes were used for the physico-chemical analysis. Cysts of Giardia spp. were found in 23.19% of the samples and oocysts of Cryptosporidium spp. in 7.24% of the samples (n=67). All of the samples analyzed were contaminated with Escherichia coli and 11.76% of the untreated water samples had turbidity values higher than the recommended limit. In the case of the treated water samples, 23.52% had turbidity values above the limit established by legislation (Portaria MS 2914/2011). The detection of pathogenic protozoans in the untreated water at the treatment plants highlights the importance of adopting preventative measures, such as the protection of areas where water is present and adequate treatment of domestic sewage, in order to reducing the risk of protozoan transmission via potable water. © 2016, Institute for Environmental Research in Hydrographic Basins (IPABHi). All rights reserved.11368970

Subclinical Hypothyroidism and the Risk of Stroke Events and Fatal Stroke: An Individual Participant Data Analysis.

OBJECTIVE: The objective was to determine the risk of stroke associated with subclinical hypothyroidism. DATA SOURCES AND STUDY SELECTION: Published prospective cohort studies were identified through a systematic search through November 2013 without restrictions in several databases. Unpublished studies were identified through the Thyroid Studies Collaboration. We collected individual participant data on thyroid function and stroke outcome. Euthyroidism was defined as TSH levels of 0.45-4.49 mIU/L, and subclinical hypothyroidism was defined as TSH levels of 4.5-19.9 mIU/L with normal T4 levels. DATA EXTRACTION AND SYNTHESIS: We collected individual participant data on 47 573 adults (3451 subclinical hypothyroidism) from 17 cohorts and followed up from 1972-2014 (489 192 person-years). Age- and sex-adjusted pooled hazard ratios (HRs) for participants with subclinical hypothyroidism compared to euthyroidism were 1.05 (95% confidence interval [CI], 0.91-1.21) for stroke events (combined fatal and nonfatal stroke) and 1.07 (95% CI, 0.80-1.42) for fatal stroke. Stratified by age, the HR for stroke events was 3.32 (95% CI, 1.25-8.80) for individuals aged 18-49 years. There was an increased risk of fatal stroke in the age groups 18-49 and 50-64 years, with a HR of 4.22 (95% CI, 1.08-16.55) and 2.86 (95% CI, 1.31-6.26), respectively (p trend 0.04). We found no increased risk for those 65-79 years old (HR, 1.00; 95% CI, 0.86-1.18) or ≥ 80 years old (HR, 1.31; 95% CI, 0.79-2.18). There was a pattern of increased risk of fatal stroke with higher TSH concentrations. CONCLUSIONS: Although no overall effect of subclinical hypothyroidism on stroke could be demonstrated, an increased risk in subjects younger than 65 years and those with higher TSH concentrations was observed

Thyroid Function Within the Reference Range and the Risk of Stroke: An Individual Participant Data Analysis.

The currently applied reference ranges for thyroid function are under debate. Despite evidence that thyroid function within the reference range is related with several cardiovascular disorders, its association with the risk of stroke has not been evaluated previously. We identified studies through a systematic literature search and the Thyroid Studies Collaboration, a collaboration of prospective cohort studies. Studies measuring baseline TSH, free T4, and stroke outcomes were included, and we collected individual participant data from each study, including thyroid function measurements and incident all stroke (combined fatal and nonfatal) and fatal stroke. The applied reference range for TSH levels was between 0.45 and 4.49 mIU/L. We collected individual participant data on 43 598 adults with TSH within the reference range from 17 cohorts, with a median follow-up of 11.6 years (interquartile range 5.1-13.9), including 449 908 person-years. Age- and sex-adjusted pooled hazard ratio for TSH was 0.78 (95% confidence interval [CI] 0.65-0.95 across the reference range of TSH) for all stroke and 0.83 (95% CI 0.62-1.09) for fatal stroke. For the free T4 analyses, the hazard ratio was 1.08 (95% CI 0.99-1.15 per SD increase) for all stroke and 1.10 (95% CI 1.04-1.19) for fatal stroke. This was independent of cardiovascular risk factors including systolic blood pressure, total cholesterol, smoking, and prevalent diabetes. Higher levels of TSH within the reference range may decrease the risk of stroke, highlighting the need for further research focusing on the clinical consequences associated with differences within the reference range of thyroid function

Occurrence Of Cryptosporidium Spp. In Small Wildlife Mammals From Three Mountainous Areas In The Brazilian Southeastern Region [ocorrência De Cryptosporidium Spp. Em Pequenos Mamíferos Silvestres De Três áreas Serranas Do Sudeste Brasileiro]

This study describes infection of Cryptosporidium spp in the natural fauna of small wildlife mammals in the Serra da Mantiqueira region. These protozoa were detected by a modified Ziehl-Neelsen technique and a direct immunofluorescent assay. From 240 captured animals, acid-resistant structures were observed in the feces of 39 specimens, and these structures were confirmed to be C. muris (5.1%) or C. parvum (5.1%) by the direct immunofluorescent assay.5612531Abranches, J., Nóbrega, H.N., Valente, P., A preliminary note on yeasts associated with fecal pellets of rodents and marsupials of Atlantic forest fragments in Rio de Janeiro, Brazil (1998) Rev. Microbiol., 29, pp. 170-173Aydin, Y., Ozkul, L.A., Infectivity of Cryptosporidium muris directly isolated from the murine stomach for various laboratory animals (1996) Vet. Parasitol., 66, pp. 257-262Bergallo, H.G., Rocha, C.F.D., Alves, M.A.S., (2000) A Fauna Ameaçada de Extinção Do Estado Do Rio de Janeiro, 168p. , Rio de Janeiro: UERJ/FAPERJBull, S.A., Chalmers, R.M., Sturdee, A.P., A survey of Cryptosporidium species in skomer bank voles (Clethrionomys glareolus skomerensis) (1998) J. Zool., 244, pp. 119-122Chalmers, R.M., Sturdee, A.P., Bull, S.A., The prevalence of Cryptosporidium parvum and C. muris in Mus domesticus, Apodemus sylvaticus and Clethrionomys glareolus in an agricultural system (1997) Parasitol. Res., 83, pp. 478-482Deng, M.Q., Cliver, D.O., Improved Immunofluorescense Assay for detection of Giardia and Cryptosporidium from asymptomatic adult cervine animals (1999) Parasitol. Res., 58, pp. 733-736Emmons, L.H., (1997) Neotropical Rainforest Mammals. A Field Guide. 2.ed., , University ChicagoFayer, R., Morgan, U., Upton, S.J., Epidemiology of Cryptosporidium: Transmission, detection and identification (2000) Int. J. Parasitol., 30, pp. 12-13Garcia, L.S., Brewer, T.C., Bruckner, D.A., Fluorescence detection of Cryptosporidium oocysts in human fecal specimens by using monoclonal antibodies (1987) J. Clin. Microbiol., 25, pp. 119-121Garcia, L.S., Shimizu, R.Y., Evaluation of nine immunoassay kits (Enzyme Immunoassay and Direct Fluorescence) for detection of Giardia lamblia and Cryptosporidium parvum in human fecal specimens (1997) J. Clin. Microbiol., 35, pp. 1526-1529Graczyk, T.K., Cranfield, M.R., Fayer, R., Evaluation of commercial enzyme immnuassay (EIA) and immunofluorescent antibody (IFA) test kits for detection of Cryptosporidium oocysts of species other than Cryptosporidium parvum (1996) Am. J. Trop. Med. Hyg., 54, pp. 274-279Henriksen, S.A., Pohlenz, J.F.L., Staining of Cryptosporidia by a modified Ziehl-Neelsen technique (1981) Acta Vet. Scand., 22, pp. 594-596Katsumata, T., Hosea, D., Rnuh, I.G., Possible Cryptosporidium muris infection in humans (2000) Am. J. Trop. Med. Hyg., 62, pp. 70-72Lindsay, D.S., Upton, S.J., Owens, D.S., Cryptosporidium andersoni n. sp. (Apicomplexa: Cryptosporiidae) from cattle, Bos taurus (2000) J. Eukaryot. Microbiol., 47, pp. 91-95O'Donoghue, P.J., Cryptosporidium and cryptosporidiosis in man and animals (1995) Int. J. Parasitol., 25, pp. 139-195Ogassawara, S., Castro, J.M., Kasai, N., Cryptosporidium tipo C.muris em bovinos do Estado de São Paulo (Nota Prévia) (1989) Anais Seminário Brasileiro de Parasitologia Veterinária, 6, p. 123. , Bagé, RS, 25 a 29 setembroPedraza-Diaz, S., Amar, C., McLauchlin, J., The identification and characterization of an unsual genotype of Cryptosporidium from human faeces as Cryptosporidium meleagridis (2000) FEMS. Microbiol. Lett., 189, pp. 189-194Pena, H.F.J., Kasai, N., Gennari, S.M., Cryptosporidium muris in dairy cattle in Brazil (1997) Vet. Parasitol., 73, pp. 353-355Rose, J.D., Environmental ecology of Cryptosporidium and public health implications (1997) Annu. Rev. Public Health, 18, pp. 135-161Sinski, E., Cryptosporidiosis in Poland: Clinical, epidemiologic and parasitologic aspects (1993) Folia Parasitol., 40, pp. 297-300Sinski, E., Bednarska, M., Bajer, M., The role of wild rodents in ecology of Cryptosporidiosis in Poland (1998) Folia Parasitol., 45, pp. 173-174Solo-Gabriele, H., Neumeister, S., US outbreaks of cryptosporidiosis (1996) J. AWWA, 88, pp. 76-86Sturdee, A.P., Chalmers, R.M., Bull, S.A., Detection of Cryptosporidium oocysts in wild mammals of mainland Britain (1999) Vet. Parasitol., 80, pp. 273-280Thompson, R.C.A., Presidential address: Rediscovering parasites using molecular towards revising the taxonomy of Echinococcus, Giardia and Cryptosporidium (2002) Int. J. Parasitol., 32, pp. 493-496Torres, J., Gracenea, M., Gómez, M.S., The occurrence of Cryptosporidium parvum and C. muris in wild rodents and insectivores in Spain (2000) Vet. Parasitol., 92, pp. 253-260Tzipori, S., Griffths, J.K., Natural history and Biology of Cryptosporidium parvum (1998) Advanc. Parasitol., 40, pp. 6-29Weber, R., Bryan, R.T., Juranek, D.D., Improved stool concentration procedure for detection of Cryptosporidium oocysts in fecal specimens (1992) J. Clin. Microbiol., 30, pp. 2869-2873Xiao, L., Morgan, U.M., Fayer, R., Cryptosporidium systematics and implications for public health (2000) Parasitol. Today, 16, pp. 287-292Xiao, L., Sulaiman, I.M., Ryan, U.M., Host adaptation and host-parasite co-evolution in Cryptosporidium: Implications for taxonomy and public health (2002) Int. J. Parasitol., 32, pp. 1773-179

Evaluation Of Activated Sludge Treatment And The Efficiency Of The Disinfection Of Giardia Species Cysts And Cryptosporidium Oocysts By Uv At A Sludge Treatment Plant In Campinas, South-east Brazil

Among many waterborne disease the giardiasis and cryptosporidiosis are of particular public health interest, because Giardia cysts and Cryptosporidium oocysts can persist for long periods in the environment, and both pathogenic protozoa have been implicated as the cause of many outbreaks of gastroenteritis in the last 25 years. In order to evaluate the efficiency of cysts and oocysts' removal by the activated sludge process, and by UV reactor in inactivating cysts and oocysts in one wastewater treatment plant (WWTP) of Campinas, three sampling points were selected for study: (1) influent. (2) treated effluent without UV disinfection and (3) treated effluent with UV disinfection, Giardia spp. cysts prevailed with higher density in the three different sample types. Cryptosporidium spp. oocysts were observed in only two samples of influent and just one sample of treated sewage with UV disinfection. In the animal infectivity assay for Giardia spp, on mouse of the UV treated group revealed trophozoites in intestinal scrapings. The results of the present study indicate that treatment by activated sludge process delivered a reduction of 98.9% of cysts and 99.7% of oocysts and UV disinfection was not completely efficient regarding the inactivation of Giardia cysts in the case of the WWTP studied. © IWA Publishing 2006.5438994Amoah, K., Craik, S., Smith, D.W., Belosevic, M., Inactivation of Cryptosporidium oocysts and Giardia cysts by ultraviolet light in the presence of natural particulate matter (2005) J. Wat., pp. 165-178Belosevic, M., Craik, S.A., Stafford, J.L., Neumann, N.F., Kruithof, J., Smith, D.W., Studies on the resistance/reactivation of Giardia muris cysts and Cryptosporidium parvum oocysts exposed to medium-pressure ultraviolet radiation (2001) FEMS Microbiol. Lett., 204, pp. 197-203Betancourt, W.Q., Rose, J.B., Drinking water treatment processes for removal of Cryptosporidium and Giardia (2004) Vet. Parasitol., 126 (1-2), pp. 219-234Briancesco, R., Bonadonna, L., An Italian study on Cryptosporidium and Giardia in wastewater, fresh water and treated water (2005) Env. Monit. Assess., 104, pp. 445-457Craun, G.F., Via, S.H., Waterborne outbreaks of cryptosporidiosis (1998) J. AWWA, 90, p. 91Darby, J.L., Snider, K.E., Tchobanoglous, G., Ultraviolet disinfection for wastewater reclamation and reuse subject to restrictive standards (1993) Wat. Env. Res., 65 (2), pp. 169-180Franco, R.M.B., Rocha-Eberhardt, R., Cantusio Neto, R., Occurrence of Cryptosporidium oocysts and Giardia cysts in raw water from the Atibaia river, Campinas, Brazil (2001) Rev. Inst. Med. Trop. S. Paulo, 43 (2), pp. 109-111(2002), www.funasa.gov.br, FUNASA - Fundação Nacional da Saúde. AvailableGarcia, A., Yanko, W., Batzer, G., Widmer, G., Giardia cysts in tertiary-treated wastewater effluents: Are they infective? (2002) Wat. Env. Res., 74, pp. 541-544Hachich, E.M., Sato, M.I.Z., Galvani, A.T., Menegon, J.R.N., Mucci, J.L.M., Giardia and Cryptosporidium in source waters of São Paulo State, Brazil (2004) Wat. Sci. Tech., 50 (1), pp. 239-245(2000), www.ibge.gov.br, IBGE - Instituto Brasileiro de Geografia e Estatística AvailableJolis, D., Lam, C., Pitt, P., Particle effects on ultraviolet disinfection of coliform bacteria in recycled water (2001) Wat. Env. Res., 73 (2), pp. 233-236Lindquist, H.D.A., Dufour, A.P., Wymer, L.J., Schaefer, F.W., II Criteria for evaluation of proposed protozoan detection methods (1999) J. Microbiol. Methods, 37, pp. 33-43Maturama, V.M.I., Ares-Mazás, M.E., Duran-Oreiro, D., Lonrenzo-Lorenzo, M.J., Efficacy of activated sludge in removing Cryptosporidium parvum oocysts from sewage (1992) Appl. Environ. Microbiol., 58 (11), pp. 3514-3516Medema, G.J., Schets, F.M., Teunis, P.F.M., Havelaar, A.H., Sedimentation of free and attached Cryptosporidium oocysts and Giardia cysts in water (1998) Appl. Environ. Microbiol., 64 (11), pp. 4460-4466Payment, P., Palnet, R., Cejaka, P., Removal of indicator bacteria, human enteric viruses, Giardia cysts, Cryptosporidium oocysts at a large wastewater primary treatment facility (2001) Can. J. Microbiol., 47, pp. 188-193Robertson, L.J., Paton, C.A., Campbell, A.T., Smith, P.G., Jackson, M.H., Gilmour, R.A., Black, S.E., Smith, H.V., Giardia cysts and Cryptosporidium oocysts at sewage treatment works in Scotland, UK (2000) Wat. Res., 34 (8), pp. 2310-2322Rochelle, P.A., Steve, J.U., Montelone, A., Woods, K., The response of Cryptosporidium parvum to UV light (2005) Trends Parasitol., 21 (2), pp. 81-87Rose, J.B., Huffman, D.E., Gennaccaro, A., Risk and control of waterborne cryptosporidiosis (2002) FEMS Microbiol. Rev., 26, pp. 113-123Santos, L.U., Bonatti, T., Cantusio-Neto, R., Franco, R.M.B., Detection of Giardia spp. cysts and Cryptosporidium oocysts in activated sludge by ether clarification technique and sucrose flotation (2004) Rev. Inst. Med. Trop. S. Paulo, 46 (6), pp. 309-313Savoye, P., Janex, M.L., Lazarova, V., Wastewater disinfection by low-pressure UV and ozone: A design approach based on water quality (2001) Wat. Sci. Tech., 43 (10), pp. 163-171Thompson, R.C.A., The zoonotic significance and molecular epidemiology of Giardia and giardiasis (2004) Vet. Parasitol., 126, pp. 15-3