Cryptosporidium muris: Infectivity and Illness in Healthy Adult Volunteers

Cynthia L. Chappell Center for Infectious Diseases, School of Public Health, University of Texas Health Science Center at Houston, Houston, Texas; Division of Infectious Diseases, Medical School, University of Texas Health Science Center at Houston, Houston, Texas; Department of Infectious Disease and Global Health, Tufts University Cummings School of Veterinary Medicine, North Grafton, Massachusetts

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Pablo C. Okhuysen Center for Infectious Diseases, School of Public Health, University of Texas Health Science Center at Houston, Houston, Texas; Division of Infectious Diseases, Medical School, University of Texas Health Science Center at Houston, Houston, Texas; Department of Infectious Disease and Global Health, Tufts University Cummings School of Veterinary Medicine, North Grafton, Massachusetts

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Rebecca C. Langer-Curry Center for Infectious Diseases, School of Public Health, University of Texas Health Science Center at Houston, Houston, Texas; Division of Infectious Diseases, Medical School, University of Texas Health Science Center at Houston, Houston, Texas; Department of Infectious Disease and Global Health, Tufts University Cummings School of Veterinary Medicine, North Grafton, Massachusetts

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Philip J. Lupo Center for Infectious Diseases, School of Public Health, University of Texas Health Science Center at Houston, Houston, Texas; Division of Infectious Diseases, Medical School, University of Texas Health Science Center at Houston, Houston, Texas; Department of Infectious Disease and Global Health, Tufts University Cummings School of Veterinary Medicine, North Grafton, Massachusetts

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Giovanni Widmer Center for Infectious Diseases, School of Public Health, University of Texas Health Science Center at Houston, Houston, Texas; Division of Infectious Diseases, Medical School, University of Texas Health Science Center at Houston, Houston, Texas; Department of Infectious Disease and Global Health, Tufts University Cummings School of Veterinary Medicine, North Grafton, Massachusetts

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Saul Tzipori Center for Infectious Diseases, School of Public Health, University of Texas Health Science Center at Houston, Houston, Texas; Division of Infectious Diseases, Medical School, University of Texas Health Science Center at Houston, Houston, Texas; Department of Infectious Disease and Global Health, Tufts University Cummings School of Veterinary Medicine, North Grafton, Massachusetts

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Although Cryptosporidium parvum and C. hominis cause the majority of human cryptosporidiosis cases, other Cryptosporidium species are also capable of infecting humans, particularly when individuals are immunocompromised. Ten C. muris cases have been reported, primarily in human immunodeficiency virus (HIV) -positive patients with diarrhea. However, asymptomatic cases were reported in two HIV-negative children, and in another case, age and immune status were not described. This study examines the infectivity of C. muris in six healthy adults. Volunteers were challenged with 105 C. muris oocysts and monitored for 6 weeks for infection and/or illness. All six patients became infected. Two patients experienced a self-limited diarrheal illness. Total oocysts shed during the study ranged from 6.7 × 106 to 4.1 × 108, and the number was slightly higher in volunteers with diarrhea (2.8 × 108) than asymptomatic shedders (4.4 × 107). C. muris-infected subjects shed oocysts longer than occurred with other species studied in healthy volunteers. Three volunteers shed oocysts for 7 months. Physical examinations were normal, with no reported recurrence of diarrhea or other gastrointestinal complaints. Two persistent shedders were treated with nitazoxanide, and the infection was resolved. Thus, healthy adults are susceptible to C. muris, which can cause mild diarrhea and result in persistent, asymptomatic infection.

Author Notes

* Address correspondence to Cynthia L. Chappell, University of Texas School of Public Health, 1200 Pressler Street, Room 644, Houston, TX 77030. E-mail: cynthia.l.chappell@uth.tmc.edu
† Theses authors contributed equally.

Financial support: This study was supported, in part, by National Center for Environmental Research Science To Achieve Results (STAR) Program of the Environmental Protection Agency Grant GR828035-01-0 (to C.L.C.), National Institutes of Health General Clinical Research Centers Grant RR-02558, and National Institute of Allergy and Infectious Diseases Grants AI52781 (to G.W.) and NO1-AI-25466 (to S.T.).

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