Cryptosporidium hominis Is a Newly Recognized Pathogen in the Arctic Region of Nunavik, Canada: Molecular Characterization of an Outbreak.

BACKGROUND:Cryptosporidium is a leading cause of childhood diarrhea in low-resource settings, and has been repeatedly associated with impaired physical and cognitive development. In May 2013, an outbreak of diarrhea caused by Cryptosporidium hominis was identified in the Arctic region of Nunavik, Qu...

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Main Authors: Karine Thivierge, Asma Iqbal, Brent Dixon, Réjean Dion, Benoît Levesque, Philippe Cantin, Lyne Cédilotte, Momar Ndao, Jean-François Proulx, Cedric P Yansouni
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2016-04-01
Series:PLoS Neglected Tropical Diseases
Online Access:http://europepmc.org/articles/PMC4825996?pdf=render
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author Karine Thivierge
Asma Iqbal
Brent Dixon
Réjean Dion
Benoît Levesque
Philippe Cantin
Lyne Cédilotte
Momar Ndao
Jean-François Proulx
Cedric P Yansouni
author_facet Karine Thivierge
Asma Iqbal
Brent Dixon
Réjean Dion
Benoît Levesque
Philippe Cantin
Lyne Cédilotte
Momar Ndao
Jean-François Proulx
Cedric P Yansouni
author_sort Karine Thivierge
collection DOAJ
description BACKGROUND:Cryptosporidium is a leading cause of childhood diarrhea in low-resource settings, and has been repeatedly associated with impaired physical and cognitive development. In May 2013, an outbreak of diarrhea caused by Cryptosporidium hominis was identified in the Arctic region of Nunavik, Quebec. Human cryptosporidiosis transmission was previously unknown in this region, and very few previous studies have reported it elsewhere in the Arctic. We report clinical, molecular, and epidemiologic details of a multi-village Cryptosporidium outbreak in the Canadian Arctic. METHODOLOGY/PRINCIPAL FINDINGS:We investigated the occurrence of cryptosporidiosis using a descriptive study of cases with onset between April 2013 and April 2014. Cases were defined as Nunavik inhabitants of any age presenting with diarrhea of any duration, in whom Cryptosporidium oocysts were detected by stool microscopy in a specialised reference laboratory. Cryptosporidium was identified in stool from 51 of 283 individuals. The overall annual incidence rate (IR) was 420 / 100,000 inhabitants. The IR was highest among children aged less than 5 years (1290 /100,000 persons). Genetic subtyping for stool specimens from 14/51 cases was determined by DNA sequence analysis of the 60 kDa glycoprotein (gp60) gene. Sequences aligned with C. hominis subtype Id in all cases. No common food or water source of infection was identified. CONCLUSIONS/SIGNIFICANCE:In this first observed outbreak of human cryptosporidiosis in this Arctic region, the high IR seen is cause for concern about the possible long-term effects on growth and development of children in Inuit communities, who face myriad other challenges such as overcrowding and food-insecurity. The temporal and geographic distribution of cases, as well as the identification of C. hominis subtype Id, suggest anthroponotic rather than zoonotic transmission. Barriers to timely diagnosis delayed the recognition of human cryptosporidiosis in this remote setting.
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spelling doaj.art-0152412fe62547609262b2b49798f2e22022-12-21T23:33:50ZengPublic Library of Science (PLoS)PLoS Neglected Tropical Diseases1935-27271935-27352016-04-01104e000453410.1371/journal.pntd.0004534Cryptosporidium hominis Is a Newly Recognized Pathogen in the Arctic Region of Nunavik, Canada: Molecular Characterization of an Outbreak.Karine ThiviergeAsma IqbalBrent DixonRéjean DionBenoît LevesquePhilippe CantinLyne CédilotteMomar NdaoJean-François ProulxCedric P YansouniBACKGROUND:Cryptosporidium is a leading cause of childhood diarrhea in low-resource settings, and has been repeatedly associated with impaired physical and cognitive development. In May 2013, an outbreak of diarrhea caused by Cryptosporidium hominis was identified in the Arctic region of Nunavik, Quebec. Human cryptosporidiosis transmission was previously unknown in this region, and very few previous studies have reported it elsewhere in the Arctic. We report clinical, molecular, and epidemiologic details of a multi-village Cryptosporidium outbreak in the Canadian Arctic. METHODOLOGY/PRINCIPAL FINDINGS:We investigated the occurrence of cryptosporidiosis using a descriptive study of cases with onset between April 2013 and April 2014. Cases were defined as Nunavik inhabitants of any age presenting with diarrhea of any duration, in whom Cryptosporidium oocysts were detected by stool microscopy in a specialised reference laboratory. Cryptosporidium was identified in stool from 51 of 283 individuals. The overall annual incidence rate (IR) was 420 / 100,000 inhabitants. The IR was highest among children aged less than 5 years (1290 /100,000 persons). Genetic subtyping for stool specimens from 14/51 cases was determined by DNA sequence analysis of the 60 kDa glycoprotein (gp60) gene. Sequences aligned with C. hominis subtype Id in all cases. No common food or water source of infection was identified. CONCLUSIONS/SIGNIFICANCE:In this first observed outbreak of human cryptosporidiosis in this Arctic region, the high IR seen is cause for concern about the possible long-term effects on growth and development of children in Inuit communities, who face myriad other challenges such as overcrowding and food-insecurity. The temporal and geographic distribution of cases, as well as the identification of C. hominis subtype Id, suggest anthroponotic rather than zoonotic transmission. Barriers to timely diagnosis delayed the recognition of human cryptosporidiosis in this remote setting.http://europepmc.org/articles/PMC4825996?pdf=render
spellingShingle Karine Thivierge
Asma Iqbal
Brent Dixon
Réjean Dion
Benoît Levesque
Philippe Cantin
Lyne Cédilotte
Momar Ndao
Jean-François Proulx
Cedric P Yansouni
Cryptosporidium hominis Is a Newly Recognized Pathogen in the Arctic Region of Nunavik, Canada: Molecular Characterization of an Outbreak.
PLoS Neglected Tropical Diseases
title Cryptosporidium hominis Is a Newly Recognized Pathogen in the Arctic Region of Nunavik, Canada: Molecular Characterization of an Outbreak.
title_full Cryptosporidium hominis Is a Newly Recognized Pathogen in the Arctic Region of Nunavik, Canada: Molecular Characterization of an Outbreak.
title_fullStr Cryptosporidium hominis Is a Newly Recognized Pathogen in the Arctic Region of Nunavik, Canada: Molecular Characterization of an Outbreak.
title_full_unstemmed Cryptosporidium hominis Is a Newly Recognized Pathogen in the Arctic Region of Nunavik, Canada: Molecular Characterization of an Outbreak.
title_short Cryptosporidium hominis Is a Newly Recognized Pathogen in the Arctic Region of Nunavik, Canada: Molecular Characterization of an Outbreak.
title_sort cryptosporidium hominis is a newly recognized pathogen in the arctic region of nunavik canada molecular characterization of an outbreak
url http://europepmc.org/articles/PMC4825996?pdf=render
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