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Published on: September 14, 2019
Molecular typing of Cryptosporidium in Israel
Tamar Grossman1, Shifra Ken-Dror2, Elsa Pavlotzky2
1Public Health Central Laboratories, Jerusalem, Israel.
Abstract:
Cryptosporidium is a protozoan parasite associated with gastrointestinal illness. In immune-compromised individuals, the infection may become life-threatening. Cryptosporidiosis is a mandatory-reported disease but little was known about its prevalence and associated morbidity in Israel. Currently, laboratory diagnosis is based on microscopy or copro-antigen tests and the disease is underreported. Molecular assays, which are more sensitive and specific, are now increasingly used for identification and screening. Here, the molecular epidemiology of cryptosporidiosis is explored for the first time. Samples from 33 patients infected during an outbreak of 146 laboratory confirmed cases that occurred in Haifa and Western Galilee in 2015 were genotyped, as well as samples from 36 patients sporadically infected during 2014-2018 in different regions. The results suggest that Cryptosporidium subtypes found in Israel are more similar to those reported in the neighboring countries Jordan and Egypt than in European countries. C. hominis was the predominant species in the center and the north of Israel, implicating human-to-human transmission. C. hominis IeA11G3T3 was the most prevalent subtype contributing to morbidity.
Insights
Cryptosporidiosis, a gastrointestinal illness, is underreported in Israel. Molecular analysis reveals subtypes similar to neighboring countries, with Cryptosporidium hominis being the predominant species, indicating human-to-human transmission.
Area of Science:
- * Infectious Diseases
- * Molecular Epidemiology
- * Parasitology
Background:
- * Cryptosporidium causes gastrointestinal illness, potentially severe in immunocompromised individuals.
- * Cryptosporidiosis is a mandatory-reported disease in Israel, yet prevalence and morbidity data are scarce.
- * Current diagnostic methods (microscopy, antigen tests) have limitations; molecular assays offer improved sensitivity and specificity.
Purpose of the Study:
- * To investigate the molecular epidemiology of cryptosporidiosis in Israel for the first time.
- * To identify Cryptosporidium species and subtypes circulating in Israel.
- * To compare Israeli subtypes with those from neighboring countries and Europe.
Main Methods:
- * Genotyping of Cryptosporidium samples from 33 patients during a 2015 outbreak (Haifa and Western Galilee).
- * Genotyping of samples from 36 patients with sporadic infections between 2014-2018 across different regions.
- * Utilized molecular assays for sensitive and specific identification and screening.
Main Results:
- * Cryptosporidium subtypes in Israel show greater similarity to those in Jordan and Egypt than in European countries.
- * Cryptosporidium hominis was the predominant species identified in central and northern Israel.
- * The C. hominis IeA11G3T3 subtype was the most prevalent, contributing significantly to patient morbidity.
Conclusions:
- * Molecular epidemiology provides crucial insights into cryptosporidiosis patterns in Israel.
- * Findings suggest regional similarities in circulating Cryptosporidium subtypes.
- * The prevalence of C. hominis indicates a significant role for human-to-human transmission in Israel.
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