Transmission of Cryptosporidium by Fresh Vegetables

Consumption of fresh fruits and vegetables is increasing thanks to a greater awareness of the human health benefits. Vegetables may become contaminated by enteric pathogens (protozoan parasites, bacteria, and viruses) by irrigation with contaminated water, fertilization with fresh animal manure, or by infected food handlers. Cryptosporidium spp. are fecal-oral protozoan parasites, known to be highly persistent in the environment. Efficient methods were developed for releasing and concentrating Cryptosporidium oocysts from leafy vegetables, and sensitive and specific methods were applied for detection. The aims of this review are to discuss the development and optimization of methods applied to elute, concentrate, and detect oocysts from leafy vegetables, to review the prevalence of Cryptosporidium oocysts on fresh leafy vegetables from various parts of the world, and to discuss cryptosporidiosis outbreaks resulting from the consumption of leafy vegetables. Three solutions were used with comparable efficiency to release oocysts from leafy vegetables: 1 M glycine solution; 0.1% Alconox; and filter elution buffer, with an efficiency of 36.2, 72.6, and 44%, respectively. The prevalence of Cryptosporidium oocysts was reported in developed, as well as from developing countries, although simple detection methods were applied. Most of the cryptosporidiosis outbreaks were reported in developed countries, which can be related to the efficient surveillance system. Transmission of infectious pathogens, such as Cryptosporidium, may be facilitated by fresh vegetables, which are imported and transferred from less developed to highly developed countries and consumed uncooked. Monitoring of Cryptosporidium oocysts by sensitive detection methods may enhance measures to prevent transmission by freshly consumed vegetables.