Skip to main content
    • Aa
    • Aa
  • Get access
    Check if you have access via personal or institutional login
  • Cited by 22
  • Cited by
    This article has been cited by the following publications. This list is generated based on data provided by CrossRef.

    Cacciò, S.M. and Chalmers, R.M. 2016. Human cryptosporidiosis in Europe. Clinical Microbiology and Infection, Vol. 22, Issue. 6, p. 471.

    Li, Fuhuang Wang, Haiyan Zhang, Zhenjie Li, Junqiang Wang, Chenrong Zhao, Jinfeng Hu, Suhui Wang, Rongjun Zhang, Longxian and Wang, Ming 2016. Prevalence and molecular characterization of Cryptosporidium spp. and Giardia duodenalis in dairy cattle in Beijing, China. Veterinary Parasitology, Vol. 219, p. 61.

    Malik, Tauseef Ahmad Kamili, Azra N. Chishti, M.Z. Tanveer, Syed Ahad, Shazia and Johri, R.K. 2016. Synergistic approach for treatment of chicken coccidiosis using berberine – A plant natural product. Microbial Pathogenesis, Vol. 93, p. 56.

    Robertson, Lucy J. 2016. Food Hygiene and Toxicology in Ready to Eat Foods.

    Sangster, Lucy Blake, Damer P. Robinson, Guy Hopkins, Timothy C. Sa, Ricardo C.C. Cunningham, Andrew A. Chalmers, Rachel M. and Lawson, Becki 2016. Detection and molecular characterisation of Cryptosporidium parvum in British European hedgehogs (Erinaceus europaeus). Veterinary Parasitology, Vol. 217, p. 39.

    Zahedi, Alireza Paparini, Andrea Jian, Fuchun Robertson, Ian and Ryan, Una 2016. Public health significance of zoonotic Cryptosporidium species in wildlife: Critical insights into better drinking water management. International Journal for Parasitology: Parasites and Wildlife, Vol. 5, Issue. 1, p. 88.

    Abdelrahma, Khaled A. Megeed, Kadria N. Abdel Hammam, Abdel Mohsen M. Morsy, Gazaa H. Seliem, Moshera M.E. and Aboelsoued, Dina 2015. Molecular Characterization of Bubaline Isolate of Cryptosporidium Species from Egypt. Research Journal of Parasitology, Vol. 10, Issue. 4, p. 127.

    Beser, Jessica Toresson, Linda Eitrem, Rickard Troell, Karin Winiecka-Krusnell, Jadwiga and Lebbad, Marianne 2015. Possible zoonotic transmission ofCryptosporidium felisin a household. Infection Ecology & Epidemiology, Vol. 5,

    Gajadhar, A.A. Lalonde, L.F. Al-Adhami, B. Singh, B.B. and Lobanov, V. 2015. Foodborne Parasites in the Food Supply Web.

    Huang, Min-Zhu Li, Jin Guan, Lan Li, Deng-Qing Nie, Xin-Min Gui, Rong and Chen, Xia 2015. Therapeutic effects of acetylspiramycin and garlicin on cryptosporidiosis among drug users. International Journal for Parasitology: Drugs and Drug Resistance, Vol. 5, Issue. 3, p. 185.

    Kaupke, Agnieszka and Rzeżutka, Artur 2015. Emergence of novel subtypes of Cryptosporidium parvum in calves in Poland. Parasitology Research, Vol. 114, Issue. 12, p. 4709.

    Liu, Xuehan Zhou, Xiaoxiao Zhong, Zhijun Zuo, Zhicai Shi, Jinjiang Wang, Yingzhu Qing, Baichun and Peng, Guangneng 2015. Occurrence of novel and rare subtype families of Cryptosporidium in bamboo rats (Rhizomys sinensis) in China. Veterinary Parasitology, Vol. 207, Issue. 1-2, p. 144.

    Rehn, Moa Wallensten, Anders Widerström, Micael Lilja, Mikael Grunewald, Maria Stenmark, Stephan Kark, Malin and Lindh, Johan 2015. Post-infection symptoms following two large waterborne outbreaks of Cryptosporidium hominis in Northern Sweden, 2010–2011. BMC Public Health, Vol. 15, Issue. 1,

    Sjöling, Åsa Sadeghipoorjahromi, Leila Novak, Daniel and Tobias, Joshua 2015. Detection of major diarrheagenic bacterial pathogens by multiplex PCR panels. Microbiological Research, Vol. 172, p. 34.

    Song, Juha Kim, C-Yoon Chang, Seo-Na Abdelkader, Tamer Said Han, Juhee Kim, Tae-Hyun Oh, Hanseul Lee, Ji Min Kim, Dong-Su Kim, Jong-Taek Oh, Hong-Shik Hur, Moonsuk Suh, Jae-Hwa and Park, Jae-Hak 2015. Detection and Molecular Characterization of <i>Cryptosporidium</i> spp. from Wild Rodents and Insectivores in South Korea. The Korean Journal of Parasitology, Vol. 53, Issue. 6, p. 737.

    Zhang, Xiao-Xuan Tan, Qi-Dong Zhou, Dong-Hui Ni, Xiao-Ting Liu, Guang-Xue Yang, Yan-Chuan and Zhu, Xing-Quan 2015. Prevalence and molecular characterization of Cryptosporidium spp. in dairy cattle, northwest China. Parasitology Research, Vol. 114, Issue. 7, p. 2781.

    Huang, Jianying Yue, Daoyou Qi, Meng Wang, Rongjun Zhao, Jinfeng Li, Junqiang Shi, Ke Wang, Ming and Zhang, Longxian 2014. Prevalence and molecular characterization of Cryptosporidium spp. and Giardia duodenalisin dairy cattle in Ningxia, northwestern China. BMC Veterinary Research, Vol. 10, Issue. 1,

    Wang, Rongjun Zhang, Longxian Axén, Charlotte Bjorkman, Camilla Jian, Fuchun Amer, Said Liu, Aiqin Feng, Yaoyu Li, Guoquan Lv, Chaochao Zhao, Zifang Qi, Meng Dong, Haiju Wang, Helei Sun, Yanru Ning, Changshen and Xiao, Lihua 2014. Cryptosporidium parvum IId family: clonal population and dispersal from Western Asia to other geographical regions. Scientific Reports, Vol. 4,

    Widerström, Micael Schönning, Caroline Lilja, Mikael Lebbad, Marianne Ljung, Thomas Allestam, Görel Ferm, Martin Björkholm, Britta Hansen, Anette Hiltula, Jari Långmark, Jonas Löfdahl, Margareta Omberg, Maria Reuterwall, Christina Samuelsson, Eva Widgren, Katarina Wallensten, Anders and Lindh, Johan 2014. Large Outbreak ofCryptosporidium hominisInfection Transmitted through the Public Water Supply, Sweden. Emerging Infectious Diseases, Vol. 20, Issue. 4, p. 581.

    Feng, Yaoyu Torres, Eucaris Li, Na Wang, Lin Bowman, Dwight and Xiao, Lihua 2013. Population genetic characterisation of dominant Cryptosporidium parvum subtype IIaA15G2R1. International Journal for Parasitology, Vol. 43, Issue. 14, p. 1141.


Molecular epidemiology and clinical manifestations of human cryptosporidiosis in Sweden

  • M. INSULANDER (a1), C. SILVERLÅS (a2), M. LEBBAD (a3), L. KARLSSON (a4), J. G. MATTSSON (a5) and B. SVENUNGSSON (a6)
  • DOI:
  • Published online: 09 August 2012

This study describes the epidemiology and symptoms in 271 cryptosporidiosis patients in Stockholm County, Sweden. Species/genotypes were determined by polymerase chain reaction–restriction fragment-length polymorphism (PCR–RFLP) of the Cryptosporidium oocyst wall protein (COWP) and 18S rRNA genes. Species were C. parvum (n=111), C. hominis (n=65), C. meleagridis (n=11), C. felis (n=2), Cryptosporidium chipmunk genotype 1 (n=2), and a recently described species, C. viatorum (n=2). Analysis of the Gp60 gene revealed five C. hominis allele families (Ia, Ib, Id, Ie, If), and four C. parvum allele families (IIa, IIc, IId, IIe). Most C. parvum cases (51%) were infected in Sweden, as opposed to C. hominis cases (26%). Clinical manifestations differed slightly by species. Diarrhoea lasted longer in C. parvum cases compared to C. hominis and C. meleagridis cases. At follow-up 25–36 months after disease onset, 15% of the patients still reported intermittent diarrhoea. In four outbreaks and 13 family clusters, a single subtype was identified, indicating a common infection source, which emphasizes the value of genotyping for epidemiological investigations.

Corresponding author
*Author for correspondence: B. Svenungsson M.D., Ph.D., Associate Professor, Smittskydd Stockholm, Box 17533, 118 91 Stockholm, Sweden. (Email:
Linked references
Hide All

This list contains references from the content that can be linked to their source. For a full set of references and notes please see the PDF or HTML where available.

2.R Fayer , M Santin , D Macarisin . Cryptosporidium ubiquitum n.sp. in animals and humans. Veterinary Parasitology 2011; 172: 2332.

3.R Fayer , M Santin . Cryptosporidium xiaoi n.sp. (Apicomplexa: Cryptosporidiidae) in sheep (Ovis aries). Veterinary Parasitology 2009; 164: 192200.

4.J Plutzer , P Karanis . Genetic polymorphism in Cryptosporidium species: an update. Veterinary Parasitology 2009; 165: 187199.

6.G Robinson , Re-description of Cryptosporidium cuniculus Inman and Takeuchi, 1979 (Apicomplexa: Cryptosporidiidae): morphology, biology and phylogeny. International Journal for Parasitology 2010; 40: 15391548.

7.K Elwin , Cryptosporidium viatorum n.sp (Apicomplexa: Cryptosporidiidae) among travellers returning to Great Britain from the Indian subcontinent, 2007–2011. International Journal for Parasitology. 2012. Published online April 2012. doi:

8.M Insulander , An outbreak of cryptosporidiosis associated with exposure to swimming pool water. Scandinavian Journal of Infectious Diseases 2005; 37: 354360.

10.WR MacKenzie , A massive outbreak in Milwaukee of Cryptosporidium infection transmitted through the public water supply. New England Journal of Medicine 1994; 331: 161167.

13.ME Mallon , Multilocus genotyping of Cryptosporidium parvum type 2: population genetics and sub-structuring. Infection, Genetics and Evolution 2003; 3: 207218.

15.B Svenungsson , Enteropathogens in adult patients with diarrhea and healthy control subjects: a 1-year prospective study in a Swedish clinic for infectious diseases. Clinical Infectious Disease 2000; 30: 770778.

16.M Lebbad , Dominance of Giardia assemblage B in Leon, Nicaragua. Acta Tropica 2008; 106: 4453.

17.L Xiao , Identification of 5 types of Cryptosporidium parasites in children in Lima, Peru. Journal of Infectious Diseases 2001; 183: 492497.

18.F Spano , PCR-RFLP analysis of the Cryptosporidium oocyst wall protein (COWP) gene discriminates between C. wrairi and C. parvum, and between C. parvum isolates of human and animal origin. FEMS Microbiology Letters 1997; 150: 209217.

19.RM Chalmers , Direct comparison of selected methods for genetic categorisation of Cryptosporidium parvum and Cryptosporidium hominis species. International Journal for Parasitology 2005; 35: 397410.

20.A Hajdu , Investigation of Swedish cases reveals an outbreak of cryptosporidiosis at a Norwegian hotel with possible links to in-house water systems. BMC Infectious Diseases 2008; 8: 152.

23.EJ Brook , Molecular epidemiology of Cryptosporidium subtypes in cattle in England. Veterinary Journal 2009; 179: 378382.

26.SF Molloy , Identification of a high diversity of Cryptosporidium species genotypes and subtypes in a pediatric population in Nigeria. American Journal of Tropical Medicine and Hygiene 2010; 82: 608613.

27.J Ng , B MacKenzie , U Ryan . Longitudinal multi-locus molecular characterisation of sporadic Australian human clinical cases of cryptosporidiosis from 2005 to 2008. Experimental Parasitology 2010; 125: 348356.

30.PR Wielinga , Molecular epidemiology of Cryptosporidium in humans and cattle in The Netherlands. International Journal for Parasitology 2008; 38: 809817.

32.F Leoni , Genetic analysis of Cryptosporidium from 2414 humans with diarrhoea in England between 1985 and 2000. Journal of Medical Microbiology 2006; 55: 703707.

33.W Saksirisampant , Intestinal parasitic infections: prevalences in HIV/AIDS patients in a Thai AIDS-care centre. Annals of Tropical Medicine and Parasitology 2009; 103: 573581.

34.W Gatei , Zoonotic species of Cryptosporidium are as prevalent as the anthroponotic in HIV-infected patients in Thailand. Annals of Tropical Medicine and Parasitology 2002; 96: 797802.

35.R Tiangtip , S Jongwutiwes . Molecular analysis of Cryptosporidium species isolated from HIV-infected patients in Thailand. Tropical Medicine and International Health 2002; 7: 357364.

38.IR Lake , Case-control study of environmental and social factors influencing cryptosporidiosis. European Journal of Epidemiology 2007; 22: 805811.

39.SS Ajjampur , Molecular and spatial epidemiology of cryptosporidiosis in children in a semiurban community in South India. Journal of Clinical Microbiology 2007; 45: 915920.

40.VA Cama , Cryptosporidium species and subtypes and clinical manifestations in children, Peru. Emerging Infectious Diseases 2008; 14: 15671574.

41.VA Cama , Differences in clinical manifestations among Cryptosporidium species and subtypes in HIV-infected persons. Journal of Infectious Diseases 2007; 196: 684691.

42.J Iqbal , N Khalid , PR Hira . Cryptosporidiosis in Kuwaiti children: association of clinical characteristics with Cryptosporidium species and subtypes. Journal of Medical Microbiology 2011; 60: 647–52.

43.JG Mattsson , Molecular typing of Cryptosporidium parvum associated with a diarrhoea outbreak identifies two sources of exposure. Epidemiology and Infection 2008; 136: 11471152.

44.LA Trotz-Williams , Genotype and subtype analyses of Cryptosporidium isolates from dairy calves and humans in Ontario. Parasitology Research 2006; 99: 346352.

45.AR Jex , Classification of Cryptosporidium species from patients with sporadic cryptosporidiosis by use of sequence-based multilocus analysis following mutation scanning. Journal of Clinical Microbiology 2008; 46: 22522262.

46.RM Chalmers , Geographic linkage and variation in Cryptosporidium hominis. Emerging Infectious Diseases 2008; 14: 496498.

47.Y Feng , Cryptosporidium genotype and subtype distribution in raw wastewater in Shanghai, China: evidence for possible unique Cryptosporidium hominis transmission. Journal of Clinical Microbiology 2009; 47: 153157.

48.R Wang , Genetic characterizations of Cryptosporidium spp. and Giardia duodenalis in humans in Henan, China. Experimental Parasitology 2011; 127: 4245.

Recommend this journal

Email your librarian or administrator to recommend adding this journal to your organisation's collection.

Epidemiology & Infection
  • ISSN: 0950-2688
  • EISSN: 1469-4409
  • URL: /core/journals/epidemiology-and-infection
Please enter your name
Please enter a valid email address
Who would you like to send this to? *