Epidemiology of Cryptosporidiosis in North American Travelers to Mexico

Parvathy Nair The University of Texas Health Science Center at Houston Medical School and School of Public Health, Houston, Texas; Baylor College of Medicine, Houston, Texas; Instituto Nacional de Salud Publica, Cuernavaca, Mexico; Universidad Autonoma de Guadalajara, Jalisco, Mexico

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Jamal A. Mohamed The University of Texas Health Science Center at Houston Medical School and School of Public Health, Houston, Texas; Baylor College of Medicine, Houston, Texas; Instituto Nacional de Salud Publica, Cuernavaca, Mexico; Universidad Autonoma de Guadalajara, Jalisco, Mexico

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Herbert L. DuPont The University of Texas Health Science Center at Houston Medical School and School of Public Health, Houston, Texas; Baylor College of Medicine, Houston, Texas; Instituto Nacional de Salud Publica, Cuernavaca, Mexico; Universidad Autonoma de Guadalajara, Jalisco, Mexico

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Jose Flores Figueroa The University of Texas Health Science Center at Houston Medical School and School of Public Health, Houston, Texas; Baylor College of Medicine, Houston, Texas; Instituto Nacional de Salud Publica, Cuernavaca, Mexico; Universidad Autonoma de Guadalajara, Jalisco, Mexico

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Lily G. Carlin The University of Texas Health Science Center at Houston Medical School and School of Public Health, Houston, Texas; Baylor College of Medicine, Houston, Texas; Instituto Nacional de Salud Publica, Cuernavaca, Mexico; Universidad Autonoma de Guadalajara, Jalisco, Mexico

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Zhi-Dong Jiang The University of Texas Health Science Center at Houston Medical School and School of Public Health, Houston, Texas; Baylor College of Medicine, Houston, Texas; Instituto Nacional de Salud Publica, Cuernavaca, Mexico; Universidad Autonoma de Guadalajara, Jalisco, Mexico

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Jaime Belkind-Gerson The University of Texas Health Science Center at Houston Medical School and School of Public Health, Houston, Texas; Baylor College of Medicine, Houston, Texas; Instituto Nacional de Salud Publica, Cuernavaca, Mexico; Universidad Autonoma de Guadalajara, Jalisco, Mexico

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Francisco G. Martinez-Sandoval The University of Texas Health Science Center at Houston Medical School and School of Public Health, Houston, Texas; Baylor College of Medicine, Houston, Texas; Instituto Nacional de Salud Publica, Cuernavaca, Mexico; Universidad Autonoma de Guadalajara, Jalisco, Mexico

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Pablo C. Okhuysen The University of Texas Health Science Center at Houston Medical School and School of Public Health, Houston, Texas; Baylor College of Medicine, Houston, Texas; Instituto Nacional de Salud Publica, Cuernavaca, Mexico; Universidad Autonoma de Guadalajara, Jalisco, Mexico

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We studied 1,179 North American travelers who visited Mexico from 2005 to 2007. Travelers’ diarrhea (TD) was reported by 521 (44%) participants. Among subjects with TD, 218 cases were examined for cryptosporidiosis by polymerase chain reaction (PCR) and enzyme-linked immunoassays (ELISA). There were 14 (6%) cases of cryptosporidiosis and 141 cases (64%) of bacterial diarrhea. Compared with bacterial diarrhea, a longer stay in Mexico was a risk factor for cryptosporidiosis. Additionally, Cryptosporidium cases passed greater number of watery stools (P < 0.05), suffered more episodes of diarrhea (P ≤ 0.05), and were more likely to experience tenesmus (P ≤ 0.05) compared with bacterial causes of TD. ELISA detected seven (3%) cases of Cryptosporidium, whereas PCR identified an additional seven cases (6%). Speciation by 18SrRNA sequencing showed that 13 cases were caused by C. parvum and only 1 case was caused by C. hominis. ELISA showed a sensitivity of 50% and specificity of 100% compared with PCR.

Author Notes

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