Karanis Panagiotis, Kourenti Christina, Smith Huw
Unit for Molecular Epidemiology and Protozoan Pathogenetics, National Research Center for Protozoan Diseases, Obihiro University for Agriculture and Veterinary Medicine, Inada-cho, Obihiro 080-8555, Japan.
J Water Health. 2007 Mar;5(1):1-38. doi: 10.2166/wh.2006.002.
At least 325 water-associated outbreaks of parasitic protozoan disease have been reported. North American and European outbreaks accounted for 93% of all reports and nearly two-thirds of outbreaks occurred in North America. Over 30% of all outbreaks were documented from Europe, with the UK accounting for 24% of outbreaks, worldwide. Giardia duodenalis and Cryptosporidium parvum account for the majority of outbreaks (132; 40.6% and 165; 50.8%, respectively), Entamoeba histolytica and Cyclospora cayetanensis have been the aetiological agents in nine (2.8%) and six (1.8%) outbreaks, respectively, while Toxoplasma gondii and Isospora belli have been responsible for three outbreaks each (0.9%) and Blastocystis hominis for two outbreaks (0.6%). Balantidium coli, the microsporidia, Acanthamoeba and Naegleria fowleri were responsible for one outbreak, each (0.3%). Their presence in aquatic ecosystems makes it imperative to develop prevention strategies for water and food safety. Human incidence and prevalence-based studies provide baseline data against which risk factors associated with waterborne and foodborne transmission can be identified. Standardized methods are required to maximize public health surveillance, while reporting lessons learned from outbreaks will provide better insight into the public health impact of waterborne pathogenic protozoa.
据报告，至少发生了325起与水相关的寄生原生动物疾病暴发事件。北美和欧洲的暴发事件占所有报告的93%，近三分之二的暴发事件发生在北美。全球范围内，超过30%的暴发事件来自欧洲，其中英国占暴发事件的24%。十二指肠贾第虫和微小隐孢子虫占暴发事件的大多数（分别为132起；40.6%和165起；50.8%），溶组织内阿米巴和卡耶塔环孢子球虫分别是9起（2.8%）和6起（1.8%）暴发事件的病原体，而刚地弓形虫和贝氏等孢球虫各导致3起暴发事件（0.9%），人芽囊原虫导致2起暴发事件（0.6%）。结肠小袋纤毛虫、微孢子虫、棘阿米巴和福氏耐格里阿米巴各导致1起暴发事件（0.3%）。它们在水生生态系统中的存在使得制定水和食品安全预防策略势在必行。基于人类发病率和患病率的研究提供了基线数据，据此可以确定与水传播和食物传播相关的风险因素。需要采用标准化方法以最大限度地加强公共卫生监测，同时报告从暴发事件中吸取的经验教训将有助于更好地了解水传播致病原生动物对公共卫生的影响。
