School of Veterinary and Life Sciences,Murdoch University,Perth,Australia.
OzFoodNet Communicable Disease Control Directorate,Perth,Western Australia,Australia.
Epidemiol Infect. 2018 Aug;146(11):1413-1424. doi: 10.1017/S0950268818001607. Epub 2018 Jul 5.
Cryptosporidium is a protozoan parasite that causes the diarrhoeal disease, cryptosporidiosis. Although many species have been identified, the majority of human disease worldwide is caused by two species; Cryptosporidium parvum and Cryptosporidium hominis. In Australia, data from the National Notifiable Diseases Surveillance System (NNDSS) show that cryptosporidiosis outbreaks occur every few years. To better understand the transmission, trends and nature of cryptosporidiosis outbreaks in Western Australia, epidemiological and genomic data from three cryptosporidiosis outbreaks in 2003, 2007 and 2011 were reviewed. The 2007 outbreak was the largest (n = 607) compared with the outbreaks in 2003 (n = 404) and 2011 (n = 355). All three outbreaks appeared to have occurred predominantly in the urban metropolitan area (Perth), which reported the highest number of case notifications; increases in case notifications were also observed in rural and remote areas. Children aged 0-4 years and non-Aboriginal people comprised the majority of notifications in all outbreaks. However, in the 2003 and 2007 outbreaks, a higher proportion of cases from Aboriginal people was observed in the remote areas. Molecular data were only available for the 2007 (n = 126) and 2011 (n = 42) outbreaks, with C. hominis the main species identified in both outbreaks. Subtyping at the glycoprotein 60 (gp60) locus identified subtype IbA10G2 in 46.3% and 89.5% of C. hominis isolates typed, respectively, in the 2007 and 2011 outbreaks, with the IdA15G1 subtype was identified in 33.3% of C. hominis isolates typed in the 2007 outbreak. The clustering of cases with the IdA15G1 subtype in the remote areas suggests the occurrence of a concurrent outbreak in remote areas during the 2007 outbreak, which primarily affected Aboriginal people. Both the C. hominis IbA10G2 and IdA15G1 subtypes have been implicated in cryptosporidiosis outbreaks worldwide; its occurrence indicates that the mode of transmission in both the 2007 and 2011 outbreaks was anthroponotic. To better understand the epidemiology, sources and transmission of cryptosporidiosis in Australia, genotyping data should routinely be incorporated into national surveillance programmes.
隐孢子虫是一种引起腹泻病的原生动物寄生虫，称为隐孢子虫病。尽管已经鉴定出许多种，但全世界大多数人类疾病是由两种引起的；小隐孢子虫和人隐孢子虫。在澳大利亚，国家法定传染病监测系统（NNDSS）的数据显示，每隔几年就会爆发隐孢子虫病。为了更好地了解西澳大利亚州隐孢子虫病爆发的传播、趋势和性质，对 2003 年、2007 年和 2011 年三次隐孢子虫病爆发的流行病学和基因组数据进行了回顾。与 2003 年（404 例）和 2011 年（355 例）的爆发相比，2007 年的爆发规模最大（n = 607）。所有三次爆发似乎都主要发生在城市大都市区（珀斯），该地区报告的病例通知数量最多；在农村和偏远地区也观察到病例通知的增加。在所有爆发中，年龄在 0-4 岁的儿童和非原住民占大多数。然而，在 2003 年和 2007 年的爆发中，在偏远地区观察到更多的原住民病例。只有 2007 年（n = 126）和 2011 年（n = 42）爆发的分子数据可用，在两次爆发中均鉴定出人隐孢子虫为主导物种。在糖蛋白 60（gp60）基因座的亚分型在 2007 年和 2011 年爆发中分别鉴定出 I 型 A10G2 和 89.5%的人隐孢子虫分离株，在 2007 年爆发中鉴定出 33.3%的人隐孢子虫分离株为 I 型 A15G1 亚型。在偏远地区发现 I 型 A15G1 亚型的病例聚类表明，在 2007 年爆发期间，偏远地区同时发生了一次爆发，主要影响原住民。人隐孢子虫的 I 型 A10G2 和 I 型 A15G1 亚型都与全世界的隐孢子虫病爆发有关；其发生表明 2007 年和 2011 年爆发的传播模式均为人际传播。为了更好地了解澳大利亚隐孢子虫病的流行病学、来源和传播，应定期将基因分型数据纳入国家监测计划。
