Recent Diarrhea is Associated with Elevated Salivary IgG Responses to Cryptosporidium in Residents of an Eastern Massachusetts Community
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Serological data suggest that Cryptosporidium infections are common but underreported. The invasiveness of blood sampling limits the application of serology in epidemiological surveillance. We pilot-tested a non-invasive salivary anti-Cryptosporidium antibody assay in a community survey involving children and adults.
Materials and Methods:
Families with children were recruited in a Massachusetts community in July; symptoms data were collected at 3 monthly follow-up mail surveys. One saliva sample per person (n = 349) was collected via mail, with the last survey in October. Samples were analyzed for IgG and IgA responses to a recombinant C. hominis gp15 sporozoite protein using a time-resolved fluorometric immunoassay. Log-transformed assay results were regressed on age using penalized B-splines to account for the strong age-dependence of antibody reactions. Positive responses were defined as fluorescence values above the upper 99% prediction limit.
Forty-seven (13.5%) individuals had diarrhea without concurrent respiratory symptoms during the 3-month-long follow-up; eight of them had these symptoms during the month prior to saliva sampling. Two individuals had positive IgG responses: an adult who had diarrhea during the prior month and a child who had episodes of diarrhea during each survey month (Fisher’s exact test for an association between diarrhea and IgG response: p = 0.0005 for symptoms during the prior month and p = 0.02 for symptoms during the entire follow-up period). The child also had a positive IgA response, along with two asymptomatic individuals (an association between diarrhea and IgA was not significant).
These results suggest that the salivary IgG specific to Cryptosporidium antigens warrants further evaluation as a potential indicator of recent infections.
- Griffiths JK: Human cryptosporidiosis: epidemiology, transmission, clinical disease, treatment, and diagnosis. Adv Parasitol 1998; 40: 37–85. CrossRef
- Blackburn BG, Craun GF, Yoder JS, Hill V, Calderon RL, Chen N, Lee SH, Levy DA, Beach MJ: Surveillance for waterborne-disease outbreaks associated with drinking water — United States, 2001–2002. MMWR Surveill Summ 2004; 53: 23–45.
- Dziuban EJ, Liang JL, Craun GF, Hill V, Yu PA, Painter J, Moore MR, Calderon RL, Roy SL, Beach MJ, Centers for Disease Control and Prevention (CDC): Surveillance for waterborne disease and outbreaks associated with recreational water — United States, 2003–2004. MMWR Surveill Summ 2006; 55: 1–30.
- DuPont HL, Chappell CL, Sterling CR, Okhuysen PC, Rose JB, Jakubowski W: The infectivity of Cryptosporidium parvum in healthy volunteers. N Engl J Med 1995; 332: 855–859. CrossRef
- Chappell CL, Okhuysen PC, Sterling CR, Wang C, Jakubowski W, DuPont HL: Infectivity of Cryptosporidium parvum in healthy adults with pre-existing anti-C. parvum serum immunoglobulin G. Am J Trop Med Hyg 1999; 60: 157–164.
- Naumova EN, Chen JT, Griffiths JK, Matyas BT, Estes-Smargiassi SA, Morris RD: Use of passive surveillance data to study temporal and spatial variation in the incidence of giardiasis and cryptosporidiosis. Public Health Rep 2000; 115: 436–447. CrossRef
- Hlavsa MC, Watson JC, Beach MJ: Cryptosporidiosis surveillance — United States 1999–2002. MMWR Surveill Summ 2005; 54: 1–8.
- Yoder JS, Beach MJ, Centers for Disease Control and Prevention (CDC): cryptosporidiosis surveillance — United States, 2003–2005. MMWR Surveill Summ 2007; 56: 1–10.
- Jones JL, Lopez A, Wahlquist SP, Nadle J, Wilson M: Survey of clinical laboratory practices for parasitic diseases. Clin Infect Dis 2004; 38: S198–S202. CrossRef
- Roberts CL, Morin C, Addiss DG, Wahlquist SP, Mshar PA, Hadler JL: Factors influencing Cryptosporidium testing in Connecticut. J Clin Microbiol 1996; 34: 2292–2293.
- Borchardt MA, Chyou PH, DeVries EO, Belongia EA: Septic system density and infectious diarrhea in a defined population of children. Environ Health Perspect 2003; 111: 742–748. CrossRef
- de Wit MA, Koopmans MP, Kortbeek LM, van Leeuwen NJ, Vinjé J, van Duynhoven YT: Etiology of gastroenteritis in sentinel general practices in The Netherlands. Clin Infect Dis 2001; 33: 280–288. CrossRef
- Wheeler JG, Sethi D, Cowden JM, Wall PG, Rodrigues LC, Tompkins DS, Hudson MJ, Roderick PJ: Study of infectious intestinal disease in England: rates in the community, presenting to general practice, and reported to national surveillance. The Infectious Intestinal Disease Study Executive. BMJ 1999; 318: 1046–1050.
- Huhulescu S, Kiss R, Brettlecker M, Cerny RJ, Hess C, Wewalka G, Allerberger F: Etiology of acute gastroenteritis in three sentinel general practices, Austria 2007. Infection 2009; 37: 103–108. CrossRef
- Moss DM, Bennett SN, Arrowood MJ, Hurd MR, Lammie PJ, Wahlquist SP, Addiss DG: Kinetic and isotypic analysis of specific immunoglobulins fromcrewmembers with cryptosporidiosis on a U.S. Coast Guard cutter. J Eukaryot Microbiol 1994; 41: 52S–55S. CrossRef
- Moss DM, Bennett SN, Arrowood MJ, Wahlquist SP, Lammie PJ: Enzyme-linked immunoelectrotransfer blot analysis of a cryptosporidiosis outbreak on a United States Coast Guard cutter. Am J Trop Med Hyg 1998; 58: 110–118.
- Priest JW, Li A, Khan M, Arrowood MJ, Lammie PJ, Ong CS, Roberts JM, Isaac-Renton J: Enzyme immunoassay detection of antigen-specific immunoglobulin G antibodies in longitudinal serum samples from patients with cryptosporidiosis. Clin Diagn Lab Immunol 2001; 8: 415–423.
- Sandhu SK, Priest JW, Lammie PJ, Hubbard A, Colford JM Jr, Eisenberg JN: The natural history of antibody responses to Cryptosporidium parasites in men at high risk of HIV infection. J Infect Dis 2006; 194: 1428–1437. CrossRef
- Moss DM, Chappell CL, Okhuysen PC, DuPont HL, Arrowood MJ, Hightower AW, Lammie PJ: The antibody response to 27-, 17-, and 15-kDa Cryptosporidium antigens following experimental infection in humans. J Infect Dis 1998; 178: 827–833. CrossRef
- Frost FJ, Muller TB, Calderon RL, Craun GF: Analysis of serological responses to Cryptosporidium antigen among NHANES III participants. Ann Epidemiol 2004; 14: 473–478. CrossRef
- Gammie A, Morris R, Wyn-Jones AP: Antibodies in crevicular fluid: an epidemiological tool for investigation of waterborne disease. Epidemiol Infect 2002; 128: 245–249. CrossRef
- McKie A, Vyse A, Maple C: Novel methods for the detection of microbial antibodies in oral fluid. Lancet Infect Dis 2002; 2: 18–24. CrossRef
- Morris M, Cohen B, Andrews N, Brown D: Stability of total and rubella-specific IgG in oral fluid samples: the effect of time and temperature. J Immunol Methods 2002; 266: 111–116. CrossRef
- Vyse AJ, Cohen BJ, Ramsay ME: A comparison of oral fluid collection devices for use in the surveillance of virus diseases in children. Public Health 2001; 115: 201–207. CrossRef
- Morris-Cunnington MC, Edmunds WJ, Miller E, Brown DW: A novel method of oral fluid collection to monitor immunity to common viral infections. Epidemiol Infect 2004; 132: 35–42. CrossRef
- Cozon G, Biron F, Jeannin M, Cannella D, Revillard JP: Secretory IgA antibodies to Cryptosporidium parvum in AIDS patients with chronic cryptosporidiosis. J Infect Dis 1994; 169: 696–699.
- Moss DM, Montgomery JM, Newland SV, Priest JW, Lammie PJ: Detection of Cryptosporidium antibodies in sera and oral fluids using multiplex bead assay. J Parasitol 2004; 90: 397–404. CrossRef
- Cevallos AM, Zhang X, Waldor MK, Jaison S, Zhou X, Tzipori S, Neutra MR, Ward HD: Molecular cloning and expression of a gene encoding Cryptosporidium parvum glycoproteins gp40 and gp15. Infect Immun 2000; 68: 4108–4116. CrossRef
- Preidis GA, Wang HC, Lewis DE, Castellanos-Gonzalez A, Rogers KA, Graviss EA, Ward HD, White AC Jr: Seropositive human subjects produce interferon gamma after stimulation with recombinant Cryptosporidium hominis gp15. Am J Trop Med Hyg 2007; 77: 583–585.
- Hale ML, Campbell TA, Campbell YG, Fong SE, Stiles BG: Development of a time-resolved immunofluorometric assay for quantitation of mucosal and systemic antibody responses. J Immunol Methods 2001; 257: 83–92. CrossRef
- Kuhls TL, Mosier DA, Crawford DL, Griffis J: Seroprevalence of cryptosporidial antibodies during infancy, childhood, and adolescence. Clin Infect Dis 1994; 18: 731–735.
- Priest JW, Bern C, Xiao L, Roberts JM, Kwon JP, Lescano AG, Checkley W, Cabrera L, Moss DM, Arrowood MJ, Sterling CR, Gilman RH, Lammie PJ: Longitudinal analysis of Cryptosporidium species-specific immunoglobulin G antibody responses in Peruvian children. Clin Vaccine Immunol 2006; 13: 123–131. CrossRef
- Strong WB, Gut J, Nelson RG: Cloning and sequence analysis of a highly polymorphic Cryptosporidium parvum gene encoding a 60-kilodalton glycoprotein and characterization of its 15- and 45-kilodalton zoite surface antigen products. Infect Immun 2000; 68: 4117–4134. CrossRef
- Leav BA, Mackay MR, Anyanwu A, O’Connor RM, Cevallos AM, Kindra G, Rollins NC, Bennish ML, Nelson RG, Ward HD: Analysis of sequence diversity at the highly polymorphic Cpgp40/15 locus among Cryptosporidium isolates from human immunodeficiency virus-infected children in South Africa. Infect Immun 2002; 70: 3881–3890. CrossRef
- Sestak K, Ward LA, Sheoran A, Feng X, Akiyoshi DE, Ward HD, Tzipori S: Variability among Cryptosporidium parvum genotype 1 and 2 immunodominant surface glycoproteins. Parasite Immunol 2002; 24: 213–219. CrossRef
- Priest JW, Kwon JP, Arrowood MJ, Lammie PJ: Cloning of the immunodominant 17-kDa antigen from Cryptosporidium parvum. Mol Biochem Parasitol 2000; 106: 261–271. CrossRef
- Imhoff B, Morse D, Shiferaw B, Hawkins M, Vugia D, Lance-Parker S, Hadler J, Medus C, Kennedy M, Moore MR, Van Gilder T, tEmerging Infections Program FoodNet Working Group: Burden of self-reported acute diarrheal illness in FoodNet surveillance areas, 1998–1999. Clin Infect Dis 2004; 38: S219–S226. CrossRef
- Naumova EN, Jagai JS, Matyas B, DeMaria A Jr, MacNeill IB, Griffiths JK: Seasonality in six enterically transmitted diseases and ambient temperature. Epidemiol Infect 2007; 135: 281–292. CrossRef
- Recent Diarrhea is Associated with Elevated Salivary IgG Responses to Cryptosporidium in Residents of an Eastern Massachusetts Community
Volume 38, Issue 2 , pp 117-123
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- 1. National Center for Environmental Assessment, US Environmental Protection Agency, 26 W. Martin Luther King Drive, Mail Stop A110, Cincinnati, OH, 45268, USA
- 2. Dept. of Public Health and Community Medicine, Tufts University School of Medicine, Boston, MA, USA
- 3. Division of Geographic Medicine and Infectious Diseases, Dept. of Medicine, Tufts Medical Center, Boston, MA, USA
- 4. Centers for Disease Control and Prevention, Atlanta, GA, USA
- 5. Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, USA
- 6. Dept. of Civil and Environmental Engineering, School of Engineering, Tufts University, Medford, MA, USA
- 7. Cummings School of Veterinary Medicine, Tufts University, Grafton, MA, USA