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. 2019 Sep 3;14(9):e0219977.
doi: 10.1371/journal.pone.0219977. eCollection 2019.

Molecular typing of Cryptosporidium in Israel

Tamar Grossman  1 , Shifra Ken-Dror  2 , Elsa Pavlotzky  2 , Julia Vainer  1 , Yael Glazer  3 , Orli Sagi  4 , Avi Peretz  5   6 , Vered Agmon  1 , Esther Marva  1 , Lea Valinsky  1
Affiliations

Molecular typing of Cryptosporidium in Israel

Tamar Grossman et al. PLoS One. .

Abstract

Cryptosporidium is a protozoan parasite associated with gastrointestinal illness. In immune-compromised individuals, the infection may become life-threatening. Cryptosporidiosis is a mandatory-reported disease but little was known about its prevalence and associated morbidity in Israel. Currently, laboratory diagnosis is based on microscopy or copro-antigen tests and the disease is underreported. Molecular assays, which are more sensitive and specific, are now increasingly used for identification and screening. Here, the molecular epidemiology of cryptosporidiosis is explored for the first time. Samples from 33 patients infected during an outbreak of 146 laboratory confirmed cases that occurred in Haifa and Western Galilee in 2015 were genotyped, as well as samples from 36 patients sporadically infected during 2014-2018 in different regions. The results suggest that Cryptosporidium subtypes found in Israel are more similar to those reported in the neighboring countries Jordan and Egypt than in European countries. C. hominis was the predominant species in the center and the north of Israel, implicating human-to-human transmission. C. hominis IeA11G3T3 was the most prevalent subtype contributing to morbidity.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. Reported Cryptosporidium cases in Israel and incidence rate 2001–2018.
Fig 2
Fig 2. Diagnosis and molecular genotyping.
Fig 3
Fig 3. Cryptosporidium cases in Haifa and West Galilee per month during 2015.
Fig 4
Fig 4. Age distribution of Cryptosporidium cases in Haifa and West Galilee during 2015.
Fig 5
Fig 5. The geographic distribution and genotypes of Cryptosporidium cases in Israel.
A. Residence of the 2015 outbreak patients (N = 146), ploted on Haifa and West Galilee geographic map. B. Residence of genotyped patients. Purple, identyfied at the HMO but not genotyped; Red, C. hominis IeA11G3T3; Green, C. hominis IbA6G3. Grey, C. hominis IdA16; Light Blue, C. hominis IbA10G2; Yellow, C. parvum IIdA20G; Orange, C. parvum IIaA15G2R1. Maps were generated using Microreact [31]; A dynamic version that includes the tested determinants can be found at Microreact https://microreact.org/project/1hgtRJKlg/4da49c44 and https://microreact.org/project/HD3sxQKDh/350ce02e for Fig 5A and Fig 5B, respectively.
Fig 6
Fig 6. Cryptosporidium cases per month in Haifa and West Galilee HMO 2003–2018.
The number of cases per month in the years 2003–2018 are shown (national database).
See this image and copyright information in PMC

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