Trichinosis in the United States, 1971.
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Biomedical subjects
Publications and source records attributed to D D Juranek.
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Cryptosporidium, an intestinal protozoan parasite, is a well-known cause of diarrhea in animals but has been recognized only recently as a cause of human disease. Since 1976, 58 cases of cryptosporidiosis in humans have been reported; 18 of the patients had normal immune function, and 40 had various immunologic abnormalities, the most common of which, acquired immune deficiency syndrome (AIDS), occurred in 33 patients. Patients with normal immune function had self-limited diarrhea, but patients with immunologic abnormalities often developed severe, irreversible diarrhea; 22 patients have died. The diagnosis of cryptosporidiosis can now be made noninvasively, but increased diagnostic proficiency has led to little improvement in control or treatment of the disease. Although 23 compounds have been evaluated in experimentally infected animals and 20 drugs have been used in human clinical trials, no effective chemotherapeutic agent for cryptosporidiosis has been identified to date.
Deliberate food and water contamination remains the easiest way to distribute biological or chemical agents for the purpose of terrorism, despite the national focus on dissemination of these agents as small-particle aerosols or volatile liquids. Moreover, biological terrorism as a result of sabotage of our food supply has already occurred in the United States. A review of naturally occurring food- and waterborne outbreaks exposes this vulnerability and reaffirms that, depending on the site of contamination, a significant number of people could be infected or injured over a wide geographic area. Major knowledge gaps exist with regard to the feasibility of current disinfection and inspection methods to protect our food and water against contamination by a number of biological and chemical agents. However, a global increase in food and water safety initiatives combined with enhanced disease surveillance and response activities are our best hope to prevent and respond quickly to food- and waterborne bioterrorism.
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