Cryptosporidiosis

Cryptosporidiosis is an infection you get from the parasite Cryptosporidium. Most people get it after accidentally swallowing water that has Cryptosporidium in it — for example, public pools or swimming areas. The parasite reproduces in your digestive system and causes watery diarrhea and other stomach problems.

Cryptosporidiosis (krip-toh-spawr-i-dahy-OH-sis) is common. There are over 800,000 cases in the U.S. each year. It’s the second most common cause of diarrhea in children.

For most people, Cryptosporidium isn’t serious. But if you don’t have a healthy immune system, it can cause long-lasting diarrhea. Severe diarrhea can be life-threatening.

Another name for cryptosporidiosis is crypto.

What are the symptoms of cryptosporidiosis?

The most common symptoms include:

• Watery diarrhea, which may be severe — 10 or more instances a day
• Stomach pain and cramping
• Nausea
• Vomiting
• Loss of appetite
• Low fever

In some cases, you may have cryptosporidiosis without any symptoms.

What causes it?

A few different species of Cryptosporidium cause cryptosporidiosis. But C. hominis and C. parvum cause most infections.

Cryptosporidium is a protozoan parasite. It’s a one-celled organism that lives off animals and people. It’s very small — you can only see it with a microscope.

How is it transmitted?

The crypto parasite spreads through the fecal-oral route — contaminated poop (feces) gets into your mouth. The most common ways in which this happens is through:

• Contaminated water: This may include untreated drinking water or accidentally swallowing contaminated water from a lake, swimming pool, hot tub or water park. Chlorine doesn’t kill Cryptosporidium. Contaminated water is the most common way to get crypto.
• Contaminated food: This includes unwashed fruits and veggies, as well as unpasteurized apple cider and milk.
• Contaminated items or surfaces: You can get crypto by touching items or surfaces that someone with crypto has come into contact with. For example, it’s common to get it from changing your baby’s dirty diapers when they’re sick.
• Infected animals: Touching petting zoo and farm animals can spread crypto.
• Sexual intercourse with an infected person: Crypto isn’t a sexually transmitted infection (STI). But you can get it from touching an infected partner’s anus (butthole) during sexual activity.

Risk factors

Anyone can get cryptosporidiosis. But children between 1 and 4 are the most likely to get it. It spreads easily among kids because they usually don’t have good handwashing habits or understand how germs spread. Infected poop in diapers also helps spread crypto.

You’re also at a higher risk of getting crypto if you:

• Are over 75
• Live or work with young children
• Drink unfiltered or untreated water, like if you’re traveling, hiking or camping
• Work with animals, especially farm animals or livestock
• Spend time in public pools, lakes or rivers
• Take care of someone who has cryptosporidiosis

You’re at risk of severe, long-term illness if you have a weakened immune system. You may have a weakened immune system if you:

• Have HIV or AIDS
• Have cancer
• Receive an organ or stem cell transplant
• Take immunosuppressants

Complications

Dehydration is one of the most common cryptosporidiosis complications. Pregnant women and infants are at a very high risk. Dehydration may cause problems like:

• Electrolyte imbalance
• Hypovolemia

Other crypto complications may include:

• Bile duct, gallbladder or pancreatic disease
• Slow growth in children

How is cryptosporidiosis diagnosed?

Your healthcare provider will first:

• Review your health history
• Ask about your symptoms
• Do a physical exam

If they think you may have cryptosporidiosis, they’ll recommend a poop (stool) test to check for Cryptosporidium. Some days, you may have a lot of parasites in your poop. But others, you may not have many at all. To make an accurate diagnosis, you may have to give a few samples over several days.

How is cryptosporidiosis treated?

If you have a healthy immune system, crypto usually goes away on its own in about two to three weeks. It’s important to drink plenty of fluids and keep yourself hydrated.

Your provider may recommend over-the-counter antidiarrheal medications, like loperamide (Imodium A-D^®) or bismuth subsalicylate (Pepto-Bismol^®). In some cases, they may prescribe a medication like diphenoxylate-atropine (Lomotil^®). These medications help prevent dehydration and mineral loss. In severe cases, you may need IV fluids to prevent or treat dehydration.

Your provider may also recommend an antiprotozoal medication, like nitazoxanide (Alinia^®). These medicines help kill Cryptosporidium and stop it from growing. Nitazoxanide isn’t effective if you have a weakened immune system.

If you have HIV or AIDS, your provider may recommend antiretroviral therapy (ART). This helps keep your immune system healthy so it can clear the parasite on its own.

Your provider will also help manage any underlying conditions you may have. This can also help manage cryptosporidiosis symptoms.

Recovery time

If you have a healthy immune system, you should feel better after a few weeks. But in some cases, your symptoms may come and go for about a month.

If your healthcare provider prescribes an antiprotozoal medication, you may start to feel better after about five days. Be sure to take all your medication as prescribed, even if you start to feel better.

Does Cryptosporidium ever go away?

If you have a weakened immune system, cryptosporidiosis may take a long time to go away — you may have symptoms for months or years.

In some cases, it may not ever go away. Many people who have AIDS will never get rid of Cryptosporidium after an infection. It may not cause serious illness. But if it does, healthcare providers will work with you to make your symptoms more manageable.

When should I see my healthcare provider?

Contact your healthcare provider if you have several bouts of watery diarrhea per day. Reach out again if your symptoms come back or get worse, if you get new symptoms or if you have severe dehydration symptoms like:

• Confusion
• Light-headedness or dizziness, especially when you stand
• Not peeing much or at all
• Dark-colored pee

See your provider right away if you have a weakened immune system and experience any infectious disease symptoms.

During your appointment, you may want to ask questions like:

• How can I manage my symptoms at home?
• What should I eat or drink?
• Are there any foods or drinks I should avoid?
• How can I avoid spreading cryptosporidiosis?

What can I expect if I have cryptosporidiosis?

For most people, it’s a self-limiting condition. That means it’ll go away on its own. But because of Cryptosporidium’s life cycle, your symptoms may go away and come back over several weeks to a month.

You can still spread the parasite for up to two weeks after your symptoms stop. Make sure you take steps to help prevent it from spreading.

Is there anything I can do to feel better?

Making sure you’re hydrated helps. Drink plenty of fluids, including:

• Water
• Broth
• Sports drinks

Don’t drink caffeinated drinks or alcohol. If you’re able, take small bites of food.

Can cryptosporidiosis be prevented?

It spreads easily. Alcohol-based hand sanitizers and pool chlorine won’t kill the parasite. Regularly taking precautions can help prevent you or anyone else from getting it. These include:

• Washing your hands often, especially before eating and after using the bathroom or touching animals
• Teaching children how important it is to wash their hands
• Washing fruit and veggies before eating
• Avoiding swimming if you have diarrhea, and waiting at least two weeks to swim after it goes away
• Avoiding untreated water or unpasteurized milk
• Avoiding sexual intercourse for at least two weeks after having diarrhea

If you have a weakened immune system, it’s best to avoid public swimming areas.

If you have HIV or AIDS, use condoms or dental dams every time you have sexual intercourse. That includes acts that could lead to direct contact with poop (like anilingus or rimming) or indirect contact (like penile-anal sex).