The oocysts of C. parvum are infectious when eliminated with the feces, and fewer than 30 of them are sufficient to cause an infection. Person-to-person spread readily occurs under conditions of poor sanitation. Infected individuals often have prolonged diarrhea and can continue to eliminate infectious cysts for 2 weeks or more after the diarrhea ceases. Moreover, the cysts can survive for long periods of time in food and water, are even more resistant to chlorine than Giardia, and are too small to be removed from drinking water by standard filtration methods. Equally troubling, C. parvum has a wide host range, infecting domestic animals such as dogs, pigs, and cattle. These animals, as well as humans, can contaminate food and drinking water. Epidemics have arisen from drinking water, swimming pools, a water slide, a zoo fountain, day care centers, unpasteurized apple juice, and other food and drink. The organism is responsible for many cases of traveler's diarrhea.
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