Prevention and Treatment

No preventive measures are available except boiling or filtering drinking water and thoroughly washing produce such as berries and leafy vegetables during an epidemic. Cotrimoxazole (trimetho-prim plus sulfamethoxazole) effectively treats most cases of cyclosporiasis.

The main features of cyclosporiasis are presented in table 24.15.

Amebiasis

Disease resulting from Entamoeba histolytica infection is called amebiasis. In the United States, cases occur mainly among male homosexuals who have many sexual partners, in poverty-stricken areas, and among migrant farm workers. Although usually a mild disease, worldwide it causes about 30,000 deaths per year, most of which occur in Mexico, parts of South America, Asia, and Africa. Life-threatening disease occurs in these areas because of the presence of virulent E. histolytica strains and crowded, unsanitary living conditions.

628 Chapter 24 Alimentary System Infections

Table 24.15 Cyclosporiasis

Symptoms

Fatigue, loss of appetite, vomiting, watery diarrhea, and weight loss. Symptoms improve in 3 to 4 days, but relapses can occur for up to a month

Incubation period

Usually about 1 week (range, 1 to 12 days)

Causative agent

Cyclospora cayetanensis, a coccidian

Pathogenesis

Biopsies of human intestine show sexual and asexual stages in the intestinal epithelium. Laboratory animals are not susceptible to the infection.

Epidemiology

The oocysts of C. cayetanensis are not infectious when discharged in the feces, and so person-to-person spread does not occur.Travelers to tropical countries are at risk of infection. Produce, especially raspberries, imported from tropical Central America, has been implicated in most North American outbreaks

Prevention and treatment

Use of boiled or filtered drinking water is advised in the tropics. Thorough washing of imported berries and leafy vegetables. Most victims are effectively treated with trimethoprim-sulfamethoxazole (trade names Bactrim, Septra)

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