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Abstract：
Cryptosporidium is a leading global cause of diarrhoea with many reported outbreaks related to water and zoonotic transmission. This study summarizes data from Public Health Surveillance reports since 2010 in New Zealand to describe exposures associated with human diarrhoea outbreaks caused by Cryptosporidium. We investigate the species and subtypes of cases involved in some of the outbreaks to elucidate transmission routes and the predominant aetiological agents of cryptosporidiosis. For the period 2010–2017, 318 cryptosporidiosis outbreaks were reported in New Zealand resulting in 1634 cases and 20 hospitalizations. The most important mode of transmission was person-to-person (primary infections and secondary or close contacts infections), relating to 260 outbreaks and 1320 cases, followed by 113 outbreaks associated with animals, resulting in 436 human cases. From 2018 to 2021, there were 37 cryptosporidiosis outbreaks associated with 324 cases. We identified the subtypes by using polymerase chain reaction targeting the gp60 gene and the likelihood of mixed subtype infections with the Tracking of Indels by DEcomposition (TIDE) algorithm. Subtype families Ib and Ig of Cryptosporidium hominis and IIa and IId of Cryptosporidium parvum were found among cases; however, C. hominis subtypes occurred in 8 of the 11 outbreaks reviewed where molecular data were available. Examination of the chromatograms showed no mixed subtype infections in the samples assessed. Subtyping data need to be routinely incorporated into national surveillance programmes to better understand the epidemiology, sources, transmission and extent of cryptosporidiosis outbreaks in New Zealand. Our study highlights the value of integrating epidemiological information and molecular typing to investigate and manage clusters of cryptosporidiosis cases.
摘要：
隐孢子虫是全球腹泻的主要原因，据报道许多与水和人畜共患传播有关的暴发。本研究总结了自2010年以来新西兰公共卫生监测报告的数据，以描述与隐孢子虫引起的人类腹泻暴发相关的暴露。我们调查了某些暴发中涉及的病例的种类和亚型，以阐明隐孢子虫病的传播途径和主要病因。在2010-2017年期间，新西兰报告了318例隐孢子虫病暴发，导致1634例病例和20例住院。最重要的传播方式是人与人之间（原发感染和继发或密切接触感染），与260起疫情和1320起病例有关，随后发生了113起与动物有关的疫情，导致436例人类病例。从2018年到2021年，有37例隐孢子虫病暴发，涉及324例病例。我们通过使用针对gp60基因的聚合酶链反应以及通过DEcomposition（TIDE）算法跟踪Indels的混合亚型感染的可能性来鉴定亚型。在病例中发现了人隐孢子虫的Ib和Ig亚型以及小隐孢子虫的IIa和IId亚型；但是，在可获得分子数据的11次疫情中，有8次发生了人源梭菌亚型。色谱图检查显示在所评估的样品中没有混合亚型感染。需要将亚型数据常规纳入国家监测方案，以更好地了解流行病学，来源,新西兰隐孢子虫病暴发的传播和程度。我们的研究强调了整合流行病学信息和分子分型对调查和管理隐孢子虫病病例群的价值。
