TechLab

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TechLab
Parasitology

• GIARDIA TEST
• Cryptosporidium TEST
• E.histolytica II TEST

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Giardia lamblia

• Background
• Morphology and life cycle
• Incidence
• Symptoms
• Available Tests for diagnosis

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Background

• First described by Leeuwenhoek in 1681
• First report of Giardiasis credited to Lambl in
  1859
• The most commonly diagnosed flagellate in the
  intestinal tract
• Three groups have been described
• Giardia muris - rodents, birds, reptiles.
• Giardia agilis - amphibians
• Giardia intestinalis (lamblia) - mammals

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SEM Giardia lamblia
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Incidence

• The most commonly isolated intestinal parasite
  worldwide
• Especially prevalent in children - outbreaks in
  daycare centers and within families
• Giardia cysts have been detected in 81 of raw
  water samples and 17 of filtered
• Waterborne transmission is a cause of Giardiasis
  in travelers and backpackers
• Can be sexually transmitted

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Symptoms

• Incubation period is usually 1-2 weeks
• Low grade fever, chills, nausea and anorexia can
  be early symptoms
• Subsequently - explosive, watery, foul smelling
  diarrhea marked abdominal gurgling flatulence
  abdominal distension and belching with a foul
  taste.
• The acute stage can resemble travelers diarrhea
  and is often not recognized as giardiasis

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A common symptom of Giardiasis is flatulence
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Available Tests

• Iodine Wet Mount
• Immunofluorescent antibody Test
• Enzyme Immunoassays
• Rapid assays - gold conjugates

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GIARDIA TEST

• Monoclonal antibody based
• Detects a cyst wall protein (CWP1)
• Variable first incubation time (results available
  in as little as 40mins)
• 3 wash steps
• Sensitivity 97 - 100
• Specificity 100

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Giardia Tests

• TechLab GIARDIA TEST
• Alexon Trend ProspecT (both micorplate flow
  through)
• Seradyn Color Vue Giardia (subsidiary of
  Alexon-Trend)
• Remel RIM (subisidiary of Alexon-Trend)
• Biosite Triage Parasite Panel
• BD ColorPac

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Available Tests for Giardia
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TechLab GIARDIA TEST

• Monoclonal antibody based
• The only test available where the protein
  detected has been fully characterized
• Detects the same protein as the other monoclonal
  antibody based tests
• Using a 10min first incubation, it is the most
  rapid microtiter EIA available
• Can be run in the same format as the
  Cryptosporidium TEST

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Cryptosporidium

• Background
• Morphology and life cycle
• Incidence
• Symptoms
• Available Tests for diagnosis

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Background

• First description of an organism resembling
  Cryptosporidia was by Clark in 1895
• In 1910 Tyzzer proposed the genus name
  Cryptosporidium for the protozoan parasite
• 1976 - first human case of Cryptosporidiosis
  described
• 1980s the onset of AIDs in the US brought
  attention to the association of Cryptosporidium
  with diarrheal illness
• Only species infectious to humans is C.parvum

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Incidence

• The prevalence rate in North America and Europe
  is 1 - 3
• It can reach up to 20 in underdeveloped
  countries
• Children are the most susceptible
• Several nosocomial infections have been reported
• Patients with late stage AIDs are very
  susceptible and develop life threatening diarrhea

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Incidence continued.

• Waterborne outbreaks continue to be a problem as
  the organism is resistant to chlorine and passes
  through filters of both filtration plants and
  public swimming pools
• In 1993, 400,000 people in Milwaukee Wisconsin
  were exposed over 100 died.
• Swimming pools are a source of infection due to
  babies in diapers and AFR (accidental fecal
  release)
• Can be foodborne

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Symptoms

• Incubation period is 5 to 28 days
• Diarrhea is profuse and watery with as many as 71
  stools per day and up to 17 liters per day
• May be accompanied by low grade fever, nausea and
  vomiting
• Symptoms wax and wane and may correlate with
  oocyst shedding

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Available Tests

• Microscopy
• Immunofluorescent Test
• EIA
• Lateral Flow Immunochromatographic Tests

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Microscopy for Cryptosporidium is insensitive due
to the small size of the organism - it is very
difficult to see!
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Cryptosporidium Tests

• TechLab Cryptosporidium TEST
• Alexon Trend ProspecT Cryptosporidium (in both
  microplate and flow through format)
• Seradyn Color Vue Cryptosporidium (subsidiary of
  Alexon Trend)
• Alexon Trend Giardia/Cryptosporidium Assay
• Biosite Triage Parasite Panel
• BD ColorPac Giardia/Cryptosporidium

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Available Tests for Cryptosporidium
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TechLab Cryptosporidium TEST

• Monoclonal Antibody based
• 2 wash steps
• Sensitivity 97
• Specificity 97.7 - 100
• Crypto and Giardia Tests can be run in the same
  format (Crypto format)

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Entamoeba histolytica

• Background
• Morphology and life cycle
• Incidence
• Symptoms
• Available Tests

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Background

• Presence of organism was first described in a
  woodworker in Northern Russia in 1875
• In 1925 Brumpt differentiated a pathogenic
  invasive form from a non pathogenic form
• Recently Clark and Diamond verified the existence
  of both pathogenic and non pathogenic strains

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Incidence

• Infections occur worldwide and it has been
  suggested that 12 of the worlds population may
  be infected
• 10 develop clinical symptoms causing between
  40,000 to 120,000 deaths per year
• Transmission by water is common in developing
  countries and does occur in this country
• Serious outbreaks have occurred in the USA,
  however, are not well documented
• Can be sexually transmitted and foodborne

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Symptoms

• Incubation period varies from a few days to
  months
• asymptomatic colonization
• acute amebic colitis - abdominal pain, bloody
  stools, fever
• fulminant colitis - abdominal pain, profuse
  bloody diarrhea, fever
• ameboma - asymptomatic lesion or a tender mass
  accompanied by dysentery

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Available Tests

• Microscopy
• Culture and zymodeme analysis
• TechLab E.histolytica Test
• Alexon Trend Entamoeba histolytica Test
• Biosite Triage Parasite Panel