Læknablaðið - 15.05.1990, Síða 46

266
LÆKNABLAÐIÐ
Tafla. Upplýsingar um sjúklinga sem greinst hafa meö Cryptosporidium sp. á íslandi.
Aldur Sjúkrahúsvist Niðurgangur Ógleði/Uppköst Hiti Uppþornun Nýlega erlendis Aðrar upplýsingar
13 mán. .. já 3 dagar já já já nei -
18 mán. .. já 4 dagar já ? já nei undanfarandi hlaupabóla
18 mán. .. já 12 dagar nei já já nei neytti ógerilsneyddrar mjólkur; Campylobacter sýking
32 mán. .. já 1-2 vikur já já já já Salmonella sýking
6 ára.... já já já Já já nei iörakveisa skömmu áöur
11 ára .... já 2 dagar já já já nei neytti ógerilsneyddrar mjólkur
19 ára .... já 1 vika já já ? nei skert lifrarstarfsemi greind síöar
21 ára .... nei já nei ? ? nei Crohn’s sjúkdómur greindist síöar
39 ára .... já um 1 mán. nei já ? nei á ónæmisbælandi lyfjum
Þrjú tilfellanna í bömum komu úr sama
læknishéraði á Suðurlandi með nokkurra
vikna millibili. Þetta gæti hugsanlega bent til
staðbundins smits.
Líklegt má telja að Cryptosporidium
sé landlægt bæði í mönnum og dýmm.
Sníkjudýrsins hefur þó ekki enn orðið vart í
dýrum hér á landi enda þess ekki verið leitað
í þeim á skipulegan hátt enn sem komið er.
Meðal annars þess vegna er of snemmt að
fullyrða nokkuð um hugsanlegar smitleiðir.
ÞAKKIR
Höfundar þakka læknum þeirra sjúklinga sem
greinst hafa með Cryptosporidium sp. fyrir að
hafa góðfúslega veitt upplýsingar um einstök
tilfelli.
SUMMARY
Infections caused by the coccidian Cryptosporidium
in humans in Iceland.
At the Institute for Experimental Pathology,
University of Iceland, Keldur, Reykjavík, routine
parasitological examinations of stool samples from
humans are performed.
Searching for Ciyptosporidium has been included
in these examinations since 1986. Among 1215
persons of all age examined from the beginning
of 1986 through June 1989, most of whom had
gastrointestinal symptoms, 9 (0.7%) were found to
be infected with Ciyptosporidium. The diagnosis
was based on the detection of Cryptosporidium
oocysts in faecal samples using the formalin
- ether/ethylacetat concentration method. For
verification these samples were stained by a
modified Ziehl-Neelsen technique.
Six of the patients were children and three were
adults. All patients had symptoms of gastroenteritis
and eight of them were hospitalized at the time of
diagnosis. In seven cases Ciyptosporidium was
the only pathogen found. One of the adults was
receiving immunosuppressive treatment and another
adult was later diagnosed with Crohn’s disease.
In all the children Cryptosporidium was diagnosed
during the months of June-September and in the
adults during October-December. Only one of the
patients had recently travelled abroad. Five of the
six children came from rural districts but the sixth
acquired symptoms abroad. Three of the infected
children came from the same rural district during
the summer of 1987 possibly indicating a local
source of infection.
The data indicate that Cryptosporidium sp. is
endemic in Iceland. The source of infection
is not known. Studies on the prevalence of
Cryptosporidium in animals in Iceland have not
yet been performed.
HEIMILDIR
1. Current WL. The biology of Cryptosporidium. ASM
News 1988; 54: 605-1 L
2. Fayer R, Ungar BLP. Cryptosporidium spp. and
cryptosporidiasis. Microbiol Rev 1986; 50: 458-83.
3. Mehihom H, ed. Parasitology in Focus. Berlin,
Heidelberg, New York: Springer-Verlag 1988.
4. Piekarski G. Medical Parasitology. New York,
Heidelberg, Berlin: Springer Verlag 1989.
5. Richter SH, Eydal M, Skímisson K. Sníkjudýr í
mönnum á Islandi fundin við rannsóknir á ámnum
1973-1988. Læknablaðið 1990; 76: 224-5.
6. Allen AVH, Ridley DS. Further observations on
the formol-ether concentration technique for faecal
parasites. The J Clin Pathol 1970; 23: 545-6.
7. Young KH, Bullock SL, Melvin DM, Spmill CL.
Ethyl Acetate as a Substitute for Diethyl Ether in
the Formalin-Ether Sedimentatíon Technique. J Clin
Microbiol 1979; 10: 852-3.
8. Henriksen SA, Pohlenz JFL. Staining of
Cryptosporidia by a Modified Ziehl-Neelsen
Technique. Acta Vet Scand 1981; 22: 594-6.
9. Eydal M, Skímisson K, Richter SH. Sníkjudýrið
Cryptosporidium sp. greint í íslendingum. Ráðstefna
um rannsóknir í læknadeild, 4, 11.-12. nóv. 1988, bls.
44.