Waterborne transmission of Giardia and Cryptosporidium at river beaches in Southern Europe (Portugal).

Giardia and Cryptosporidium are the most frequent enteric protozoa causing gastroenteritis in humans worldwide. Intense recreational activity at Portuguese river beaches triggered the opportunity for a 2-year seasonal survey of 19 large river basin beaches. A total of 74 samples were collected and processed according to USEPA Method 1623 to detect Cryptosporidium and Giardia (oo)cysts. Faecal indicators (thermotolerant/total coliforms, Escherichia coli, and enterococci) and physicochemical parameters were also analysed according to the EU Bath Water Directive (BWD). Results pointed to a widespread presence of these protozoa at Portuguese river beaches. The percentage of samples testing positive for Giardia and Cryptosporidium were 85 and 82% respectively, with no significant differences between wet and dry seasons (p > 0.05). Although Portuguese river beaches present a very low exposure risk for infection with Giardia and Cryptosporidium (under 10(-3)), a few particular cases revealed values over 0.2%, and were related to stormy wet events. The correlation between levels of Giardia and thermotolerant coliforms, E. coli and enterococci, was high (r ≥ 0.87, p < 0.001), suggesting the need to carry out specific procedures for the detection of Giardia and Cryptosporidium whenever the values of those faecal indicators approach the maximum allowed level of the EU BWD.

Epidemiological and genetic characterization of Toxoplasma gondii in urban pigeons from the area of Lisbon (Portugal).

Circumstantial evidence suggests that birds may be a good indicator of soil contamination, since they feed from the ground. Therefore a study was conducted to assess the prevalence of Toxoplasma gondii in urban pigeons (Columba livia) from different areas of the city of Lisbon and to genetically characterize T. gondii strains isolated from infected animals, in order to assess circulating genotypes. Sera from 695 pigeons captured at 33 different localities of the city of Lisbon were assayed by the direct agglutination test (DAT) showing a 4.6% prevalence. One third of flocks sampled revealed to be infected with T. gondii, with prevalence ranging between 5% and 62.5%. T. gondii DNA could be characterized directly from brain tissue from 12 of 23 seropositive pigeons. Microsatellite typing revealed that 9 strains belonged to type II, 2 were type III and one was type I. No recombinant or atypical genotypes were found. Attempts to recover viable T. gondii strains through bioassay in mice resulted in the isolation of 9 strains.

In vitro isolation and seroprevalence of Toxoplasma gondii in stray cats and pigeons in Lisbon, Portugal.

Oral contamination with Toxoplasma gondii oocysts shed by cats into the environment has been linked to severe outbreaks of human toxoplasmosis. Pigeons (Columba livia) are highly susceptible to oral infection with oocysts and indirectly indicate soil contamination, since they feed from the ground. A seroprevalence study was performed on cats and pigeons captured in the city of Lisbon. Serum samples collected from 1507 pigeons captured at 64 feeding sites and 423 stray cats were screened for antibodies anti-T. gondii using a commercial direct agglutination test. Seroprevalence in pigeons was 2.6% (39/1507) (95% CI: 1.9-3.5%) and 37.5% (24/64) of pigeon flocks sampled showed to be infected with T. gondii. The proportion of infected pigeons within seropositive flocks ranged between 4.8% and 21.1%. Among cats, seroprevalence was 44.2% (187/423) (95% CI: 39.5-49.1%). Isolation of T. gondii from animal tissues was attempted by in vitro assay. Inoculation of brain homogenates from 20 pigeons and 56 cats into Vero cell cultures allowed isolation of T. gondii from 13 pigeons (65%) and 15 cats (26.8%). Inoculation of muscle homogenates (heart and limbs) prepared by acid-peptic digestion from a subset of 15 cats resulted in the recovery of T. gondii from 10 cats (66.7%).

Prevalence and risk factors for Giardia duodenalis infection among children: a case study in Portugal.

BACKGROUND: Giardia duodenalis is a widespread parasite of mammalian species, including humans. The prevalence of this parasite in children residing in Portugal is currently unknown. This study intended to estimate G. duodenalis infection prevalence and identify possible associated risk factors in a healthy paediatric population living in the District of the Portuguese capital, Lisbon. METHODS: Between February 2002 and October 2008, 844 children were randomly selected at healthcare centres while attending the national vaccination program. A stool sample and a questionnaire with socio-demographic data were collected from each child. Giardia infection was diagnosed by direct examination of stools and antigen detection by ELISA. RESULTS: The population studied revealed a gender distribution of 52.8% male and 47.2% female. Age distribution was 47.4% between 0-5 years and 52.6% between 6-15 years.The prevalence of Giardia infection was 1.9% (16/844) when estimated by direct examination and increased to 6.8% (57/844) when ELISA results were added. The prevalence was higher among children aged 0-5 years (7.8%), than among older children (5.8%), and was similar among genders (6.9% in boys and 6.5% in girls). The following population-variables were shown to be associated risk factors for G. duodenalis infection: mother's educational level (odds ratio (OR)= 4.49; confidence interval (CI): 1.20-16.84), father's educational level (OR = 12.26; CI: 4.08-36.82), presence of Helicobacter pylori infection (OR = 1.82; CI: 1.05-3.15), living in houses with own drainage system (OR = 0.10; CI: 0.02-0.64) and reported household pet contact, especially with dogs (OR = 0.53; CI: 0.31-0.93). CONCLUSION: The prevalence of giardiasis in asymptomatic children residing in the region of Lisbon is high. Several risk factors were associated with Giardia prevalence and highlight the importance of parents' education and sanitation conditions in the children's well being. The association between G. duodenalis and H. pylori seems an important issue deserving further investigation in order to promote prevention or treatment strategies.