Looking for Cryptosporidium: the application of advances in detection and diagnosis

• Diagnosis of cryptosporidiosis is currently based on a variety of laboratory methods.
• Typing of isolates supports disease investigations, but application is inconsistent.
• To harmonise work, there is a need for consensus in multi-locus typing schemes.
• Translation of genomic data into improved diagnostic and typing assays will facilitate future harmonisation.

The protozoan Cryptosporidium is a major public and animal health concern. Young children, immunocompromised people, and pre-weaning animals are especially vulnerable, but treatment options are limited and there is no vaccine. A laboratory diagnosis is required to confirm cases of cryptosporidiosis, and species and genotype determination is essential in distinguishing human from non-human sources, understanding transmission, and strengthening the epidemiological evidence for causative links in outbreaks. However, testing is not consistent, as demonstrated by investigation of a significant increase in cases in some European countries during 2012. Many methods employed are laborious and time-consuming; recent advances, translated into diagnostic assays, can improve testing and facilitate typing to support clinical and environmental investigations.