Useful For


Determining the etiology of community acquired diarrhea.


Reflex Tests

Reporting Name

Available separately

Always performed

Cryptosporidium IFA NO YES
Giardia IFA NO YES
Iodine Wet mount NO YES
Trichrome Stain NO YES
Modified acid fast for Isospora and Cyclospora YES NO



Testing Algorithm


Specimens are tested concurrently for the presence of Giardia cysts and Cryptosporidium oocysts. All specimens are simultaneously stained with Trichrome and Iodine wet mount to search for other intestinal parasites.


Indications for Testing


Community acquired and travel associated acute or chronic diarrhea.


Special Instructions and Forms


Cryptosporidiosis is a Provincial Notifiable Disease. More Provincial information can be obtained from LINK


Clinical Information


Cryptosporidium spp. are intracellular parasites that primarily infect epithelial cells of the stomach, intestine, and the biliary ducts. In severely immunocompromised persons, the respiratory tract is sometimes involved. Cryptosporidium spp. have a worldwide distribution, and their oocysts are ubiquitously present in the environment. Transmission of C. hominis is mostly from person-to-person (anthroponotic) where as C. parvum is typically zoonitic from livestock to humans. Exposure occurs through fecal-oral transmission by animal to human, waterborne (typically spring and late summer due to recreational water exposure), foodborne (mostly associated with fruits, vegetables, shellfish, and unpasteurized apple cider and milk) and person-to-person.


Cryptosporidiosis occurs in patients with acquired immunodeficiency syndrome (AIDS) and as a self-limited moderate diarrhea in young children, especially daycare attendees and their relatives. Cryptosporidiosis can cause a profuse and watery diarrhea, abdominal cramps, anorexia, fever, nausea, general malaise and vomiting. The disease course can be variable, ranging from a self-limiting diarrhea to more severe and protracted syndrome more commonly seen in immunocompromised patient populations.


The disease occurs worldwide and has become recognized as one of the most common causes of waterborne disease in humans in North America. Extensive waterborne outbreaks have been associated with contamination of drinking water; exposure to contaminated recreational water including swimming pools, water slides, hot tubs, and lakes; and consumption of contaminated beverages.


Reference Values






Detection of Cryptosporidium oocysts is diagnostic for cryptosporidiosis.





White Jr., A. C. 2010. Cryptosporidium Species, p. 3547-3560. In Mandell, D., Bennett, J. E., and Dolin, R. 2010. Principles and practice of infectious diseases, 7th ed., vol. 2. Churchill Livingstone, Elsevier, Philadelphia, PA.


Xiao, L., and Cama, V. 2007. Crytosporidium, p. 2122-2132. In Murray, P. R., Baron, E. J., Jorgensen, J. H., Landry, M. L., and Pfaller, M. A. Manual of Clinical Microbiology, 9th ed., vol. 2. ASM Press, American Society for Microbiology, Washington, DC.


Meridian Biosciences Inc. 2008. MeriFluor Cryptosporidium/Giardia: Package insert. Meridian Biosciences Inc. Cincinnati, OH.


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