Current World Status of Balantidium coli

California Department of Health, Viral and Rickettsial Disease Laboratory, Richmond, California 9480, USA.
Clinical microbiology reviews (Impact Factor: 17.41). 11/2008; 21(4):626-38. DOI: 10.1128/CMR.00021-08
Source: PubMed


Balantidium coli is a cosmopolitan parasitic-opportunistic pathogen that can be found throughout the world. Pigs are its reservoir hosts, and humans become infected through direct or indirect contact with pigs. In rural areas and in some developing countries where pig and human fecal matter contaminates the water supply, there is a greater likelihood that balantidiosis may develop in humans. The infection may be subclinical in humans, as it mostly is in pigs, or may develop as a fulminant infection with bloody and mucus-containing diarrhea; this can lead to perforation of the colon. The disease responds to treatment with tetracycline or metronidazole. Balantidiosis is a disease that need never exist given access to clean water and a public health infrastructure that monitors the water supply and tracks infections. Its spread can be limited by sanitary measures and personal hygiene, but it is a disease that will be around as long as there are pigs. Immunocompromised individuals have developed balantidiosis without any direct contact with pigs, perhaps with rats or contaminated produce as a possible source of infection. For the clinician, balanatidiosis should be included in the differential diagnosis for persistent diarrhea in travelers to or from Southeast Asia, the Western Pacific islands, rural South America, or communities where close contact with domestic swine occurs. Warming of the earth's surface may provide a more favorable environment, even in the now-temperate areas of the world, for survival of trophic and cystic stages of Balantidium, and its prevalence may increase. Effective sanitation and uncontaminated water are the most useful weapons against infection. Fortunately, balantidiosis responds to antimicrobial therapy, and there have been no reports of resistance to the drugs of choice.

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    • "(Blanc, 1912), Trypanoxyuris sp (Vevers, 1923), Necator americanus (Stiles, 1902; Stiles, 1906) y Prostenorchis spp. (Travassos, 1915) (Gómez et al., 1992; Gómez et al., 2000; González, 2004; Tachibana et al., 2001; Niichiro et al., 2002; Gracenea et al., 2002; Phillips et al., 2004; Appelbee et al., 2005; Parra et al., 2005; Orduz et al., 2005; Stoner et al., 2005; Schuster et al., 2008; Beltrán-Saavedra, 2009; Sprong et al., 2009; Barrera et al., 2010; Castañeda et al., 2010; Rasambainarivo & Junge, 2010; Lee et al., 2012). "
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    ABSTRACT: Zoos are places with a high diversity of animals, some of which may have acquired a particular parasite load in both their area of origin or during their captivity. The probability of animal keepers contracting zoonotic diseases increases due to constant contact with the animals in their daily work. This descriptive ecological study was performed in order to establish the presence of intestinal parasites with zoonotic potential in captive animals at the Cali Zoological garden. In february 2013, serial pools of stools from psittacids (3 species), cebids (2 species), atelids (2 species), caviids (1 species), and lemurids (1 species), were collected and analyzed using direct smear and concentration techniques. Convenience sampling taking 53 individuals including mammals and birds was performed, yielding parasitological prevalence of 89%, distributed as follows: 57.2 % for helminths (31.8% Trichurida, 6.35% Ascaridida, 6.35% Uncinarias and 12.7 % Strongyloides sp.) and 31.8% for protozoa (19.05% Entamoeba spp. and 12.70 % Giardia spp.). The presence of potential zoonotic parasites in the positive samples such as Giardia spp., Entamoeba spp. and Strongyloides spp. demands studies in larger populations of animals and species using molecular methods. Keywords: Animals in captivity-intestinal parasites-prevalence-zoo-zoonoses.
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    • "Although pigs and rats have been used to study Neobalantidium infections [17], [18], [19], captive African great apes offer a valuable model, which might help us to unravel the factors contributing to the development of clinical balantidiasis in humans, because both humans and African great apes are not natural hosts for N. coli [4] and unlike in pigs and rats clinical outcomes have been observed in apes [2], [6], [7], [8], [9]. The occurrence of N. coli in captive African great apes has been explained by (i) the presence of reservoir(s) in captive facilities or/and (ii) differences in the diet of wild and captive apes [4]. "
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    ABSTRACT: Infections caused by the intestinal ciliate Neobalantidium coli are asymptomatic in most hosts. In humans and captive African great apes clinical infections occasionally occur, manifested mainly by dysentery; however, factors responsible for development of clinical balantidiasis have not been fully clarified. We studied the effect of dietary starch on the intensities of infection by N. coli in two groups of captive chimpanzees. Adult chimpanzees infected by N. coli from the Hodonín Zoo and from the Brno Zoo, Czech Republic, were fed with a high starch diet (HSD) (average 14.7% of starch) for 14 days, followed by a five-day transition period and subsequently with a period of low starch diet (LoSD) (average 0.1% of starch) for another 14 days. We collected fecal samples during the last seven days of HSD and LoSD and fixed them in 10% formalin. We quantified trophozoites of N. coli using the FLOTAC method. The numbers of N. coli trophozoites were higher during the HSD (mean ± SD: 49.0±134.7) than during the LoSD (3.5±6.8). A generalized linear mixed-effects model revealed significantly lower numbers of the N. coli trophozoites in the feces during the LoSD period in comparison to the HSD period (treatment contrast LoSD vs. HSD: 2.7±0.06 (SE), z = 47.7; p<0.001). We conclude that our data provide a first indication that starch-rich diet might be responsible for high intensities of infection of N. coli in captive individuals and might predispose them for clinically manifested balantidiasis. We discuss the potential nutritional modifications to host diets that can be implemented in part to control N. coli infections.
    PLoS ONE 11/2013; 8(11):e81374. DOI:10.1371/journal.pone.0081374 · 3.23 Impact Factor
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    • "The major factors leading to human balantidiasis include (i) close contact between pigs and humans, (ii) a lack of appropriate waste disposal in swine and human excrement contaminate drinking water sources (e.g., wells and streams) and food, and (iii) subtropical and/or tropical climatic conditions (e.g., warmth and humidity) favoring survival of cysts. In institutional populations (mental hospitals, prisons, and orphanages), where pigs are an unlikely source of infection, outbreaks are the result of asymptomatic carriers and the difficulties involved in maintaining hygienic control36. In our study, the only elderly that presented B. coli in the feces were institutionalized and probably acquired the protozoan prior to the admission to the institution considering that the local hygienic conditions were strictly controlled and the elderly had no contact with the external environment. "
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    ABSTRACT: Little is known about the frequency of intestinal parasites in the elderly due to a lack of attention given to the occurrence of these infections among older adults. This study compares the frequency of Strongyloides stercoralis and other enteroparasites between elderly living in nursing homes (n = 100) and those noninstitutionalized (n = 100) from Uberlândia, state of Minas Gerais, southeastern Brazil, associated with data of epidemiological and socio-demographic conditions. Through coproparasitological examination of both groups, enteroparasites were detected in 15 of 200 individuals examined (7.5%; CI: 5.1- 9.9). S. stercoralis was the most frequent parasite 10/200 (5%; CI: 4.2-5.8), being significantly higher in males and in individuals with autonomy for daily living activities. There were no statistical differences in the prevalence of parasites between the two groups compared. In conclusion, S. stercoralis infection was highly prevalent in elderly patients and it does not depend on whether the individual was institutionalized or not.
    Revista do Instituto de Medicina Tropical de São Paulo 10/2013; 55(5):309-13. DOI:10.1590/S0036-46652013000500003 · 1.01 Impact Factor
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