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Multiple risk factors associated with a large statewide increase in cryptosporidiosis

  • A. L. VALDERRAMA (a1) (a2), M. C. HLAVSA (a3), A. CRONQUIST (a4), S. COSGROVE (a4), S. P. JOHNSTON (a3), J. M. ROBERTS (a3), M. L. STOCK (a5), L. XIAO (a3), K. XAVIER (a4) and M. J. BEACH (a3)...
Abstract
SUMMARY

Cryptosporidium species have emerged as a major cause of outbreaks of diarrhoea and have been associated with consumption of contaminated recreational and drinking water and food as well as contact with infected attendees of child-care programmes. In August 2007, the Colorado Department of Public Health and Environment detected an increase in cryptosporidiosis cases over baseline values. We conducted a case-control study to assess risk factors for infection and collected stool specimens from ill persons for microscopy and molecular analysis. Laboratory-confirmed cases (n=47) were more likely to have swallowed untreated water from a lake, river, or stream [adjusted matched odds ratio (aOR) 8·0, 95% confidence interval (CI) 1·3–48·1], have had exposure to recreational water (aOR 4·6, 95% CI 1·4–14·6), or have had contact with a child in a child-care programme or in diapers (aOR 3·8, 95% CI 1·5–9·6). Although exposure to recreational water is commonly implicated in summertime cryptosporidiosis outbreaks, this study demonstrates that investigations of increased incidence of cases in summer should also examine other potential risk factors. This study emphasizes the need for public health education efforts that address the multiple transmission routes for Cryptosporidium and appropriate prevention measures to avoid future transmission.

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Corresponding author
*Author for correspondence: A. L. Valderrama, Ph.D., R.N., National Center for Chronic Disease Prevention and Health Promotion, 4770 Buford Hwy, NE, Atlanta, GA 30341, MS K-47. (Email: AValderrama@cdc.gov)
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1.XM Chen , Cryptosporidiosis. New England Journal of Medicine 2002; 346: 17231731.

2.G Nichols . Epidemiology. In: R Fayer , L Xiao , eds. Cryptosporidium and Cryptosporidiosis, 2nd edn.Boca Raton, FL: CRC Press, 2008, pp. 79–118.

11.BG Blackburn , Cryptosporidiosis associated with ozonated apple cider. Emerging Infectious Diseases 2006; 12: 684686.

12.PS Millard , An outbreak of cryptosporidiosis from fresh-pressed apple cider. Journal of the American Medical Association 1994; 272: 15921596.

13.ES Quiroz , An outbreak of cryptosporidiosis linked to a foodhandler. Journal of Infectious Diseases 2000; 181: 695700.

16.G Turabelidze , Communitywide outbreak of cryptosporidiosis in rural Missouri associated with attendance at child care centers. Archives of Pediatrics and Adolescent Medicine 2007; 161: 878883.

18.Centers for Disease Control and Prevention. Cryptosporidiosis among children attending day-care centers – Georgia, Pennsylvania, Michigan, California, New Mexico. Morbidity and Mortality Weeekly Report 1984; 33: 599601.

20.L Xiao , Identification of 5 types of Cryptosporidium parasites in children in Lima, Peru. Journal of Infectious Diseases 2001; 183: 492497.

21.IM Sulaiman , Unique endemicity of cryptosporidiosis in children in Kuwait. Journal of Clinical Microbiology 2005; 43: 28052809.

22.TF Jones . Changing challenges of bacterial enteric infection in the United States. Journal of Infectious Diseases 2009; 199: 465466.

23.RL Cordell , DG Addiss . Cryptosporidiosis in child care settings: a review of the literature and recommendations for prevention and control. Pediatric Infectious Disease Journal 1994; 13: 310317.

26.Centers for Disease Control and Prevention. Preventing cryptosporidiosis: a guide to water filters and bottled water (http://www.cdc.gov/crypto/factsheets/filters.html). Accessed 19 November 2008.

28.PR Hunter , Sporadic cryptosporidiosis case-control study with genotyping. Emerging Infectious Diseases 2004; 10: 12411249.

29.B Robertson , Case-control studies of sporadic cryptosporidiosis in Melbourne and Adelaide, Australia. Epidemiology and Infection 2002; 128: 419431.

30.SL Roy , Risk factors for sporadic cryptosporidiosis among immunocompetent persons in the United States from 1999 to 2001. Journal of Clinical Microbiology 2004; 42: 29442951.

31.D Casemore . Towards a US national estimate of the risk of endemic waterborne disease – sero-epidemiologic studies. Journal of Water Health 2006; 4 (Suppl. 2): 121163.

32.GJ Leitch , Dietary fiber and giardiasis: dietary fiber reduces rate of intestinal infection by Giardia lamblia in the gerbil. American Journal of Tropical Medicine and Hygiene 1989; 41: 512520.

33.LM Fox , LD Saravolatz . Nitazoxanide: a new thiazolide antiparasitic agent. Clinical Infectious Diseases 2005; 40: 11731180.

34.VR Anderson , MP Curran . Nitazoxanide: a review of its use in the treatment of gastrointestinal infections. Drugs 2007; 67: 19471967.

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Epidemiology & Infection
  • ISSN: 0950-2688
  • EISSN: 1469-4409
  • URL: /core/journals/epidemiology-and-infection
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