SUMMARYAn outbreak of cryptosporidiosis resulted in 516 cases in Wiltshire and Oxfordshire. The outbreak caused widespread interest and led to an official inquiry. The majority of cases were in children; 8% of cases were admitted to hospital and the median duration of illness was 3 weeks. The geographical distribution of cases matched the distribution of water supplies from three treatment works and cryptosporidium oocysts were found at these works and in the treated water. Attack rates in electoral wards supplied by the three treatment works were significantly higher than in other wards. The cause of the outbreak appeared to be the failure of normal treatment to remove oocysts. Measures at the treatment works reduced the number of oocysts detected in treated water, after which the outbreak came to an end. The conclusion of the investigations was that cryptosporidiosis is a risk of conventionally treated public water supplies.
We examined the effect of the decision in 1981 in Oxfordshire to cease routine vaccination of schoolchildren for tuberculosis. All notifications, laboratory and death certificate reports of tuberculosis between 1973 and 1989 were reviewed. Results showed that the incidence of tuberculosis in Oxfordshire continued to decline with an annual 5 per cent decrease. The incidence increased with age from a mean annual rate of 6.18 per 100,000 at age 0-10 to 19.90 per 100,000 at age 71-80. There was a higher incidence in the Asian population, with a mean annual rate of 79.6 per 100,000 compared with 7.35 per 100,000 in non-Asians. Four cases had occurred since 1981 in children who had not been immunized routinely at school. All four children had other risk factors in addition to not receiving BCG vaccine. We did not find a need to resume the routine vaccination programme. However, the findings demonstrated the need to be effective in contract-tracing and in vaccinating those most at risk.
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