Cryptosporidiosis in Great Yarmouth — the investigation of an outbreak

Brown, Emma; Casemore, D.P.; Gerken, Anne; Greatorex, I.F.

doi:10.1016/s0033-3506(89)80095-2

Cited by 13 publications

(4 citation statements)

References 7 publications

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“…Person-person transmission has been documented for Cryptosporidium (17)(18)(19)(20)(21)(22)(23). For the Milwaukee outbreak, it was estimated that 5 percent of the outbreak cases were due to within-household transmission (24).…”

Section: Discussionmentioning

confidence: 99%

The Role of Disease Transmission and Conferred Immunity in Outbreaks: Analysis of the 1993 Cryptosporidium Outbreak in Milwaukee, Wisconsin

Eisenberg

Lei

Hubbard

et al. 2005

American Journal of Epidemiology

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The authors examined two competing hypotheses regarding the cause of the 1993 Cryptosporidium outbreak in Milwaukee, Wisconsin. The first was that oocyst contamination of the drinking-water influent, coupled with a treatment plant failure, resulted in a point-source outbreak. The second was that the outbreak was the result of transmission processes that amplified the oocyst concentration in the drinking-water effluent. Analysis of the model suggested that 1) transmission directly from person to person contributed 10% (95% confidence interval: 6%, 21%) of the total cases; 2) closing the drinking-water plant prevented 19% (95% confidence interval: 17%, 21%) of the additional cases of disease that occurred compared with the scenario in which the plant had not been closed, a result primarily driven by conferred immunity that resulted in depletion of the susceptible population; and 3) the outbreak was caused by a transmission cycle due to infectious persons shedding pathogens into the sewage, environmental transport of these pathogens via Lake Michigan to the drinking-water plant, and infection of susceptible persons via exposure to drinking water. The incidence data were consistent with this hypothesis. Further simulations suggested that increasing the distance between the wastewater effluent and the drinking-water influent may have prevented the outbreak.

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Section: Discussionmentioning

confidence: 99%

The Role of Disease Transmission and Conferred Immunity in Outbreaks: Analysis of the 1993 Cryptosporidium Outbreak in Milwaukee, Wisconsin

Eisenberg

Lei

Hubbard

et al. 2005

American Journal of Epidemiology

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“…This is not surprising and is biologically plausible considering the route of transmission. Furthermore, it is well recognized as a source of secondary transmission according to previous research [22][23][24].…”

Section: Discussionmentioning

confidence: 99%

Case-control studies of sporadic cryptosporidiosis in Melbourne and Adelaide, Australia

et al. 2002

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Few studies have assessed risk factors for sporadic cryptosporidiosis in industrialized countries, even though it may be numerically more common than outbreaks of disease. We carried out case-control studies assessing risk factors for sporadic disease in Melbourne and Adelaide, which have water supplies from different ends of the raw water spectrum. In addition to examining drinking water, we assessed several other exposures. 201 cases and 795 controls were recruited for Melbourne and 134 cases and 536 controls were recruited for Adelaide. Risk factors were similar for the two cities, with swimming in public pools and contact with a person with diarrhoea being most important. The consumption of plain tap water was not found to be associated with disease. This study emphasizes the need for regular public health messages to the public and swimming pool managers in an attempt to prevent sporadic cryptosporidiosis, as well as outbreaks of disease.

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“…However, zoonotic transmission cannot explain the large number of infections reported from persons living and working in urban areas where exposure to animal feces is minimal. Present evidence indicates that person-to-person transmission of cryptosporidiosis is common (3,30,45,94,217,237,341). In 1983, an accidental laboratory infection demonstrated that a human isolate of C. parvum could be transmitted from one person to another (33).…”

Section: Sources Of Human Infectionmentioning

confidence: 93%

Cryptosporidiosis

1991

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Before 1982, only eight case reports of human cryptosporidiosis and fewer than 30 papers on Cryptosporidium spp. appeared in the biomedical literature. At that time, cryptosporidiosis was thought to be an infrequent infection in animals and rarely an opportunistic infection in humans. The concept of Cryptosporidium spp. as pathogens has changed dramatically within the past 8 years because of improved diagnostic techniques, increased awareness within the biomedical community, and the development of basic research programs in numerous laboratories. Presently, greater than 1,000 publications including over 400 case reports in the biomedical literature address Cryptosporidium spp. and cryptosporidiosis. Cryptosporidium parvum is now thought to be one of the three most common enteropathogens causing diarrheal illness in humans worldwide, especially in developing countries. It is likely that cryptosporidiosis was previously included in the 25 to 35% of diarrheal illness with unknown etiology. Because of the severity and length of diarrheal illness and because no effective therapy has been identified, cryptosporidiosis is one of the most ominous infections associated with AIDS. The role of C. parvum as an enteropathogen is well established; documentation of its role as a cause of hepatobiliary and respiratory diseases is now appearing in the literature. Our present understanding of the natural history, epidemiology, biology, and immunology of Cryptosporidium spp. as well as the clinical features, pathogenicity, and treatment of cryptosporidiosis are reviewed here.

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Cryptosporidiosis in Great Yarmouth — the investigation of an outbreak

Cited by 13 publications

References 7 publications

The Role of Disease Transmission and Conferred Immunity in Outbreaks: Analysis of the 1993 Cryptosporidium Outbreak in Milwaukee, Wisconsin

The Role of Disease Transmission and Conferred Immunity in Outbreaks: Analysis of the 1993 Cryptosporidium Outbreak in Milwaukee, Wisconsin

Case-control studies of sporadic cryptosporidiosis in Melbourne and Adelaide, Australia

Cryptosporidiosis

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