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An outbreak of waterborne cryptosporidiosis in Swindon and Oxfordshire

Published online by Cambridge University Press:  15 May 2009

A. J. Richardson ,
R. A Frankenberg ,
A. C. Buck ,
J. B. Selkon ,
J. S. Colbourne ,
J. W. Parsons  and
R. T. Mayon-White
A. J. Richardson
Affiliation:
Department of Public Health Medicine, Wessex Regional Health Authority, Romsey Road, Winchester SO22 5DH
R. A Frankenberg
Affiliation:
Department of Public Health Medicine, Oxfordshire Health Authority, Manor House, Headley Way, Oxford 0X3 9DZ
A. C. Buck
Affiliation:
Pathology Department, Princess Margaret Hospital, Okus Road, Swindon SN1 4JU
J. B. Selkon
Affiliation:
Oxford Public Health Laboratory, John Radcliffe Hospital, Oxford
J. S. Colbourne
Affiliation:
Thames Water Services, New River Head, Roseberry Avenue, London EC1 4TP
J. W. Parsons
Affiliation:
Swindon Health Authority, Okus Road, Swindon SN1 4JU.
R. T. Mayon-White
Affiliation:
Department of Public Health Medicine, Oxfordshire Health Authority, Manor House, Headley Way, Oxford 0X3 9DZ
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Summary

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An 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 eryptosporidium 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.

Type
Research Article
Information
Epidemiology & Infection , Volume 107 , Issue 3 , December 1991 , pp. 485 - 495
Copyright
Copyright © Cambridge University Press 1991

References

REFERENCES

1.Report of an Expert Group. DOE, DOH. Cryptosporidium in water supplies. London: HMSO, 1990.Google Scholar
2.Nime, FA, Burek, JD, Page, DL, Holscher, MA, Yardley, JH. Acute enterocolitis in a human being infected with the protozoan cryptosporidium. Gastroenterol 1976; 70: 592–8.CrossRefGoogle Scholar
3.Wolfson, JS, Richter, JM, Waldron, MA, Weber, DJ, McCarthy, DM, Hopkins, CC. Cryptosporidiosis in immunocompetent patients. N Eng J Med 1985; 312: 1278–82.CrossRefGoogle ScholarPubMed
4.Soave, R.Danner, RL, Honig, CL et al. , Cryptosporidiosis in homosexual men. Ann Intern Med 1984; 100: 504–11.CrossRefGoogle ScholarPubMed
5.Baxby, D.Hart, CA.The incidence of cryptosporidiosis: a two-year prospective survey in a children's hospital. J Hyg 1986; 96: 107–11.CrossRefGoogle ScholarPubMed
6.Casemore, DP.Epidemiological aspects of human cryptosporidiosis. Epidemiol Infect 1990; 104: 1–28.CrossRefGoogle ScholarPubMed
7.Casemore, DP.The epidemiology of human cryptosporidiosis. PHLS Microbiology Digest 1989; 6: 54–66.Google Scholar
8.Current, WL, Reese, NC, Ernst, JV et al. , Human cryptosporidiosis in immunocompetent and immunodeficient persons. N Eng J Med 1988; 308: 1252–7.CrossRefGoogle Scholar
9.Soave, R, Armstrong, D.Cryptosporidium and cryptosporidiosis. Rev Infect Disease 1986; 8: 1012–3.CrossRefGoogle ScholarPubMed
10.Fayer, R.Ungar, BLP.Cryptosporidium spp. and cryptosporidiosis. Microbiol Rev 1986: 50: 458–83.CrossRefGoogle ScholarPubMed
11.Casemore, DP.Cryptosporidiosis: another source. Br Med J 1989; 298: 750–1.CrossRefGoogle ScholarPubMed
12.Casemore, DP, Jessop, EG, Douce, D.Jackson, FB.Cryptosporidium plus campvlobacter. An outbreak in a semi-rural population. J Hyg 1986; 96: 95–105.CrossRefGoogle Scholar
13.Hayes, EB, Matte, TD, O'Brien, TR et al. , Large community outbreak of cryptosporidiosis due to contamination of a filtered public water supply. N Eng J Med 1989; 320: 1372–6.CrossRefGoogle ScholarPubMed
14.D'Antonio, RG, Winn, RE, Taylor, JP et al. , A waterborne outbreak of cryptosporidiosis in normal hosts. Ann Intern Med 1985; 103: 886–8.CrossRefGoogle ScholarPubMed
15.Smith, HV, Girdwood, RWA, Patterson, VVJ et al. , Waterborne outbreak of cryptosporidiosis. Lancet 1988; ii: 1484.CrossRefGoogle Scholar
16.Rush, BA, Chapman, PA, Ineson, RW.Cryptosporidium and drinking water. Lancet 1987; ii: 632–3.CrossRefGoogle Scholar
17.Koch, KL, Phillips, DJ.Aber, RC, Current, WL.Cryptosporidiosis in hospital personnel: evidence for person-to-person transmission. Ann Intern Med 1985; 102: 593–6.CrossRefGoogle ScholarPubMed
18.Hannah, J, Riordan, T.Case to case spread of cryptosporidiosis: evidence from a day nursery outbreak. Public Health 1988; 102: 539–44.CrossRefGoogle Scholar
19.Alpert, G, Bell, LM, Kirkpatrick, CE et al. , Outbreak of cryptosporidiosis in a day care centre. Pediatrics 1986; 77: 152–7.CrossRefGoogle Scholar
20.Baxby, D, Hart, CA, Blundell, N.Shedding of oocysts by immunocompetent individuals with cryptosporidiosis. J Hyg 1985; 95: 703–9.CrossRefGoogle ScholarPubMed
21.Pohjola, S, Oksanen, H, Jokiph, L, Jokiph, AMM. Outbreak of cryptosporidiosis among veterinary students. Scand J Infect Dis 1986; 18: 173–8.CrossRefGoogle Scholar
22.Ribiero, CD, Palmer, SR.Family outbreak of cryptosporidiosis. Br Med J 1986; 292: 377.CrossRefGoogle Scholar
23.Dick, TA. Report of an enquiry into water supplies in Oxford and Swindon following an outbreak of cryptosporidiosis during February-March 1989. Thames Water Utilities 1989.Google Scholar
24.Mayon-White, RT, Frankenberg, RA.Boil the water. Lancet 1989; ii: 216.CrossRefGoogle Scholar
25.Henrikson, SA, Pohlenz, JFL.Staining of cryptosporidia by a modified Ziehl-Xeelsen technique. Acta Vet Scand 1981; 22: 594–6.CrossRefGoogle Scholar
26.Casemore, DP, Armstrong, M, Jackson, B.Screening for cryptosporidium in stools. Lancet 1984; i: 734–5.CrossRefGoogle Scholar
27.McClauchin, J, Casemore, DP, Harrison, TG, Gerson, PJ, Samuel, D, Taylor, AG.Identification of cryptosporidium oocysts by monoclonal antibody. Lancet 1987; i: 51.CrossRefGoogle Scholar
28.Musial, CE, Arrowood, MJ, Sterling, CR, Gerba, CP.Detection of cryptosporidium in water using polypropylene cartridge filters. Appl Environ Microbiol 1987; 53: 687–92.CrossRefGoogle ScholarPubMed
29.Ongerth, JE, Stibbs, HH.Identification of cryptosporidium oocysts in river water. Appl Environ Microbiol 1987; 53: 672–6.CrossRefGoogle ScholarPubMed
30.Rose, JB.Occurrence and significance of cryptosporidium in water. J Am Waterworks Assoc 1988; 80: 53–8.CrossRefGoogle Scholar
31.Rose, JB, Kayed, D, Madore, MS et al. , Methods for the recovery of Giardia and Cryptosporidium from environmental waters and their comparative occurrence. In: Wallis, PM.Hammond, BR, eds. Advances in giardia research. Calgary: University of Calgary Press, 1988.Google Scholar
32.Clifford, CP.Crook, DWM, Conlon, CP, Fraise, AP, Day, DG, Peto, TEA.Impact of waterborne outbreak of cryptosporidium on AIDS and renal transplantation patients. Lancet 1990; 335: 1455–6.CrossRefGoogle Scholar
33.Isaac-Renton, JL.Fogel, D, Stibbs, HH, Ongerth, JE.Giardia and cryptosporidium in drinking water. Lancet 1987; i: 973–1.CrossRefGoogle Scholar
34.Smith, HV.Environmental aspects of cryptosporidium: a review. J R Soc Med 1990; 83: 629–31.CrossRefGoogle ScholarPubMed
35.Current, WL.Cryptosporidium: Its biology and potential for environmental transmission. CRC Critical Reviews in Environmental Control 1986; 17: 21–51.CrossRefGoogle Scholar
36.Galbraith, NS, Barrett, NJ, Stanwell-Smith, R.Water and disease after Croydon: A review of water-borne and water-associated disease in the UK 1937–86. J Inst Water Environ Management 1987; 1: 7–21.CrossRefGoogle Scholar
37.Smith, HV, Patterson, WJ, Hardie, R et al. , An outbreak of waterborne cryptosporidiosis caused by post-treatment contamination. Epidemiol Infect 1989; 103: 703–15.CrossRefGoogle ScholarPubMed
38.Interim report of the expert group. DOE, DOH. Cryptosporidium in water. Department of Health EL(89)P/139. 1989.Google Scholar