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Outbreak of cryptosporidiosis associated with a disinfected groundwater supply

Published online by Cambridge University Press:  15 May 2009

S. A. Bridgman ,
R. M. P. Robertson ,
Q. Syed ,
N. Speed ,
N. Andrews  and
P. R. Hunter
S. A. Bridgman
Affiliation:
School of Postgraduate Medicine, University of Keele, Keele, Staffordshire ST5 5BG
R. M. P. Robertson
Affiliation:
North Cheshire Health, Lister Road, Astmoor West Estate, Runcorn, WA7 1TW
Q. Syed
Affiliation:
North-West Regional Health Authority, Warrington
N. Speed
Affiliation:
Environmental Health Division, Warrington Borough Council
N. Andrews
Affiliation:
Statistics Unit, Public Health Laboratory Service, Colindale, London
P. R. Hunter
Affiliation:
Public Health Laboratory Service, Chester
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In an outbreak of cryptosporidiosis in Warrington. a town in North-West England. 47 cases were recorded between November 1992 and February 1993. most within the first month. There was a strong statistical association between cases and residence in an area supplied from two groundwater sources. In a case-control study, a strong association between having drunk unboiled tap water from these sources, and a dose-response relationship were found. Oocysts were not detected in the water supply. During very heavy rainfall one source of water was found to drain surface water directly from a field containing livestock faeces, thereby bypassing natural sandstone filtration. Exceptionally heavy rainfall occurred at the probable time of infection. After withdrawal of the original water supply, the outbreak rapidly subsided. It was concluded that there was very strong evidence that this outbreak was waterborne. This, the second documented outbreak of cryptosporidiosis attributable to a groundwater supply, demonstrates that infection can be transmitted from a disinfected groundwater source despite apparently satisfactory treated water quality. We recommend that guidelines for protection of groundwater are implemented, raw groundwater should be routinely monitored for microbiological contamination, and the structure of all sources and waterworks should be assessed in risk surveys of water catchment areas.

Type
Research Article
Information
Epidemiology & Infection , Volume 115 , Issue 3 , December 1995 , pp. 555 - 566
Copyright
Copyright © Cambridge University Press 1995

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