Approaches to the detection of very small, common, and easily missed outbreaks that together contribute substantially to human Cryptosporidium infection

A. D.M. Briggs, Naomi Boxall, D. Van Santen, R. M. Chalmers, N. D. McCarthy*

*Corresponding author for this work

    Research output: Contribution to journalArticlepeer-review

    17 Citations (Scopus)

    Abstract

    Water supply-associated cryptosporidiosis outbreaks have decreased in England since the application of risk reduction measures to public water supplies. We hypothesized that smaller outbreaks were occurring which could be better detected by enhanced surveillance. Rolling analysis of detailed questionnaire data was applied prospectively in a population of 2.2 million in the south of England in 2009 and 2010. Detection of spatiotemporal clusters using SaTScan was later undertaken retrospectively. Together these approaches identified eight outbreaks, compared to an expectation of less than one based on national surveillance data. These outbreaks were small and associated with swimming pool use or, less commonly, direct (e.g. petting-farm) contact with animals. These findings suggest that frequent small-scale transmission in swimming pools is an important contributor to disease burden. Identification of swimming pool-level risk factors may inform preventative measures. These findings and the approaches described may be applicable to many other populations and to some other diseases.

    Original languageEnglish
    Pages (from-to)1869-1876
    Number of pages8
    JournalEpidemiology and Infection
    Volume142
    Issue number9
    DOIs
    Publication statusPublished - Sept 2014

    Bibliographical note

    Copyright:
    Copyright 2014 Elsevier B.V., All rights reserved.

    Keywords

    • Cryptosporidium
    • outbreaks
    • spatial modelling
    • surveillance
    • waterborne infections

    Fingerprint

    Dive into the research topics of 'Approaches to the detection of very small, common, and easily missed outbreaks that together contribute substantially to human Cryptosporidium infection'. Together they form a unique fingerprint.

    Cite this