Hostname: page-component-586b7cd67f-dsjbd Total loading time: 0 Render date: 2024-11-26T05:54:33.203Z Has data issue: false hasContentIssue false

An outbreak of waterborne cryptosporidiosis caused by post-treatment contamination

Published online by Cambridge University Press:  15 May 2009

H. V. Smith
Affiliation:
Scottish Parasite Diagnostic Laboratory, Department of Bacteriology, Stobhill General Hospital, Glasgow G21 3UW, UK
W. J. Patterson
Affiliation:
Community Medicine Department, Ayrshire Central Hospital, Irvine KA12 8SS
R. Hardie
Affiliation:
Area Microbiology Laboratory, Crosshouse Hospital, Kilmarnock KA2 OBE
L. A. Greene
Affiliation:
Strathclyde Water Department, Balmore Road, Glasgow G22 6NU
C. Benton
Affiliation:
Strathclyde Water Department, Balmore Road, Glasgow G22 6NU
W. Tulloch
Affiliation:
Environmental Health Department, Cunninghame District Council, Friars Croft, Irvine, KA12 8EE
R. A. Gilmour
Affiliation:
Scottish Parasite Diagnostic Laboratory, Department of Bacteriology, Stobhill General Hospital, Glasgow G21 3UW, UK
R. W. A. Girdwood
Affiliation:
Scottish Parasite Diagnostic Laboratory, Department of Bacteriology, Stobhill General Hospital, Glasgow G21 3UW, UK
J. C. M. Sharp
Affiliation:
Communicable Diseases (Scotland) Unit, Ruchill Hospital, Glasgow G20 9NB
G. I. Forbes
Affiliation:
Scottish Home and Health Department, St Andrew's House, Edinburgh EH1 3DE
Rights & Permissions [Opens in a new window]

Summary

Core share and HTML view are not available for this content. However, as you have access to this content, a full PDF is available via the ‘Save PDF’ action button.

An outbreak of waterborne cryptosporidiosis affecting 27 persons, diagnosed stool positive, occurred in Ayrshire in April 1988. Twenty-one of the 27 confirmed cases required some form of fluid replacement therapy. Local general practitioners indicated a two- to fivefold increase in diarrhoeal disease during the outbreak, and following enquiries made by Environmental Health Officers it became apparent that many hundreds of people had suffered a diarrhoeal illness at that time. Cryptosporidium spp. oocysts were detected in the treated chlorinated water supply system, in the absence of faecal bacterial indicators. Oocyst contamination of a break-pressure tank containing final water for distribution was the cause of this waterborne outbreak. An irregular seepage of oocyst-containing water, which increased during heavy rains, was the cause of the break-pressure tank contamination, rather than a failure of the water-treatment processes. The waterborne route should be considered when clusters of cryptosporidiosis associated with potable water occur. Waterborne cryptosporidiosis can occur in the absence of other faecal indicators of contamination.

Type
Research Article
Copyright
Copyright © Cambridge University Press 1989

References

REFERENCES

1.Meisel, JL, Perera, DR, Meligro, BS, Rubin, MD.Overwhelming watery diarrhoea associated with Cryptosporidium in an immunosuppressed patient. Gastroenterology 1976; 70: 1156–60.CrossRefGoogle Scholar
2.Nime, FA, Burek, JD, Page, DL.Acute enterocolitis in a human being infected with the protozoan Cryptosporidium. Gastroenterology 1976; 70: 592–8.CrossRefGoogle Scholar
3.Fayer, R, Ungar, BLP.Cryptosporidium spp. and cryptosporidiosis. Microbiol Rev 1986; 50 (1): 458–83.CrossRefGoogle ScholarPubMed
4.Current, WL, Reese, NC, Ernst, JV, Bailey, WS, Heyman, MB, Weinstein, WM.Human cryptosporidiosis in immunocompetent and immunodeficient persons. N Engl J Med 1983; 308: 1251 7.CrossRefGoogle ScholarPubMed
5.Centers for Disease Control. Human cryptosporidiosis — Alabama. MMWR 1982; 31: 225–54.Google Scholar
6.D'Antonio, RG, Winn, RE, Taylor, JP, Justafson, TL, Current, WL, Rhodes, MM, Gary, GW, Zajac, RA.A waterborne outbreak of cryptosporidiosis in normal hosts. Ann Intern Med 1985; 103: 886–8.CrossRefGoogle ScholarPubMed
7.Hayes, EB, Matte, TD, O'Brien, TR et al. Contamination of a conventionally treated filtered public water supply by Cryptosporidium associated with a large community outbreak of cryptosporidiosis. N Eng J Med 1989; 320: 1372–6.CrossRefGoogle Scholar
8.H.M.S.O. The Investigation and Control of Food Poisoning in Scotland. H.M.S.O. (Edinburgh) 1980. 45 pp.Google Scholar
9.Casemore, DP, Armstrong, M, Sands, RL.Laboratory diagnosis of cryptosporidiosis. J Clin Pathol 1985; 38: 1337–41.CrossRefGoogle ScholarPubMed
10.Department of the Environment Department of Health and Social Security & Public Health Laboratory Service. The Bacteriological Examination of Drinking Water Supplies. Reports on Public Health and Medical Subjects No. 71, London: HMSO 1983. 122 pp.Google Scholar
11.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
12.Smith, HV, Gilmour, RA, Smith, PG et al. A modified method for the detection of Cryptosporidium spp. oocysts in water-related samples. CDS Weekly Report 1989; 89/15: 713.Google Scholar
13.Baxby, D, Blundell, N, Hart, CA.The development and performance of a simple, rapid, sensitive method for the detection of Cryptosporidium oocysts in faeces. J Hyg 1984; 92: 317–23.CrossRefGoogle Scholar
14.McLaughlin, J, Casemore, DP, Harrison, TB, Gerson, J, Samuel, D, Taylor, AG.Identification of Cryptosporidium sp. oocysts by monoclonal antibodies. Lancet 1987; 1: 51.CrossRefGoogle Scholar
15.Smith, HV, McDiarmid, E, Smith, AL, Hinson, AR, Gilmour, RA.An analysis of staining methods for the detection of Cryptosporidium spp. oocysts in water-related samples. Parasitology 1989. In press.CrossRefGoogle ScholarPubMed
16.Ernest, JA, Blagburn, BL, Lindsay, DS, Current, WL.Infection dynamics of Cryptosporidium parvum (Apicomplexa: Cryptosporidiidae) in neonatal mice (Mus musculus). J Parasitol 1986; 72: 796–95.CrossRefGoogle ScholarPubMed
17.Miller, RA, Brondson, MA, Morton, WR. Determination of the infectious dose of Cryptosporidium and the influence of inoculum size on disease severity in a primate model. Proc Ann Meet Am Soc Microbiol Washington D.C. 1986, p. 49.Google Scholar
18.Current, WL.Cryptosporidium: its biology and potential for environmental transmission. Crit Rev Environ Control 1987; 17: 2151.CrossRefGoogle Scholar
19.Campbell, I, Tzipori, S, Hutchison, G, Angus, KW.Effect of disinfectant on survival of Cryptosporidium oocysts. Vet Rec 1982; 111: 414–15.CrossRefGoogle ScholarPubMed
20.Smith, HV, Smith, AL, Girdwood, RWA, Carrington, E.The effect of free chlorine on the viability of Cryptosporidium spp. oocysts. WRC publication PRU 2023-M Water Research Centre. Medmenham, Bucks, UK, 1988.Google Scholar
21.Rose, JR.Occurrence and significance of Cryptosporidium in water. J Am Watwks Ass 1988; 80: 53–8.Google Scholar