Hostname: page-component-cd9895bd7-dk4vv Total loading time: 0 Render date: 2024-12-22T15:27:42.493Z Has data issue: false hasContentIssue false

Municipal drinking water and cryptosporidiosis among persons with AIDS in Los Angeles County

Published online by Cambridge University Press:  15 May 2009

F. Sorvillo*
Affiliation:
HIV Epidemiology Program, Los Angeles County Department of Health Services, Los Angeles, CA, USA
L. E. Lieb
Affiliation:
HIV Epidemiology Program, Los Angeles County Department of Health Services, Los Angeles, CA, USA
B. Nahlen
Affiliation:
Division of HIV/AIDS, Centers for Disease Control and Prevention, Atlanta, GA, USA
J. Miller
Affiliation:
Department of Water and Power, City of Los Angeles, CA, USA
L. Mascola
Affiliation:
HIV Epidemiology Program, Los Angeles County Department of Health Services, Los Angeles, CA, USA
L. R. Ash
Affiliation:
Department of Epidemiology, School of Public Health, University of California at Los Angeles, CA, USA
*
* Correspondence and reprint requests to: Frank Sorvillo, HIV Epidemiology Program, 600 S. Commonwealth, Suite 805. Los Angeles, CA 90005, USA.
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.

To assess unfiltered drinking water as a source of cryptosporidium infection in patients with the acquired immunodeficiency syndrome (AIDS) the prevalence of cryptosporidiosis among persons with AIDS in Los Angeles County was assessed by water service area. One water distributor, serving approximately 60% of the county's residents (area B), has consistently employed filtration. The other company, which serves the remainder of the county (area A), did not institute nitration until mid-December 1986. This difference provided a ‘natural experiment ’ in which to assess the effect of municipal water filtration on the level of cryptosporidiosis among persons with AIDS. The prevalence of cryptosporidiosis among AIDS patients was compared for the two water service areas for the time period (1983–6) preceding the implementation of filtration in area A. From 1983 to 1986 the age-standardized prevalence of cryptosporidiosis among AIDS patients was 32% lower in area A (4·2%), which received unfiltered water, than in area B (6·2%). Following addition of filtration in area A, the prevalence of cryptosporidiosis among AIDS patients decreased by 20%; however, a decline, of 47%, was also observed in area B. The similar baseline levels of cryptosporidiosis and the corresponding post-filtration decline in both areas suggest that filtration had no effect on levels of cryptosporidiosis among persons with AIDS. Thus it does not appear that municipal drinking water is an important risk factor for cryptosporidiosis in AIDS patients residing in Los Angeles County.

Type
Research Article
Copyright
Copyright © Cambridge University Press 1994

References

REFERENCES

1.Casemore, DP, Epidemiologic aspects of human cryptosporidiosis. Epidemiol Infect 1990; 104: 128.CrossRefGoogle ScholarPubMed
2.Gellin, BG, Soave, R, Coccidian infections in AIDS. Med Clin N Am 1992; 76: 205–34.CrossRefGoogle ScholarPubMed
3.Petersen, C, Cryptosporidiosis in patients infected with the human immunodeficiency virus. Clin Infect Dis 1992; 15: 903–9.CrossRefGoogle ScholarPubMed
4.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
5.Richardson, AJ, Frankenberg, RA, Buck, AC, et al. An outbreak of waterborne cryptosporidiosis in Swindon and Oxfordshire. Epidemiol Infect 1991; 107: 485–95.CrossRefGoogle ScholarPubMed
6.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
7.Gallaher, MM, Herndon, JL, Nims, LJ, Sterling, CR, Grabowski, DJ, Hull, HF, Cryptosporidiosis and surface water. Am J Public Health 1989; 79: 3942.CrossRefGoogle ScholarPubMed
8.LeChevallier, MW, Norton, WD, Lee, RG, Occurrence of giardia and Cryptosporidium spp. in surface water supplies. Appl Environ Microbiol 1991; 57: 2610–16.CrossRefGoogle ScholarPubMed
9.Campbell, I, Tzipori, AS, Hutchison, G, Angus, KW, Effect of disinfectants on survival of cryptosporidium oocysts. Vet Rec 1982; 111: 414–15.CrossRefGoogle ScholarPubMed
10.Ernest, JA, Blagburn, BI, Lindsay, DS, Infection dynamics of Cryptosporidium parvum (Apicomplexa: Cryptosporididae) in neonatal mice (Mus muscularis). J Parasitol 1986; 72: 796–98.CrossRefGoogle Scholar
11.Miller, RA, Bronsdon, MA, Morton, WR, Experimental crvptosporidiosis in a primate model. J Infect Dis 1990; 161: 312–5.CrossRefGoogle Scholar
12.Centers for Disease Control. Human cryptosporidiosis - Alabama. MMWR 1982; 31: 252–4.Google Scholar
13.Clifford, CP, Crook, DWM, Conlon, CP, Fraise, AP, Day, DG, Peto, TEA, Impact of waterborne outbreak of cryptosporidiosis on AIDS and renal transplant patients. Lancet 1990; 335: 1455–6.CrossRefGoogle ScholarPubMed
14.LeChevallier, MW, Norton, WD, Lee, RG, Giardia and Cryptosporidium spp. in filtered drinking water supplies. Appl Environ Microbiol 1991; 57: 2617–21.CrossRefGoogle ScholarPubMed
15.Rosenblum, L, Buehler, JW, Morgan, MW et al. , The completeness of AIDS case reporting. 1988: a multistate collaborative surveillance project. Am J Public Health 1992; 82: 1495–9.CrossRefGoogle Scholar
16.Goodgame, RW, Genta, RM, White, AC, Chappell, CL, Intensity of infection in AIDS-associated cryptosporidiosis. J Infect Dis 1993; 167: 704–9.CrossRefGoogle ScholarPubMed
17.Alpert, G, Bell, LM, Kirkpatrick, CE et al. , Outbreak of cryptosporidiosis in a day-care center. Pediatrics 1986; 77: 152–7.CrossRefGoogle Scholar
18.Waterman, S, Keene, W, Meade, J, Sterling, C, Ruiz-Matus, C, Cryptosporidiosis in a group of travelers to Puerto Vallarta, Mexico, 1986. In: Steffen, R, Lobel, HO, Haworth, J, Bradley, DJ, eds. Travel medicine. Proceedings of the First Conference on International Travel Medicine, Zürich, Switzerland, 5–8 April 1988. Berlin, Heidelberg: Springer-Verlag; 1989: 326–7.CrossRefGoogle Scholar
19.Joce, RE, Bruce, J, Keily, D et al. , An outbreak of cryptosporidiosis associated with a swimming pool. Epidemiol Infect 1991; 107: 497508.CrossRefGoogle ScholarPubMed
20.Sorvillo, FJ, Lieb, LE, Kerndt, PR, Ash, LR, Epidemiology of cryptosporidiosis among persons with AIDS in Los Angeles County. Am J Trop Med Hyg (In press).Google Scholar
21.Morgenstern, H, Uses of ecologic analysis in epidemiologic research. Am J Public Health 1982; 72: 1336–43.CrossRefGoogle ScholarPubMed
22.Weber, R, Bryan, RT, Bishop, HS et al. , Threshold of detection of cryptosporidium oocysts in human stool specimens: evidence of low sensitivity of current diagnostic methods. J Clin Microbiol 1991; 29: 1323–7.CrossRefGoogle ScholarPubMed
23.Craun, GF, Waterborne outbreaks of giardiasis. In: Jakubowski, W, Hoff, JC, eds. Waterborne transmission of giardiasis. Cincinnati: Environmental Protection Agency, 1979.Google ScholarPubMed