An outbreak of Cryptosporidium hominis infection at an Illinois recreational waterpark

L. M. Causer, T. Handzel, P. Welch, M. Carr, D. Culp, R. Lucht, K. Mudahar, D. Robinson, E. Neaver, S. Fenton, C. Rose, L. Craig, M. Arrowood, S. Wahlquist, L. Xiao, Y. M. Lee, L. Mirel, Deborah A Levy, M. J. Beach, G. Poquette & 1 others M. S. Dworkin

Research output: Contribution to journalArticle

36 Citations (Scopus)

Abstract

Cryptosporidium has become increasingly recognized as a pathogen responsible for outbreaks of diarrhoeal illness in both immunocompetent and immunocompromised persons. In August 2001, an Illinois hospital reported a cryptosporidiosis cluster potentially linked to a local waterpark. There were 358 case-patients identified. We conducted community-based and waterpark-based case-control studies to examine potential sources of the outbreak. We collected stool specimens from ill persons and pool water samples for microscopy and molecular analysis. Laboratory-confirmed case-patients (n=77) were more likely to have attended the waterpark [odds ratio (OR) 16.0, 95% confidence interval (CI) 3.8-66.8], had pool water in the mouth (OR 6.0, 95% CI 1.3-26.8), and swallowed pool water (OR 4.5, 95% CI 1.5-13.3) than age-matched controls. Cryptosporidium was found in stool specimens and pool water samples. The chlorine resistance of oocysts, frequent swimming exposures, high bather densities, heavy usage by diaper-aged children, and increased recognition and reporting of outbreaks are likely to have contributed to the increasing trend in number of swimming pool-associated outbreaks of cryptosporidiosis. Recommendations for disease prevention include alteration of pool design to separate toddler pool filtration systems from other pools. Implementation of education programmes could reduce the risk of faecal contamination and disease transmission.

Original languageEnglish (US)
Pages (from-to)147-156
Number of pages10
JournalEpidemiology and Infection
Volume134
Issue number1
DOIs
StatePublished - Feb 1 2006

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Cryptosporidium
Disease Outbreaks
Cryptosporidiosis
Water
Odds Ratio
Confidence Intervals
Infection
Swimming Pools
Oocysts
Chlorine
Mouth
Case-Control Studies
Microscopy
Education

ASJC Scopus subject areas

  • Epidemiology
  • Infectious Diseases

Cite this

Causer, L. M., Handzel, T., Welch, P., Carr, M., Culp, D., Lucht, R., ... Dworkin, M. S. (2006). An outbreak of Cryptosporidium hominis infection at an Illinois recreational waterpark. Epidemiology and Infection, 134(1), 147-156. https://doi.org/10.1017/S0950268805004619

An outbreak of Cryptosporidium hominis infection at an Illinois recreational waterpark. / Causer, L. M.; Handzel, T.; Welch, P.; Carr, M.; Culp, D.; Lucht, R.; Mudahar, K.; Robinson, D.; Neaver, E.; Fenton, S.; Rose, C.; Craig, L.; Arrowood, M.; Wahlquist, S.; Xiao, L.; Lee, Y. M.; Mirel, L.; Levy, Deborah A; Beach, M. J.; Poquette, G.; Dworkin, M. S.

In: Epidemiology and Infection, Vol. 134, No. 1, 01.02.2006, p. 147-156.

Research output: Contribution to journalArticle

Causer, LM, Handzel, T, Welch, P, Carr, M, Culp, D, Lucht, R, Mudahar, K, Robinson, D, Neaver, E, Fenton, S, Rose, C, Craig, L, Arrowood, M, Wahlquist, S, Xiao, L, Lee, YM, Mirel, L, Levy, DA, Beach, MJ, Poquette, G & Dworkin, MS 2006, 'An outbreak of Cryptosporidium hominis infection at an Illinois recreational waterpark', Epidemiology and Infection, vol. 134, no. 1, pp. 147-156. https://doi.org/10.1017/S0950268805004619
Causer, L. M. ; Handzel, T. ; Welch, P. ; Carr, M. ; Culp, D. ; Lucht, R. ; Mudahar, K. ; Robinson, D. ; Neaver, E. ; Fenton, S. ; Rose, C. ; Craig, L. ; Arrowood, M. ; Wahlquist, S. ; Xiao, L. ; Lee, Y. M. ; Mirel, L. ; Levy, Deborah A ; Beach, M. J. ; Poquette, G. ; Dworkin, M. S. / An outbreak of Cryptosporidium hominis infection at an Illinois recreational waterpark. In: Epidemiology and Infection. 2006 ; Vol. 134, No. 1. pp. 147-156.
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