Multiple risk factors associated with a large statewide increase in cryptosporidiosis.


Cryptosporidium species have emerged as a major cause of outbreaks of diarrhoea and have been associated with consumption of contaminated recreational and drinking water and food as well as contact with infected attendees of child-care programmes. In August 2007, the Colorado Department of Public Health and Environment detected an increase in cryptosporidiosis cases over baseline values. We conducted a case-control study to assess risk factors for infection and collected stool specimens from ill persons for microscopy and molecular analysis. Laboratory-confirmed cases (n=47) were more likely to have swallowed untreated water from a lake, river, or stream [adjusted matched odds ratio (aOR) 8.0, 95% confidence interval (CI) 1.3-48.1], have had exposure to recreational water (aOR 4.6, 95% CI 1.4-14.6), or have had contact with a child in a child-care programme or in diapers (aOR 3.8, 95% CI 1.5-9.6). Although exposure to recreational water is commonly implicated in summertime cryptosporidiosis outbreaks, this study demonstrates that investigations of increased incidence of cases in summer should also examine other potential risk factors. This study emphasizes the need for public health education efforts that address the multiple transmission routes for Cryptosporidium and appropriate prevention measures to avoid future transmission.

DOI: 10.1017/S0950268809002842

Cite this paper

@article{Valderrama2009MultipleRF, title={Multiple risk factors associated with a large statewide increase in cryptosporidiosis.}, author={Amy L . Valderrama and Michele C Hlavsa and Alicia B . Cronquist and Shaun Cosgrove and Stephanie P. Johnston and Jacquelin M. Roberts and Matthew L. Stock and Lihua Xiao and Karen Xavier and Michael Beach}, journal={Epidemiology and infection}, year={2009}, volume={137 12}, pages={1781-8} }