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Published in: Irish Journal of Medical Science (1971 -) 4/2017

01-11-2017 | Original Article

Waterborne outbreak of cryptosporidiosis in the South East of Ireland: weighing up the evidence

Authors: M. Mahon, S. Doyle

Published in: Irish Journal of Medical Science (1971 -) | Issue 4/2017

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Abstract

Background

In late Spring 2012, 12 cases of cryptosporidiosis in a town in the South East of Ireland were notified to the regional Department of Public Health.

Aim

The purpose of this paper is to describe the outbreak and the investigative process which led to the conclusion that the source was a public drinking water supply.

Methods

Outbreak and incident control teams were convened to investigate and control the outbreak.

Results

Eleven cases were speciated as Cryptosporidium parvum. GP60 analysis demonstrated that 10 were C. parvum IIaA20G3R1, indicating that the cases were linked. The public water supply was the only common risk factor identified. Increased water sampling identified Cryptosporidium muris/andersoni in the treated water at one of two water treatment plants (Water Treatment Plant, WTP A) for the supply, and on the network. C. parvum was subsequently identified in raw water from WTP A.

Conclusions

The Health Service Executive (HSE) concluded that this outbreak was “probably associated with water” produced at WTP A based on (1) descriptive epidemiological evidence suggesting water-related illness and excluding other obvious explanations; and (2) water treatment failure at WTP A. WTP A was closed to facilitate an upgrade. No boil water notice was required as a supplementary supply was available. The upgrade was completed and the incident closed in 2013.
Literature
1.
go back to reference Bouzid A, Hunter PR, Chalmers RM, Typer KM (2013) Cryptosporidium pathogenicity and virulence. Clin Microbiol 26(1):115–134CrossRef Bouzid A, Hunter PR, Chalmers RM, Typer KM (2013) Cryptosporidium pathogenicity and virulence. Clin Microbiol 26(1):115–134CrossRef
2.
go back to reference Cacciò SM (2005) Molecular epidemiology of human cryptosporidiosis. Parassitologia 47(2):185–192PubMed Cacciò SM (2005) Molecular epidemiology of human cryptosporidiosis. Parassitologia 47(2):185–192PubMed
3.
go back to reference Chalmers RM, Smith R, Elwin K, Clifton-Hadley FA, Giles M (2011) Epidemiology of anthroponotic and zoonotic human cryptosporidiosis in England and Wales, 2004–2006. Epidemiol Infect 139(5):700–712CrossRefPubMed Chalmers RM, Smith R, Elwin K, Clifton-Hadley FA, Giles M (2011) Epidemiology of anthroponotic and zoonotic human cryptosporidiosis in England and Wales, 2004–2006. Epidemiol Infect 139(5):700–712CrossRefPubMed
4.
go back to reference Strong WB, Gut J, Nelson RG (2000) Cloning and sequence analysis of a highly polymorphic Cryptosporidium parvum gene encoding a 60-kDa glycoprotein and characterization of its 15- and 45-kDa zoite surface antigen products. Infect Immun 68(7):4117–4134CrossRefPubMedPubMedCentral Strong WB, Gut J, Nelson RG (2000) Cloning and sequence analysis of a highly polymorphic Cryptosporidium parvum gene encoding a 60-kDa glycoprotein and characterization of its 15- and 45-kDa zoite surface antigen products. Infect Immun 68(7):4117–4134CrossRefPubMedPubMedCentral
5.
go back to reference Zintl A, Ezzaty-Mirashemi M, Chalmers RM et al (2011) Longitudinal and spatial distribution of GP60 subtypes in human cryptosporidiosis cases in Ireland. Epidemiol Infect 139:1945–1955CrossRefPubMed Zintl A, Ezzaty-Mirashemi M, Chalmers RM et al (2011) Longitudinal and spatial distribution of GP60 subtypes in human cryptosporidiosis cases in Ireland. Epidemiol Infect 139:1945–1955CrossRefPubMed
6.
go back to reference Chalmers RM, Smith RP (2011) Zoonotic linkage and variation in Cryptosporidium parvum from patients in the United Kingdom. Parasitol Res 108:1321–1325CrossRefPubMed Chalmers RM, Smith RP (2011) Zoonotic linkage and variation in Cryptosporidium parvum from patients in the United Kingdom. Parasitol Res 108:1321–1325CrossRefPubMed
7.
go back to reference Glaberman S, Moore JE, Lowery CJ et al (2002) Three drinking-water-associated cryptosporidiosis outbreaks, Northern Ireland. Emerg Infect Dis 8(6):631–633CrossRefPubMedPubMedCentral Glaberman S, Moore JE, Lowery CJ et al (2002) Three drinking-water-associated cryptosporidiosis outbreaks, Northern Ireland. Emerg Infect Dis 8(6):631–633CrossRefPubMedPubMedCentral
9.
go back to reference World Health Organization (2002) Water and Health. A joint report from the European Environmental Agency and the WHO Regional Office for Europe. In: Bartram J, Thyssen N, Gowers A, Pond K, Lack T (eds) WHO Regional Publications Series no. 93:122, WHO, Finland World Health Organization (2002) Water and Health. A joint report from the European Environmental Agency and the WHO Regional Office for Europe. In: Bartram J, Thyssen N, Gowers A, Pond K, Lack T (eds) WHO Regional Publications Series no. 93:122, WHO, Finland
12.
go back to reference Environmental Protection Agency (2011) EPA Drinking Water Advice Note. Advice Note No. 9: Cryptosporidium Sampling and Monitoring, Version 1. Dublin: EPA Environmental Protection Agency (2011) EPA Drinking Water Advice Note. Advice Note No. 9: Cryptosporidium Sampling and Monitoring, Version 1. Dublin: EPA
13.
go back to reference Peng MM, Matos O, Gatei W et al (2001) A comparison of Cryptosporidium subgenotypes from several geographical regions. J Eukaryot Microbiol 48(Suppl):28s–31sCrossRef Peng MM, Matos O, Gatei W et al (2001) A comparison of Cryptosporidium subgenotypes from several geographical regions. J Eukaryot Microbiol 48(Suppl):28s–31sCrossRef
14.
go back to reference Alves M, Xiao L, Sulaiman I, Lal AA, Matos O, Antunes F (2003) Subgenotype analysis of Cryptosporidium isolates from humans, cattle and zoo ruminants in Portugal. J Clin Microbiol 41(6):2744–2747CrossRefPubMedPubMedCentral Alves M, Xiao L, Sulaiman I, Lal AA, Matos O, Antunes F (2003) Subgenotype analysis of Cryptosporidium isolates from humans, cattle and zoo ruminants in Portugal. J Clin Microbiol 41(6):2744–2747CrossRefPubMedPubMedCentral
15.
go back to reference Chalmers RM, Ferguson C, Cacciò SM et al (2005) Direct comparison of selected methods of genetic characterisation of Cryptosporidium parvum and Cryptosporidium hominis species. Int J Parasitol 35(4):397–410CrossRefPubMed Chalmers RM, Ferguson C, Cacciò SM et al (2005) Direct comparison of selected methods of genetic characterisation of Cryptosporidium parvum and Cryptosporidium hominis species. Int J Parasitol 35(4):397–410CrossRefPubMed
16.
go back to reference Hawker J, Begg N, Blair I, Reintjes R, Weinberg J, Ekdahl K (2012) Communicable disease control and health protection handbook, 3rd edn. Wiley-Blackwell, OxfordCrossRef Hawker J, Begg N, Blair I, Reintjes R, Weinberg J, Ekdahl K (2012) Communicable disease control and health protection handbook, 3rd edn. Wiley-Blackwell, OxfordCrossRef
17.
go back to reference National Disease Surveillance Centre (2004) Report of the Waterborne Cryptosporidiosis Subcommittee of the Scientific Advisory Committee. NDSC, Dublin National Disease Surveillance Centre (2004) Report of the Waterborne Cryptosporidiosis Subcommittee of the Scientific Advisory Committee. NDSC, Dublin
18.
go back to reference Xiao L, Fayer R, Ryan U, Upton SJ (2004) Cryptosporidium taxonomy: recent advances and implications for public health. Clin Microbiol Rev 17(1):72–97CrossRefPubMedPubMedCentral Xiao L, Fayer R, Ryan U, Upton SJ (2004) Cryptosporidium taxonomy: recent advances and implications for public health. Clin Microbiol Rev 17(1):72–97CrossRefPubMedPubMedCentral
19.
go back to reference Thompson HP, Dooley JSG, Kenny J et al (2007) Genotypes and subtypes of Cryptosporidium spp. in neonatal calves in Northern Ireland. Parasitol Res 100:619–624CrossRefPubMed Thompson HP, Dooley JSG, Kenny J et al (2007) Genotypes and subtypes of Cryptosporidium spp. in neonatal calves in Northern Ireland. Parasitol Res 100:619–624CrossRefPubMed
20.
go back to reference Karanis P, Kourenti C, Smith H (2007) Waterborne transmission of protozoan parasites: a worldwide review of outbreaks and lessons learnt. J Water Health 5(1):1–38CrossRefPubMed Karanis P, Kourenti C, Smith H (2007) Waterborne transmission of protozoan parasites: a worldwide review of outbreaks and lessons learnt. J Water Health 5(1):1–38CrossRefPubMed
21.
22.
go back to reference Widerstorm M, Schönning C, Lilja M et al (2014) Large outbreak of Cryptosporidium hominis infection transmitted through the public water supply, Sweden. Emerg Infect Dis 20:581–589CrossRef Widerstorm M, Schönning C, Lilja M et al (2014) Large outbreak of Cryptosporidium hominis infection transmitted through the public water supply, Sweden. Emerg Infect Dis 20:581–589CrossRef
23.
go back to reference Pelly H, Cormican M, O’Donovan D et al (2007) A large outbreak of cryptosporidiosis in western Ireland linked to a public water supply: a preliminary report. Euro Surveill 12(5):E070503.3PubMed Pelly H, Cormican M, O’Donovan D et al (2007) A large outbreak of cryptosporidiosis in western Ireland linked to a public water supply: a preliminary report. Euro Surveill 12(5):E070503.3PubMed
Metadata
Title
Waterborne outbreak of cryptosporidiosis in the South East of Ireland: weighing up the evidence
Authors
M. Mahon
S. Doyle
Publication date
01-11-2017
Publisher
Springer London
Published in
Irish Journal of Medical Science (1971 -) / Issue 4/2017
Print ISSN: 0021-1265
Electronic ISSN: 1863-4362
DOI
https://doi.org/10.1007/s11845-016-1552-1

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