Epidemiology and Infection

The changing epidemiology of cryptosporidiosis in North West England

W. SOPWITH a1c1, K. OSBORN a2, R. CHALMERS a3 and M. REGAN a1
a1 Health Protection Agency, North West Regional Office, Liverpool, UK
a2 United Utilities, Warrington, UK
a3 Cryptosporidium Reference Unit, National Public Health Service for Wales, Swansea, UK

Article author query
sopwith w   [PubMed][Google Scholar] 
osborn k   [PubMed][Google Scholar] 
chalmers r   [PubMed][Google Scholar] 
regan m   [PubMed][Google Scholar] 


Between 1996 and 2000, rates of cryptosporidiosis in North West England were significantly higher than overall in England and Wales, particularly during the first half of each year. In addition, during the second quarter of each year in this period, up to 40% of all cases recorded in England and Wales were from the North West Region. In 2001, cryptosporidiosis dramatically decreased throughout the United Kingdom and the springtime excess of cases formerly seen in the North West was no longer apparent. This changed epidemiology was due to a decline in cases of Cryptosporidium parvum (formerly genotype 2), associated with zoonotic transmission. Although the initial loss of a spring peak of infection corresponded with the outbreak of foot-and-mouth disease throughout the United Kingdom, its continued absence relates to major structural changes in the North West public water supply. This study highlights the far-reaching public health benefit of local working relationships in addressing re-occurring disease issues.

(Published Online July 14 2005)
(Accepted May 24 2005)

c1 Health Protection Agency NW, DBH House, 105 Boundary St, Liverpool L5 9YJ, UK. (Email: Will.sopwith@hpa.org.uk)