Epidemiology and Infection

Gastrointestinal infection

Epidemiology of anthroponotic and zoonotic human cryptosporidiosis in England and Wales, 2004–2006

R. M. CHALMERSa1 c1, R. SMITHa2, K. ELWINa1, F. A. CLIFTON-HADLEYa3 and M. GILESa3

a1 Cryptosporidium Reference Unit, Public Health Wales Microbiology ABM, Singleton Hospital, Swansea, UK

a2 Centre for Epidemiology and Risk Analysis, Veterinary Laboratories Agency – Weybridge, New Haw, Addlestone, Surrey, UK

a3 Food and Environment Safety Department, Veterinary Laboratories Agency – Weybridge, New Haw, Addlestone, Surrey, UK

SUMMARY

In order to monitor epidemiological trends, Cryptosporidium-positive samples (n=4509) from diarrhoeic patients were typed. Compared to the previous 4 years, the proportion of Cryptosporidium hominis cases in 2004–2006 increased to 57·3%, while 38·5% were C. parvum. The remaining 4·2% cases included mixed C. parvum and C. hominis infections, C. meleagridis, C. felis, C. ubiquitum and a novel genotype. When the typing results were combined with enhanced surveillance data to monitor risk exposures, C. hominis was linked to urban dwelling, previous diarrhoea in the household, any travel especially abroad, and using a swimming or paddling pool. C. parvum was linked to having a private water supply, contact with surface water, visiting or living on a farm, and contact with farm animal faeces. The proportion of laboratory-confirmed indigenous cases acquired from direct contact with farm animals was estimated to be 25% for C. parvum and 10% of all reported Cryptosporidium cases.

(Accepted June 14 2010)

(Online publication July 12 2010)

Correspondence:

c1 Author for correspondence: Dr R. M. Chalmers, Cryptosporidium Reference Unit, Public Health Wales Microbiology, Singleton Hospital, Swansea SA2 8QA, UK. (Email: Rachel.chalmers@wales.nhs.uk)

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