TY - JOUR
T1 - Outbreak of cryptosporidiosis associated with a disinfected groundwater supply
AU - Bridgman, S. A.
AU - Robertson, R. M. P.
AU - Syed, Q.
AU - Speed, N.
AU - Andrews, N.
AU - Hunter, P. R.
PY - 1995/12
Y1 - 1995/12
N2 - In an outbreak of cryptosporidiosis in Warrington. a town in North-West England. 47 cases were recorded between November 1992 and February 1993. most within the first month. There was a strong statistical association between cases and residence in an area supplied from two groundwater sources. In a case-control study, a strong association between having drunk unboiled tap water from these sources, and a dose-response relationship were found. Oocysts were not detected in the water supply. During very heavy rainfall one source of water was found to drain surface water directly from a field containing livestock faeces, thereby bypassing natural sandstone filtration. Exceptionally heavy rainfall occurred at the probable time of infection. After withdrawal of the original water supply, the outbreak rapidly subsided. It was concluded that there was very strong evidence that this outbreak was waterborne. This, the second documented outbreak of cryptosporidiosis attributable to a groundwater supply, demonstrates that infection can be transmitted from a disinfected groundwater source despite apparently satisfactory treated water quality. We recommend that guidelines for protection of groundwater are implemented, raw groundwater should be routinely monitored for microbiological contamination, and the structure of all sources and waterworks should be assessed in risk surveys of water catchment areas.
AB - In an outbreak of cryptosporidiosis in Warrington. a town in North-West England. 47 cases were recorded between November 1992 and February 1993. most within the first month. There was a strong statistical association between cases and residence in an area supplied from two groundwater sources. In a case-control study, a strong association between having drunk unboiled tap water from these sources, and a dose-response relationship were found. Oocysts were not detected in the water supply. During very heavy rainfall one source of water was found to drain surface water directly from a field containing livestock faeces, thereby bypassing natural sandstone filtration. Exceptionally heavy rainfall occurred at the probable time of infection. After withdrawal of the original water supply, the outbreak rapidly subsided. It was concluded that there was very strong evidence that this outbreak was waterborne. This, the second documented outbreak of cryptosporidiosis attributable to a groundwater supply, demonstrates that infection can be transmitted from a disinfected groundwater source despite apparently satisfactory treated water quality. We recommend that guidelines for protection of groundwater are implemented, raw groundwater should be routinely monitored for microbiological contamination, and the structure of all sources and waterworks should be assessed in risk surveys of water catchment areas.
UR - http://www.scopus.com/inward/record.url?eid=2-s2.0-0029586565&partnerID=MN8TOARS
U2 - 10.1017/S0950268800058726
DO - 10.1017/S0950268800058726
M3 - Article
VL - 115
SP - 555
EP - 566
JO - Epidemiology and Infection
JF - Epidemiology and Infection
SN - 0950-2688
IS - 3
ER -