TY - JOUR AU - Widerström, Micael AU - Schönning, Caroline AU - Lilja, Mikael AU - Lebbad, Marianne AU - Ljung, Thomas AU - Allestam, Görel AU - Ferm, Martin AU - Björkholm, Britta AU - Hansen, Anette AU - Hiltula, Jari AU - Långmark, Jonas AU - Löfdahl, Margareta AU - Omberg, Maria AU - Reuterwall, Christina AU - Samuelsson, Eva AU - Widgren, Katarina AU - Wallensten, Anders AU - Lindh, Johan T1 - Large Outbreak of Cryptosporidium hominis Infection Transmitted through the Public Water Supply, Sweden T2 - Emerging Infectious Disease journal PY - 2014 VL - 20 IS - 4 SP - 581 SN - 1080-6059 AB - In November 2010, ≈27,000 (≈45%) inhabitants of Östersund, Sweden, were affected by a waterborne outbreak of cryptosporidiosis. The outbreak was characterized by a rapid onset and high attack rate, especially among young and middle-aged persons. Young age, number of infected family members, amount of water consumed daily, and gluten intolerance were identified as risk factors for acquiring cryptosporidiosis. Also, chronic intestinal disease and young age were significantly associated with prolonged diarrhea. Identification of Cryptosporidium hominis subtype IbA10G2 in human and environmental samples and consistently low numbers of oocysts in drinking water confirmed insufficient reduction of parasites by the municipal water treatment plant. The current outbreak shows that use of inadequate microbial barriers at water treatment plants can have serious consequences for public health. This risk can be minimized by optimizing control of raw water quality and employing multiple barriers that remove or inactivate all groups of pathogens. KW - cryptosporidiosis/epidemiology KW - cryptosporidiosis/prevention & control KW - cryptosporidiosis/transmission KW - diarrhea KW - disease outbreaks KW - drinking water KW - molecular typing KW - questionnaires KW - risk factors KW - water microbiology KW - water supply KW - waste management, parasites KW - waterborne infections KW - cryptosporidiosis/prevention and control KW - Cryptosporidium hominis infection KW - waste management KW - parasites KW - Sweden DO - 10.3201/eid2004.121415 UR - https://wwwnc.cdc.gov/eid/article/20/4/12-1415_article ER - End of Reference