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Volume 26, Number 3—March 2020
CME ACTIVITY - Synopsis

Epidemiology of Cryptosporidiosis, New York City, New York, USA, 1995–20181

Lisa Alleyne, Robert Fitzhenry, Kimberly A. Mergen, Noel Espina, Erlinda Amoroso, Daniel Cimini, Sharon Balter2, Ana Maria Fireteanu, Anne Seeley, Lorraine Janus, Bruce Gutelius3, Susan Madison-Antenucci, and Corinne N. ThompsonComments to Author 
Author affiliations: New York City Department Health and Mental Hygiene, Long Island City, New York, USA (L. Alleyne, R. Fitzhenry, E. Amoroso, D. Cimini, S. Balter, A.M. Fireteanu, B. Gutelius, C.N. Thompson); New York State Department of Health, Albany, New York, USA (K.A. Mergen, N. Espina, S. Madison-Antenucci); New York City Department of Environmental Protection, Corona, New York, USA (A. Seeley, L. Janus)

Main Article

Table 2

Reported exposures of cryptosporidiosis patients stratified by those with and without international or domestic travel outside New York City, New York, USA, during period of interest before symptom onset for patients, 20002018*

Characteristic Age, y/sex group, no. positive/no. tested (%)
p value
<20/All 20–59/M >59/M >20/F Total
Interviewed patients 500/555 (90.1) 1,000/1,359 (73.6) 71/87 (81.6) 434/537 (80.8) 2,005/2,538 (79) <0.001
International travel 254/492 (51.6) 158/993 (15.9) 16/72 (22.2) 155/431 (36.0) 583/1,988 (29.3) <0.001
Domestic travel 99/445 (22.2) 208/910 (22.9) 12/65 (18.5) 81/395 (20.5) 400/1,815 (22.0) 0.77
No travel 149/474 (31.4) 562/908 (61.9) 39/67 (58.2) 179/401 (44.6) 929/1,850 (50.2) <0.001
High-risk sex† ND 234/546 (42.9) 6/37 (16.2) 30/174 (17.2) 270/757 (35.7) <0.001
Recreational water contact‡ 35 (23.5) 46 (8.2) 3 (7.7) 12 (6.7) 96 (10.3) <0.001
Child care attendee§ 14/61 (23.0) ND ND ND ND NA
Animal contact¶ 36 (24.2) 197 (35.1) 5 (12.8) 64 (35.8) 302 (32.5) 0.02
Ate high-risk food# 61 (40.9) 338 (60.2) 16 (41.0) 113 (63.1) 528 (56.9) <0.001
Drank NYC tap water 68 (45.6) 403 (71.7) 23 (59.0) 119 (66.5) 613 (66.0) <0.001
Treated NYC tap water** 53 (35.8) 217 (38.6) 16 (41.0) 73 (40.8) 359 (38.7) 0.50
Used NYC tap water†† 117 (78.5) 496 (88.3) 31 (79.5) 165 (92.2) 809 (87.1) <0.001
Drank high-risk water‡‡ 2/145 (1.4) 8/549 (1.5) 0/37 (0) 2/174 (1.1) 12/905 (1.3) >0.99

*Percentages in parentheses reflect percentage of patients who were interviewed during each period. Period of interest is defined as 1 month for patients given a diagnosis during January 1995–April 2010, and 2 weeks for patients given a diagnosis during May 2010–December 2018. NA, not applicable; ND, no data were collected; NYC, New York City.
†For adults >18 years of age, defined as having anal sex (receptive or insertive), insertion of a finger or a tongue in or around a partner’s anus, or having oral sex.
‡Defined as water from a hot tub, public or private swimming pool, stream, ocean, or recreational water park.
§For children <5 years of age.
¶Defined as having a pet, being exposed to an animal, changing cat litter, picking up dog stool, visiting a zoo, having a pet, or having a job that required contact with animals.
#Defined as raw or unpasteurized cheese, milk or cider, cooked or uncooked shellfish, and unpeeled fruit or vegetables.
**Patients either boiled or filtered NYC municipal water before drinking.
††Used NYC municipal water to brush teeth, wash vegetables/fruit, make ice, or make juice.
‡‡High-risk water was defined as water from a stream, spring, pond, or private well.

Main Article

1Preliminary results were presented at the annual meeting of the Council of State and Territorial Epidemiologists, June 11–13, 2018; West Palm Beach, Florida, USA.

2Current affiliation: Los Angeles County Department of Health, Los Angeles, California, USA.

3Current affiliation: Centers for Disease Control and Prevention, Atlanta, Georgia, USA.

Page created: February 19, 2020
Page updated: February 19, 2020
Page reviewed: February 19, 2020
The conclusions, findings, and opinions expressed by authors contributing to this journal do not necessarily reflect the official position of the U.S. Department of Health and Human Services, the Public Health Service, the Centers for Disease Control and Prevention, or the authors' affiliated institutions. Use of trade names is for identification only and does not imply endorsement by any of the groups named above.
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