Published Date: 1998-05-10 23:50:00
Subject: PRO/AH/EDR> Cryptosporidiosis - UK
Archive Number: 19980510.0927
CRYPTOSPORIDIOSIS - UK
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A ProMED-mail post
See Also
Cryptosporidiosis - England (South-East) 970310233335Date: Fri, 08 May 1998 12:47:26 -0400
From: Robert A. LaBudde <ral@lcfltd.com>
Anglian Water was cited as saying that cryptosporidium had been found in a
water sample taken at a treatment works in Marham, Norfolk, and a boil water
advisory was issued for around 80,000 people.
Residents in the nearby towns of Downham Market, Wisbech and March were
being advised to take precautions until the problem was eradicated.
A spokesman for Anglian Water was cited as saying there were no known cases
of sickness in the area as a result of the infection, adding, "This was
found in a water sample taken at our treatment works and, in conjunction
with local health authority officials, we are advising people in the
affected areas to boil water as a precaution. We apologise for the
inconvenience but the health and safety of customers must come first. Tests
are now being carried out to find and eradicate the source of the problem.
At the moment we cannot say how long it will be before everything is back to
normal."
The scare comes 14 months after people in 300,000 homes in Hertfordshire and
north London were told to boil water after Cryptosporidium was found in
supplies.
At least 30 people had stomach ailments thought to have been caused by the
infection.
--
Robert A. LaBudde, PhD, PAS, Dpl. ACAFS e-mail: ral@lcfltd.com
Least Cost Formulations, Ltd. URL: http://lcfltd.com/
824 Timberlake Drive Tel: 757-467-0954
Virginia Beach, VA 23464-3239 Fax: 757-467-2947
***
[2
Date: Sun, 10 May 1998 14:00:44 -0500
From: Martin Hugh-Jones <mehj2020@vt8200.vetmed.lsu.edu>
Source: EUROSURVEILANCE, Week 19: 7 May, 1998,
<http://www.eurosurv.org/main.htm>
Increased cases of Cryptosporidium infection in central Scotland
About 120 Cryptosporidium infections have been reported to departments of
public health medicine in the central belt of Scotland (Argyll & Clyde,
Forth Valley, Greater Glasgow, Lanarkshire, and Lothian Health Boards) since
the beginning of April, many of them in week 18. Reports of
cryptosporidiosis in Scotland usually peak in late March and April, but few
of the recent 120 cases are included in the national total of 168 cases
reported to the Scottish Centre for Infection and Environmental Health
(SCIEH) in the first 18 weeks of 1998. The true total to date is likely to
be 200-250, considerably higher than the total of 144 for the first 18 weeks
of 1997. Between 600 and 900 cases have been reported in each of the past
eight years. Cryptosporidiosis is a protozoal infection that causes profuse
watery diarrhoea and abdominal pain, sometimes with anorexia, vomiting, and
fever. Infection may be asymptomatic, but the disease can be life
threatening in immunocompromised patients.
Consultants in public health medicine from central Scotland, relevant water
authorities, the Scottish Parasite Reference Laboratory, SCIEH, and the
Scottish Office met on 1 May to consider the situation. Most of the recent
cases of cryptosporidiosis are children, but all age groups are represented.
A few patients have been admitted to hospital, including two elderly women.
A substantial proportion of the cases are thought to be due to animal
contact, particularly at 'petting farms' or animal markets, where children
are encouraged to handle young animals. Cases are known to have consumed
potable water from several different public water supplies, and routine
water monitoring has shown no deviation from baseline levels. Risk factors
among individual cases are being investigated more closely. It seems likely
that several factors have contributed to this outbreak.
Press statements have emphasised the need for careful hygiene when handling
farm animals or sick pets and to prevent spread from person to person, and
have advised against the consumption of untreated water from any source.
People in the UK with impaired immunity (for example, patients with AIDS or
on renal dialysis) have already been advised not to drink unboiled water
from any source (1), and only water that has been boiled previously should
be given to babies to drink or used to reconstitute their feeds. Water
supplies are being monitored more closely, local health professionals have
been advised, and farmers and teachers are being sent information on health
and safety at open farms.
Reference:
1.Department of the Environment and Department of Health. Cryptosporidium in
water supplies. Second report of the group of experts ('Badenoch Report').
London: HMSO, 1995
--
Reported by Peter Christie
Scottish Centre for Infection and Environmental Health,
Glasgow, Scotland
e-mail: christie@scieh.tcom.co.uk
[The Editors of Eurosurveilance had commented:
>From the editors: "The emergence of cryptosporidiosis"
One of the first issues of Eurosurveillance reported the first outbreak of
cryptosporidiosis identified in the Netherlands (1). Awareness of the
importance of the coccidian protozoon Cryptosporidium parvum has increased
since it was first identified as a cause of human enteritis in 1976.
Cryptosporidiosis is particularly severe and protracted in people with
impaired immunity, but can cause several weeks of debility and watery
diarrhoea in immunocompetent people. Surveys of stools carried out in
developed countries have shown the prevalence of infection to be between <1%
and 4.5%, and many infections are subclinical (2). Children under 2 years of
age (and their carers), animal handlers, travellers, and homosexual men are
particularly likely to be infected. A quick look through past issues of CDR
Review identified outbreaks associated with contaminated water supplies (3),
contact with animals (including by children visiting open farms) (4-6),
swimming pools (7,8), and consumption of inadequately pasteurised milk (9).
This issue of Eurosurveillance Weekly reports on the recent observation of a
higher than expected number of cases in Scotland. It is too early to know
the reason(s) for this observation, but advice about personal hygiene and
sanitary disposal of faeces, handwashing after contact with animals, and the
advice that drinking water for people with impaired immunity and for babies
should always be boiled are generally applicable.
References:
1.van Asperen IA, Mank T, Medema GJ, Stijnen C, de Boer AS, Groot JF, et al.
An outbreak of cryptosporidiosis in the Netherlands. Eurosurveillance 1996;
1: 11-2. <http://www.ceses.org/eurosurv/>
2.Benenson AS. Control of communicable diseases manual. Sixteenth edition.
Washington DC: American Public Health Association, 1995.
3.Morgan D, Allaby M, Crook S, Casemore D, Healing TD, Soltanpoor N, et al.
Waterborne cryptosporidiosis associated with a borehole supply. Commun Dis
Rep CDR Rev 1995; 5: R93-7.
4.Dawson A, Griffin R, Fleetwood A, Barrett NJ. Farm visits and zoonoses.
Commun Dis Rep CDR Rev 1995; 5: R81-6.
5.Evans MR, Gardner D. Cryptosporidiosis associated with an educational farm
holiday. Commun Dis Rep CDR Rev 1996; 6: R50-1 (correction R67).
6.Sayers GM, Dillon MC, Connolly E, Thornton L, Hyland E, Loughman E, et al.
Cryptosporidosis in children who visited an open farm. Commun Dis Rep CDR
Rev 1996; 6:R140-4.
7.Hunt DA, Sebugwawo S, Edmondson SG, Casemore DP. Cryptosporidiosis
associated with a swimming pool complex. Commun Dis Rep CDR Rev 1994; 4:
R20-2 (correction R36).
8.Sundkvist T, Dryden M, Gabb R, Soltanpoor N, Casemore D, Stuart J.
Outbreak of cryptosporidiosis associated with a swimming pool in Andover.
Commun Dis Rep CDR Rev 1997; 7: R190-2.
9.Djuretic T, Wall PG, Nichols G. General outbreaks of infectious intestinal
disease associated with milk and dairy products in England and Wales: 1992
to 1996. Commun Dis Rep CDR Rev 1997; 7: R41-5.
--
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