title: Clinical and epidemiologic features of a massive waterborne outbreak of cryptosporidiosis in persons with HIV infection.
abstract: During March and April 1993, a massive outbreak of Cryptosporidium infection resulted from contamination of the public water supply in Milwaukee, Wisconsin. The health impact of this outbreak in HIV-infected persons was unknown but was perceived as severe. We surveyed HIV-infected persons who resided in the greater Milwaukee area to examine the acute health impact of cryptosporidiosis on this population. Data from a random-digit dialing survey in the general population residing in the same area were used for comparison. The attack rate of watery diarrhea suggestive of cryptosporidiosis was lower in HIV-infected persons (32%) than in the general population (51%). There was no significant difference in attack rate in HIV-infected persons based on CD4+ T-lymphocyte count. In persons with watery diarrhea, HIV-infected persons were more likely to experience cough (42%), fever (52%), and dehydration (55%). In HIV-infected persons with watery diarrhea, persons with CD4+ T-lymphocyte counts <200/microl had longer duration of diarrhea and were more likely to seek medical attention and be hospitalized. During this massive waterborne outbreak, HIV-infected persons were not more likely to experience symptomatic Cryptosporidium infection than the general population. However, once infected, the duration and severity of illness was greater in HIV-infected persons, especially if the CD4+ T-lymphocyte count was <200/microl.
authors.affiliation: Bureau of Public Health, Wisconsin Division of Health, Madison 53703-3044, USA.
authors.forename: H R
authors.initials: HR
authors.lastname: Frisby
authors.forename: D G
authors.initials: DG
authors.lastname: Addiss
authors.forename: W J
authors.initials: WJ
authors.lastname: Reiser
authors.forename: B
authors.initials: B
authors.lastname: Hancock
authors.forename: J M
authors.initials: JM
authors.lastname: Vergeront
authors.forename: N J
authors.initials: NJ
authors.lastname: Hoxie
authors.forename: J P
authors.initials: JP
authors.lastname: Davis
mesh_terms: D017088:AIDS-Related Opportunistic Infections / Q000453:epidemiology*; D000328:Adult; D018791:CD4 Lymphocyte Count; D003457:Cryptosporidiosis / Q000453:epidemiology*; D003967:Diarrhea / Q000453:epidemiology; D004196:Disease Outbreaks; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D014867:Water / Q000469:parasitology*; D014922:Wisconsin / Q000453:epidemiology
chemical_list: D014867:Water