title: [Cryptosporidium hominis diarrhea outbreak and transmission linked to diaper infant use].
abstract: OBJECTIVE
  On the basis of several cases of cryptosporidiosis detected in a child day-care center, we stablished the extent of the outbreak and investigated causes of parasite transmission.
  
  
  METHODS
  A retrospective cohort study was designed on all children attending day-care center and care givers to determine their infection status and identify risk factors associated to the outbreak.
  
  
  RESULTS
  24 cases of cryptosporidiosis were detected, with an attack rate of 0.46 (24/52); 12 of them were parasitologycally confirmed. All care givers were negative for Cryptosporidium and none of them reported symptoms of acute gastroenteritis. Transmission pattern was compatible with person to person modes. Among the factors investigated, two were associated with the risk of disease: diaper wear (relative risk = 2.06; p = 0.059); and diarrhea in relatives (relative risk = 2.05; p = 0.01). In all confirmed cases, Cryptosporidium hominis (previously known as C. parvum, genotype 1), was identified.
  
  
  CONCLUSIONS
  Cryptosporidiosis should be considered as a possible cause of outbreaks of gastroenteritis at day-care centers. Increasing care on diaper changing practices, specially over children with diarrhea, may be the key factor to prevent transmission of Cryptosporidium.
authors.affiliation: Servicio de Medicina Preventiva, Hospital Clínico Universitario Lozano Blesa, Zaragoza, España.
authors.forename: María
authors.initials: M
authors.lastname: Teresa Ortega
authors.forename: Alberto
authors.initials: A
authors.lastname: Vergara
authors.forename: Joaquín
authors.initials: J
authors.lastname: Guimbao
authors.forename: Antonio
authors.initials: A
authors.lastname: Clavel
authors.forename: Patricia
authors.initials: P
authors.lastname: Gavín
authors.forename: Andrés
authors.initials: A
authors.lastname: Ruiz
mesh_terms: D002656:Child Day Care Centers; D002675:Child, Preschool; D003457:Cryptosporidiosis / Q000453:epidemiology / Q000635:transmission*; D041381:Diapers, Infant; D003967:Diarrhea / Q000453:epidemiology / Q000382:microbiology; D003968:Diarrhea, Infantile / Q000453:epidemiology / Q000382:microbiology*; D004196:Disease Outbreaks; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D012189:Retrospective Studies