title: A statewide outbreak of Cryptosporidium and its association with the distribution of public swimming pools.
abstract: In order to characterize the association between county-level risk factors and the incidence of Cryptosporidium in the 2007 Iowa outbreak, we used generalized linear mixed models with the number of Cryptosporidium cases per county as the dependent variable. We employed a spatial power covariance structure, which assumed that the correlation between the numbers of cases in any two counties decreases as the distance between them increases. County population size was included in the model to adjust for population differences. Independent variables included the number of pools in specific pool categories (large, small, spa, wading, waterslide) and pool-owner classes (apartment, camp, country club or health club, hotel, municipal, school, other) as well as the proportion of residents aged <5 years. We found that increases in the number of bigger pools, pools with more heterogeneous mixing (municipal pools vs. country club or apartment pools), and pools catering to young children (wading pools) are associated with more cases at the county level.
authors.affiliation: Department of Infectious Disease, University of Iowa, Iowa City, 52242, USA. philip-polgreen@uiowa.edu
authors.forename: P M
authors.initials: PM
authors.lastname: Polgreen
authors.forename: J D
authors.initials: JD
authors.lastname: Sparks
authors.forename: L A
authors.initials: LA
authors.lastname: Polgreen
authors.forename: M
authors.initials: M
authors.lastname: Yang
authors.forename: M L
authors.initials: ML
authors.lastname: Harris
authors.forename: M A
authors.initials: MA
authors.lastname: Pentella
authors.forename: J E
authors.initials: JE
authors.lastname: Cavanaugh
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D003457:Cryptosporidiosis / Q000453:epidemiology* / Q000469:parasitology; D003458:Cryptosporidium / Q000302:isolation & purification*; D004196:Disease Outbreaks; D005260:Female; D006801:Humans; D007223:Infant; D007484:Iowa / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D013551:Swimming Pools / Q000592:standards*; D013997:Time Factors; D014867:Water / Q000469:parasitology*; D055815:Young Adult
chemical_list: D014867:Water