title: A community outbreak of cryptosporidiosis in sydney associated with a public swimming facility: a case-control study.
abstract: In February, 2008, the South Eastern Sydney Illawarra Public Health Unit investigated an outbreak of cryptosporidiosis within the south east region of Sydney, Australia. Thirty-one cases with laboratory-confirmed cryptosporidiosis and 97 age- and geographically matched controls selected by random digit dialling were recruited into a case-control study and interviewed for infection risk factors. Cryptosporidiosis was associated with swimming at Facility A (matched odds ratio = 19.4, 95% confidence interval: 3.7-100.8) and exposure to household contacts with diarrhoea (matched odds ratio = 7.7, 95% confidence interval: 1.9-31.4) in multivariable conditional logistic regression models. A protective effect for any animal contact was also found (matched odds ratio = 0.2, 95% confidence interval: 0.1-0.7). Cryptosporidium hominis subtype IbA10G2 was identified in 8 of 11 diagnostic stool samples available for cases. This investigation reaffirms the importance of public swimming pools as potential sources of Cryptosporidium infection and ensuring their compliance with water-quality guidelines. The protective effect of animal contact may be suggestive of past exposure leading to immunity.
authors.affiliation: South Eastern Sydney Illawarra Public Health Unit, Health Reform Transition Organisation-Southern, Locked Mail Bag 9, Wollongong, NSW 2526, Australia.
authors.forename: Darren J
authors.initials: DJ
authors.lastname: Mayne
authors.forename: Kelly-Anne
authors.initials: KA
authors.lastname: Ressler
authors.forename: Diane
authors.initials: D
authors.lastname: Smith
authors.forename: Gareth
authors.initials: G
authors.lastname: Hockey
authors.forename: Susan J
authors.initials: SJ
authors.lastname: Botham
authors.forename: Mark J
authors.initials: MJ
authors.lastname: Ferson