title: Outbreak of cryptosporidiosis associated with a man-made chlorinated lake--Tarrant County, Texas, 2008.
abstract: In July 2008, clusters of laboratory-confirmed cryptosporidiosis cases and reports of gastrointestinal illness in persons who visited a lake were reported to Tarrant County Public Health. In response, epidemiologic, laboratory, and environmental health investigations were initiated. A matched case-control study determined that swallowing the lake water was associated with illness (adjusted odds ratio = 16.3; 95% confidence interval: 2.5-infinity). The environmental health investigation narrowed down the potential sources of contamination. Laboratory testing detected Cryptosporidium hominis in case-patient stool specimens and Cryptosporidium species in lake water. It was only through the joint effort that epidemiologic, laboratory, and environmental health investigators could determine that >1 human diarrheal fecal incidents in the lake likely led to contamination of the water. This same collaborative effort will be needed to develop and maintain an effective national Model Aquatic Health Code.
authors.affiliation: Division of Parasitic Diseases and Malaria, Center for Global Health/Centers for Disease Control and Prevention, Atlanta, GA 30333, USA. pcantey@cdc.gov
authors.forename: Paul T
authors.initials: PT
authors.lastname: Cantey
authors.forename: Anita K
authors.initials: AK
authors.lastname: Kurian
authors.forename: David
authors.initials: D
authors.lastname: Jefferson
authors.forename: Micky M
authors.initials: MM
authors.lastname: Moerbe
authors.forename: Karen
authors.initials: K
authors.lastname: Marshall
authors.forename: William R
authors.initials: WR
authors.lastname: Blankenship
authors.forename: Gary R
authors.initials: GR
authors.lastname: Rothbarth
authors.forename: Jimee
authors.initials: J
authors.lastname: Hwang
authors.forename: Rebecca
authors.initials: R
authors.lastname: Hall
authors.forename: Jonathan
authors.initials: J
authors.lastname: Yoder
authors.forename: Joan
authors.initials: J
authors.lastname: Brunkard
authors.forename: Stephanie
authors.initials: S
authors.lastname: Johnston
authors.forename: Lihua
authors.initials: L
authors.lastname: Xiao
authors.forename: Vincent R
authors.initials: VR
authors.lastname: Hill
authors.forename: John
authors.initials: J
authors.lastname: Sarisky
authors.forename: Max A
authors.initials: MA
authors.lastname: Zarate-Bermudez
authors.forename: Charles
authors.initials: C
authors.lastname: Otto
authors.forename: Michele C
authors.initials: MC
authors.lastname: Hlavsa
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D016022:Case-Control Studies; D003457:Cryptosporidiosis / Q000453:epidemiology* / Q000469:parasitology* / Q000517:prevention & control; D003458:Cryptosporidium / Q000302:isolation & purification* / Q000502:physiology; D003967:Diarrhea / Q000469:parasitology; D004196:Disease Outbreaks; D004326:Drinking; D005243:Feces / Q000469:parasitology; D005260:Female; D054879:Halogenation; D006801:Humans; D007231:Infant, Newborn; D060106:Lakes / Q000469:parasitology*; D008297:Male; D016017:Odds Ratio; D012307:Risk Factors; D013781:Texas / Q000453:epidemiology