title: Cryptosporidiosis outbreak in visitors of a UK industry-compliant petting farm caused by a rare Cryptosporidium parvum subtype: a case-control study.
abstract: A case-control study was conducted to investigate an outbreak of 46 cases of cryptosporidiosis in visitors to a petting farm in England. Details of exposures on the farm were collected for 38 cases and 39 controls, recruited through snowball sampling. Multivariable logistic regression identified that cases were 5·5 times more likely than controls to have eaten without washing their hands [95% confidence interval (CI) 1·51-19·9, P = 0·01] and 10 times less likely to report being informed of risk of infection on arrival (odds ratio 0·10, 95% CI 0·01-0·71, P = 0·02). An uncommon Cryptosporidium parvum gp60 subtype (IIaA19G1R1) was identified in a lamb faecal sample and all subtyped cases (n = 22). We conclude that lack of verbal advice and non-compliance with hand washing are significantly associated with a risk of cryptosporidiosis on open farms. These findings highlight the public health importance of effectively communicating risk to petting farm visitors in order to prevent future outbreaks of zoonotic infections.
authors.affiliation: Field Epidemiology Service,Public Health England,Leeds,UK.
authors.forename: L
authors.initials: L
authors.lastname: Utsi
authors.affiliation: Health Protection Team,Yorkshire and the Humber Public Health England Centre,Leeds,UK.
authors.forename: S J
authors.initials: SJ
authors.lastname: Smith
authors.affiliation: Cryptosporidium Reference Unit,Public Health Wales Microbiology,Swansea,UK.
authors.forename: R M
authors.initials: RM
authors.lastname: Chalmers
authors.affiliation: Field Epidemiology Service,Public Health England,Leeds,UK.
authors.forename: S
authors.initials: S
authors.lastname: Padfield
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000383:Agriculture; D000818:Animals; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D003457:Cryptosporidiosis / Q000453:epidemiology* / Q000469:parasitology; D016785:Cryptosporidium parvum / Q000302:isolation & purification*; D004196:Disease Outbreaks; D004739:England / Q000453:epidemiology; D005243:Feces / Q000469:parasitology; D005260:Female; D006235:Hand Disinfection; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D055815:Young Adult; D015047:Zoonoses / Q000453:epidemiology* / Q000469:parasitology
keywords: Cryptosporidium; hand hygiene; outbreaks; public health; zoonoses