An outbreak of Cryptosporidium hominis infection at an Illinois recreational waterpark
An outbreak of Cryptosporidium hominis infection at an Illinois recreational waterpark
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DOI：
10.1017/s0950268805004619
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发表时间：
2006-02-01
影响因子：
4.2
通讯作者：
Dworkin, MS
中科院分区：
文献类型：
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作者：
Causer, LM;Handzel, T;Dworkin, MS
隐孢子虫已日益被认为是导致免疫能力和免疫功能低下者腹泻疾病暴发的病原体。2001年8月，伊利诺伊州的一家医院报告说，一群隐孢子虫病可能与当地的一个水上公园有关。确诊病例358例。我们进行了以社区为基础和以水上公园为基础的病例对照研究，以检查潜在的暴发源。我们收集了病人的粪便样本和池水样本，用于显微镜和分子分析。与年龄匹配的对照组相比，经实验室确诊的患者(n=77)更有可能去过水上乐园[优势比(OR)16.0，95%可信区间(CI)3.8~66.8]，嘴里含着泳池水(OR 6.0，95%CI 1.3~26.8)，吞下泳池水(OR 4.5，95%CI 1.5~13.3)。在粪便标本和池水标本中发现隐孢子虫。卵囊对氯的抵抗力、频繁的游泳暴露、高浴者密度、尿布年龄儿童的大量使用以及对爆发的认识和报告的增加，可能是与游泳池相关的隐孢子虫病暴发数量增加的趋势所致。预防疾病的建议包括改变泳池设计，将幼儿泳池过滤系统与其他泳池分开。实施教育方案可以减少粪便污染和疾病传播的风险。
Cryptosporidium has become increasingly recognized as a pathogen responsible for outbreaks of diarrhoeal illness in both immunocompetent and immunocompromised persons. In August 2001, an Illinois hospital reported a cryptosporidiosis cluster potentially linked to a local waterpark. There were 358 case-patients identified. We conducted community-based and waterpark-based case-control studies to examine potential sources of the outbreak. We collected stool specimens from ill persons and pool water samples for microscopy and molecular analysis. Laboratory-confirmed case-patients (n = 77) were more likely to have attended the waterpark [odds ratio (OR) 16.0, 95 % confidence interval (CI) 3.8-66.8], had pool water in the mouth (OR 6.0, 95 % CI 1.3-26.8), and swallowed pool water (OR 4.5, 95 % CI 1.5-13.3) than age-matched controls. Cryptosporidium was found in stool specimens and pool water samples. The chlorine resistance of oocysts, frequent swimming exposures, high bather densities, heavy usage by diaper-aged children, and increased recognition and reporting of outbreaks are likely to have contributed to the increasing trend in number of swimming pool-associated outbreaks of cryptosporidiosis. Recommendations for disease prevention include alteration of pool design to separate toddler pool filtration systems from other pools. Implementation of education programmes could reduce the risk of faecal contamination and disease transmission.