International Journal of Epidemiology 2000;29:376-379
© International Epidemiological Association 2000
Serological analysis of a cryptosporidiosis epidemic
a The Southwest Center for Managed Care Research, Lovelace Respiratory Research Institute, Albuquerque, NM 98108, USA.
b Gunther F Craun and Associates, 101 West Frederick Street, The Professional Building, Suite 205, Staunton, VA 24401, USA.
c Simcoe County District Health Unit, 15 Sperling Drive, Barrie, Ontario,L4M 6K9, Canada.
d Ontario Ministry of Health, Laboratory Services Branch, Orillia Regional Public Health Laboratory, 750 Memorial Avenue, Orillia, Ontario, L3V 6K5, Canada.
e National Health and Environmental Effects Laboratory, US Environmental Protection Agency, Research Triangle Park, NC 27711, USA.
Reprint requests to: Floyd J Frost, Southwest Center for Managed Care Research, 2425 Ridgecrest Drive SE, Albuquerque, NM 87108, USA.
Background A cryptosporidiosis epidemic occurred among residents and visitors to Collingwood, Ontario, during March 1996. Fifty-five per cent of 36 confirmed cases were Collingwood visitors and 57% of Collingwood resident cases were under 10 years of age. The low level of reported diarrhoeal illness among adult Collingwood residents caused government officials and physicians to question whether an epidemic had occurred in Collingwood.
Methods To better evaluate the extent of the epidemic, anonymous surplus sera from 89 adult Collingwood residents, collected for routine tests prior to, during and after the epidemic, and from 80 adult Toronto residents were tested using a Western blot assay for IgG antibody response to two Cryptosporidium antigen groups (15/17-kDa and 27-kDa).
Results For sera collected from 1 January 1996 to 17 June 1996, a higher fraction of Collingwood residents had a detectable serological response (P < 0.002) and the mean intensity of serological responses was higher for Collingwood than Toronto residents (P < 0.001). The mean intensity of serological responses for Collingwood residents was higher in specimens drawn during the 8 weeks following the initial case reports compared to those drawn before or after this period (15/ 17-kDa, P < 0.02; 27-kDa, P < 0.10).
Conclusions These elevated serological responses indicate that Cryptosporidium infections among Collingwood residents likely occurred more commonly than illness reports suggested, consistent with a community-wide cryptosporidiosis epidemic. Similar studies should be considered in future suspected cryptosporidiosis epidemic investigations.
Keywords Cryptosporidium, serological survey, epidemic
Accepted 26 August 1999
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