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Swimming Pool-Related Outbreak of a Rare gp60 Subtype of Cryptosporidium hominis, England, October 2016

Helen Bagnall, Rachel Chalmers, Michelle Henderson, Stewart Sorrell, Guy Robinson, Kristin Elwin, Gayle Dolan

Water, Volume: 13, Issue: 22, Start page: 3152

Swansea University Authors: Rachel Chalmers, Guy Robinson, Kristin Elwin

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DOI (Published version): 10.3390/w13223152

Abstract

In October 2016, Public Health England was initially notified of four cases of cryptosporidiosis among users of two swimming pools. We investigated to identify further cases, the outbreak source, and ensure the implementation of appropriate control measures. Probable primary cases had diarrhoea and...

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Published in: Water
ISSN: 2073-4441
Published: MDPI AG 2021
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URI: https://cronfa.swan.ac.uk/Record/cronfa58670
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spelling 2021-12-10T17:44:00.1226610 v2 58670 2021-11-15 Swimming Pool-Related Outbreak of a Rare gp60 Subtype of Cryptosporidium hominis, England, October 2016 900a2910defaf8b5487da2d098b417e6 Rachel Chalmers Rachel Chalmers true false 583b4f5c3bb164d0d3595a48bf3a9c50 Guy Robinson Guy Robinson true false 33fd534495a9b496d6b5b301cb0bc4bf Kristin Elwin Kristin Elwin true false 2021-11-15 FGMHL In October 2016, Public Health England was initially notified of four cases of cryptosporidiosis among users of two swimming pools. We investigated to identify further cases, the outbreak source, and ensure the implementation of appropriate control measures. Probable primary cases had diarrhoea and reported swimming in the pools 1–12 days prior to illness; confirmed cases were verified by the reference laboratory. Secondary cases had contact with primary cases 1–12 days prior to illness. We identified twenty-two cases: eleven were primary (eight confirmed) and eleven were secondary (five confirmed). Four cases were infected with C. parvum (different gp60 subtypes); all were primary and swam at two pools. Seven primary and secondary cases were infected with C. hominis gp60 subtype IdA16, and all were associated one pool. Failings in pool water treatment and management were identified that likely contributed to the load on the filters and their efficiency. Our investigation identified a complex outbreak, with secondary transmission, involving exposures to two swimming pools. C. hominis IdA16 is rare; it has been isolated from only three previous UK cases. We hypothesize that C. hominis cases arose from a common exposure, and the C. parvum cases were likely sporadic. This investigation highlights the value of integrating epidemiology and microbiology to investigate clusters of Cryptosporidium cases, defining the extent of the outbreak and the likely transmission pathways. Journal Article Water 13 22 3152 MDPI AG 2073-4441 Cryptosporidium, typing, outbreaks, swimming pools, gp60 9 11 2021 2021-11-09 10.3390/w13223152 COLLEGE NANME Medicine, Health and Life Science - Faculty COLLEGE CODE FGMHL Swansea University 2021-12-10T17:44:00.1226610 2021-11-15T14:07:56.6315520 Faculty of Medicine, Health and Life Sciences Swansea University Medical School - Medicine Helen Bagnall 1 Rachel Chalmers 2 Michelle Henderson 3 Stewart Sorrell 4 Guy Robinson 5 Kristin Elwin 6 Gayle Dolan 7 58670__21539__7083c40f63fa40c581e749b754996a67.pdf water-13-03152.pdf 2021-11-15T14:07:56.6311714 Output 709345 application/pdf Version of Record true Copyright: © 2021 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license true eng https://creativecommons.org/licenses/by/4.0/
title Swimming Pool-Related Outbreak of a Rare gp60 Subtype of Cryptosporidium hominis, England, October 2016
spellingShingle Swimming Pool-Related Outbreak of a Rare gp60 Subtype of Cryptosporidium hominis, England, October 2016
Rachel Chalmers
Guy Robinson
Kristin Elwin
title_short Swimming Pool-Related Outbreak of a Rare gp60 Subtype of Cryptosporidium hominis, England, October 2016
title_full Swimming Pool-Related Outbreak of a Rare gp60 Subtype of Cryptosporidium hominis, England, October 2016
title_fullStr Swimming Pool-Related Outbreak of a Rare gp60 Subtype of Cryptosporidium hominis, England, October 2016
title_full_unstemmed Swimming Pool-Related Outbreak of a Rare gp60 Subtype of Cryptosporidium hominis, England, October 2016
title_sort Swimming Pool-Related Outbreak of a Rare gp60 Subtype of Cryptosporidium hominis, England, October 2016
author_id_str_mv 900a2910defaf8b5487da2d098b417e6
583b4f5c3bb164d0d3595a48bf3a9c50
33fd534495a9b496d6b5b301cb0bc4bf
author_id_fullname_str_mv 900a2910defaf8b5487da2d098b417e6_***_Rachel Chalmers
583b4f5c3bb164d0d3595a48bf3a9c50_***_Guy Robinson
33fd534495a9b496d6b5b301cb0bc4bf_***_Kristin Elwin
author Rachel Chalmers
Guy Robinson
Kristin Elwin
author2 Helen Bagnall
Rachel Chalmers
Michelle Henderson
Stewart Sorrell
Guy Robinson
Kristin Elwin
Gayle Dolan
format Journal article
container_title Water
container_volume 13
container_issue 22
container_start_page 3152
publishDate 2021
institution Swansea University
issn 2073-4441
doi_str_mv 10.3390/w13223152
publisher MDPI AG
college_str Faculty of Medicine, Health and Life Sciences
hierarchytype
hierarchy_top_id facultyofmedicinehealthandlifesciences
hierarchy_top_title Faculty of Medicine, Health and Life Sciences
hierarchy_parent_id facultyofmedicinehealthandlifesciences
hierarchy_parent_title Faculty of Medicine, Health and Life Sciences
department_str Swansea University Medical School - Medicine{{{_:::_}}}Faculty of Medicine, Health and Life Sciences{{{_:::_}}}Swansea University Medical School - Medicine
document_store_str 1
active_str 0
description In October 2016, Public Health England was initially notified of four cases of cryptosporidiosis among users of two swimming pools. We investigated to identify further cases, the outbreak source, and ensure the implementation of appropriate control measures. Probable primary cases had diarrhoea and reported swimming in the pools 1–12 days prior to illness; confirmed cases were verified by the reference laboratory. Secondary cases had contact with primary cases 1–12 days prior to illness. We identified twenty-two cases: eleven were primary (eight confirmed) and eleven were secondary (five confirmed). Four cases were infected with C. parvum (different gp60 subtypes); all were primary and swam at two pools. Seven primary and secondary cases were infected with C. hominis gp60 subtype IdA16, and all were associated one pool. Failings in pool water treatment and management were identified that likely contributed to the load on the filters and their efficiency. Our investigation identified a complex outbreak, with secondary transmission, involving exposures to two swimming pools. C. hominis IdA16 is rare; it has been isolated from only three previous UK cases. We hypothesize that C. hominis cases arose from a common exposure, and the C. parvum cases were likely sporadic. This investigation highlights the value of integrating epidemiology and microbiology to investigate clusters of Cryptosporidium cases, defining the extent of the outbreak and the likely transmission pathways.
published_date 2021-11-09T04:15:22Z
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