Cryptosporidium outbreaks: identification, diagnosis, and management.

Abstract

In 2016 an outbreak of Cryptosporidium potentially linked to swimming pools occurred in the West Midlands region in England. This highlighted the importance of prompt identification of Cryptosporidium by primary care and notification to Public Health England (PHE) to assist with patient management and outbreak control. This article outlines the epidemiology and processes to be followed should suspected Cryptosporidium cases present to primary care. Infection with the protozoan parasite Cryptosporidium results from ingestion of oocysts from faecally-contaminated water or food, direct person-to-person contact, or zoonotic spread. The incubation period (the time between exposure to Cryptosporidium and development of symptoms) varies but is on average between 5–7 days.1,2 Infection usually results in an acute illness lasting up to 3 weeks in otherwise healthy people, although asymptomatic infections are common and can be a source of infection for others.2 The symptoms are characterised by an abrupt onset of profuse watery diarrhoea with mucus (rarely blood) and abdominal cramping that may be associated with nausea, anorexia, and possibly fever. Although the infection is self-limiting in most patients, in the very young, older people, and in immunosuppressed individuals it can be a debilitating illness. Cryptosporidium occurs worldwide and is the fourth most common cause of gastrointestinal …