Abstract
Continuous exposure to low levels of Cryptosporidium oocysts is associated with production of protective antibodies. We investigated prevalence of antibodies against the 27-kDa Cryptosporidium oocyst antigen among blood donors in 2 areas of Scotland supplied by drinking water from different sources with different filtration standards: Glasgow (not filtered) and Dundee (filtered). During 2006-2009, seroprevalence and risk factor data were collected; this period includes 2007, when enhanced filtration was introduced to the Glasgow supply. A serologic response to the 27-kDa antigen was found for ≈75% of donors in the 2 cohorts combined. Mixed regression modeling indicated a 32% step-change reduction in seroprevalence of antibodies against Cryptosporidium among persons in the Glasgow area, which was associated with introduction of enhanced filtration treatment. Removal of Cryptosporidium oocysts from water reduces the risk for waterborne exposure, sporadic infections, and outbreaks. Paradoxically, however, oocyst removal might lower immunity and increase the risk for infection from other sources.
Highlights
Continuous exposure to low levels of Cryptosporidium oocysts is associated with production of protective antibodies
Variations in other risk factors can obscure an effect associated with reduced exposure to oocysts in drinking water
Study Participants The original cohort consisted of 791 blood donors from Glasgow and 260 from Dundee
Summary
Continuous exposure to low levels of Cryptosporidium oocysts is associated with production of protective antibodies. We investigated prevalence of antibodies against the 27-kDa Cryptosporidium oocyst antigen among blood donors in 2 areas of Scotland supplied by drinking water from different sources with different filtration standards: Glasgow (not filtered) and Dundee (filtered). Oocysts must be physically removed from water supplies; inadequate water filtration can expose persons to risk for infection from viable oocysts [8,9,10,11]. Where drinking-water filtration has been enhanced to reduce oocysts counts, the incidence of reported clinical Cryptosporidium infection has been reduced [6,11]. Variations in other risk factors (e.g., foreign travel, direct animal contact) can obscure an effect associated with reduced exposure to oocysts in drinking water. Water Filtration and Cryptosporidium to Cryptosporidium oocyst proteins could be used to detect associations with variations in oocyst exposure
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