Responding to the risks from Cryptosporidium. A case study

Abstract

A large outbreak of waterbone cryptosporidiosis around Oxford and Swindon in 1989 led to the Government setting up an independent Group of Experts, chaired by Sir John Badenoch, to advise on the way forward. The Group made fifty-one recommendations which were all accepted by Government in 1990.Risk is not managed by setting enforceable numerical standards for oocysts in drinking water. Instead, Government regulators ensure water utilities follow the Expert Group's wide-ranging recommendations as good practice. These seek to keep oocyst levels as low as possible in source waters, and to ensure filtration - where made - is undertaken adequately.A national programme of research has provided information to help the water industry and Government regulators meet the Badenoch Group recommendations. Part of the programme has included two national workshops.After five years experience of managing this new risk, in 1995 the Government invited the independent Group of Experts to make a second report. This reviewed the effectiveness of the earlier recommendations, and findings from the national research programme.A pragmatic style of regulation has emerged for minimising waterborne cryptosporidiosis. This paper describes how national strategy has developed for managing risks posed by this emerging pathogen. It also highlights some emerging guiding principles and philosophies which could be used again by water utilities and Government if confronted by another new waterborne public health risk for which no hard-and-fast rules can be applied.