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Cryptosporidium parvum infections in a cohort of veterinary students in Sweden

  • P. KINROSS (a1) (a2), J. BESER (a3), K. TROELL (a4), C. SILVERLÅS (a4), C. BJÖRKMAN (a5), M. LEBBAD (a3), J. WINIECKA-KRUSNELL (a3), J. LINDH (a3) and M. LÖFDAHL (a3)...
  • Please note a correction has been issued for this article.

Summary

In March 2013, a veterinary student tested positive for Cryptosporidium; four classmates reported similar gastrointestinal symptoms. We aimed to identify source(s) and risk factors for Cryptosporidium infection in university persons symptomatic between 21 January and 14 April 2013. Sixty-four (79%) students from a cohort of 81 fourth-year veterinary students completed questionnaires, identifying 13 cases; four were Cryptosporidium parvum GP60 subtype IIaA16G1R1b, two were IIdA24G1, seven did not submit stool samples. Thirteen cases attended the university's field clinic before symptom onset (13/37 attendees, 35%); 11 visited at least one of four farms where students recalled seeing calves with diarrhoea. C. parvum subtype IIaA16G1R1b was identified in calves at one of the farms. Entering pens of calves with diarrhoea [relative risk (RR) 7·6, 95% confidence interval (CI) 1·7–33·5] and eating in clinic cars (RR 9·1, 95% CI 1·3–65·8) were associated with being a case. Washing hands at least twice per farm visit (0 cases, P = 0·03) was protective. This outbreak investigation was notable for rapid and effective collaboration between public health, veterinary and environmental sectors, leading to swift identification of a microbiological and epidemiological link between cases, infected calves and their farms. We recommend frequent hand-washing using proper technique and dissuasion from eating in clinic cars to minimize possible exposure to contaminated surfaces.

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Copyright

This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http://creativecommons.org/licenses/by/3.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.

Corresponding author

* Author for corresponding: Mr P. Kinross, Surveillance and Response Support Unit, European Centre for Disease Prevention and Control (ECDC), Tomtebodavägen 11A, 171 83 Stockholm, Sweden. (Email: pete.kinross@ecdc.europa.eu)

References

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1. Preiser, G, Preiser, L, Madeo, L. An outbreak of cryptosporidiosis among veterinary science students who work with calves. Journal of American College Health 2003; 51: 213215.
2. Reif, JS, et al. Human cryptosporidiosis associated with an epizootic in calves. American Journal of Public Health 1989; 79: 15281530.
3. Silverlås, C, Cryptosporidium infection in dairy cattle – prevalence, age distribution and associated management factors (dissertation). Uppsala, Sweden: Sveriges lantbruksuniversitet, 2010, 77 pp.
4. Silverlås, C, Blanco-Penedo, I. Cryptosporidium spp. in calves and cows from organic and conventional dairy herds. Epidemiology and Infection 2013; 141: 529539.
5. Silverlås, C, et al. Is there a need for improved cryptosporidium diagnostics in Swedish calves? International Journal for Parasitology 2013; 43: 155161.
6. Silverlas, C, et al. Molecular characterisation of Cryptosporidium isolates from Swedish dairy cattle in relation to age, diarrhoea and region. Veterinary Parasitology 2010; 169: 289295.
7. Robertson, LJ, et al. Cryptosporidiosis in farmed animals. In: Caccio, SM, Widmer, G, eds. Cryptosporidium: Parasite and Disease. Vienna: Springer-Verlag, 2014, pp. 149235.
8. Bouzid, M, et al. Cryptosporidium pathogenicity and virulence. Clinical Microbiology Reviews 2013; 26: 115134.
9. Smith, HV, Nichols, RA. Cryptosporidium: detection in water and food. Experimental Parasitology 2010; 124: 6179.
10. Pohjola, S, et al. Outbreak of cryptosporidiosis among veterinary students. Scandinavian Journal of Infectious Diseases 1986; 18: 173178.
11. Heymann, DL (ed.). Control of Communicable Diseases Manual, 19th edn. Washington, DC: American Public Health Association Publications, 2008, pp. 746.
12. Public Health Agency of Sweden (Folkhälsomyndigheten). Cryptosporidium infection statistics (http://www.folkhalsomyndigheten.se/amnesomraden/statistik-och-undersokningar/sjukdomsstatistik/cryptosporidiuminfektion/). Accessed 5 August 2013.
13. Mattsson, JG, et al. Molecular typing of Cryptosporidium parvum associated with a diarrhoea outbreak identifies two sources of exposure. Epidemiology and Infection 2008; 136: 11471152.
14. Insulander, M, et al. Molecular epidemiology and clinical manifestations of human cryptosporidiosis in Sweden. Epidemiology and Infection 2013; 141: 10091020.
15. Persson, K, Svenungsson, B, de Jong, B. An outbreak of cryptosporidiosis at a day-care centre in Sweden. Eurosurveillance 2007; 12: E070823.
16. Gherasim, A, et al. Two geographically separated food-borne outbreaks in Sweden linked by an unusual Cryptosporidium parvum subtype, October 2010. Eurosurveillance 2012; 17.
17. Widerstrom, M, et al. Large outbreak of Cryptosporidium hominis infection transmitted through the public water supply, Sweden. Emerging Infectious Diseases 2014; 20: 581589.
18. Xiao, L, et al. Identification of 5 types of Cryptosporidium parasites in children in Lima, Peru. Journal of Infectious Diseases 2001; 183: 492497.
19. Xiao, L, et al. Genetic diversity within Cryptosporidium parvum and related Cryptosporidium species. Applied and Environmental Microbiology 1999; 65: 33863391.
20. Alves, M, et al. Subgenotype analysis of cryptosporidium isolates from humans, cattle, and zoo ruminants in Portugal. Journal of Clinical Microbiology 2003; 41: 27442747.
21. Gait, R, et al. Outbreak of cryptosporidiosis among veterinary students. Veterinary Record 2008; 162: 843845.
22. Grinberg, A, et al. Retrospective cohort study of an outbreak of cryptosporidiosis caused by a rare Cryptosporidium parvum subgenotype. Epidemiology and Infection 2011; 139: 15421550.
23. Kiang, KM, et al. Recurrent outbreaks of cryptosporidiosis associated with calves among students at an educational farm programme, Minnesota, 2003. Epidemiology and Infection 2006; 134: 878886.
24. Haagsma, JA, et al. Infectious disease risks associated with occupational exposure: a systematic review of the literature. Occupational and Environmental Medicine 2012; 69: 140146.
25. Semenza, JC, et al. Climate change impact assessment of food- and waterborne diseases. Critical Reviews in Environmental Science and Technology, 2012, 42: 857890.

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