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

United Kingdom Field Epidemiology Training Programme, Public Health England, London NW9 5EQ, UK
Field Epidemiology Service North East, Public Health England, Gallowgate, Newcastle Upon Tyne NE1 4WH, UK
Cryptosporidium Reference Unit, Public Health Wales Microbiology and Health Protection, Singleton Hospital, Swansea SA2 8QA, UK
Swansea University Medical School, Swansea University, Singleton Park, Swansea SA2 8PP, UK
Public Health England, North East and Yorkshire Region, Newcastle Civic Centre, Barras Bridge, Newcastle Upon Tyne NE1 8QH, UK
Environmental Health, Planning Policy, Climate Change and Strategic Transport Economy, Innovation and Growth, Gateshead Council, Civic Centre, Regent Street, Gateshead NE8 1HH, UK
Author to whom correspondence should be addressed.
Academic Editor: Athena Mavridou
Water 2021, 13(22), 3152;
Received: 20 September 2021 / Revised: 28 October 2021 / Accepted: 1 November 2021 / Published: 9 November 2021
(This article belongs to the Special Issue Healthy Recreational Waters: Sanitation and Safety Issues)
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. View Full-Text
Keywords: Cryptosporidium; typing; outbreaks; swimming pools; gp60 Cryptosporidium; typing; outbreaks; swimming pools; gp60
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MDPI and ACS Style

Bagnall, H.; Chalmers, R.M.; Henderson, M.; Sorrell, S.; Robinson, G.; Elwin, K.; Dolan, G. Swimming Pool-Related Outbreak of a Rare gp60 Subtype of Cryptosporidium hominis, England, October 2016. Water 2021, 13, 3152.

AMA Style

Bagnall H, Chalmers RM, Henderson M, Sorrell S, Robinson G, Elwin K, Dolan G. Swimming Pool-Related Outbreak of a Rare gp60 Subtype of Cryptosporidium hominis, England, October 2016. Water. 2021; 13(22):3152.

Chicago/Turabian Style

Bagnall, Helen, Rachel M. Chalmers, Michelle Henderson, Stewart Sorrell, Guy Robinson, Kristin Elwin, and Gayle Dolan. 2021. "Swimming Pool-Related Outbreak of a Rare gp60 Subtype of Cryptosporidium hominis, England, October 2016" Water 13, no. 22: 3152.

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