Journal
JOURNAL OF INFECTIOUS DISEASES
Volume 219, Issue 7, Pages 1121-1129Publisher
OXFORD UNIV PRESS INC
DOI: 10.1093/infdis/jiy634
Keywords
Cryptosporidium; sporadic cryptosporidiosis; case-control study; risk factors; the Netherlands
Categories
Funding
- European Center for Disease Prevention and Control (European Program for Intervention Epidemiology Training fellowships)
- Dutch Ministry of Public Health, Welfare, and Sports (VWS), through National Institute for Public Health and the Environment (RIVM)
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Background. In 2012, cryptosporidiosis cases increased in the Netherlands, but no single source was identified. In April 2013, we began a 3-year population-based case-control study coupled with genotyping to identify risk factors for sporadic cryptosporidiosis. Methods. Cryptosporidium cases were laboratory confirmed (by microscopy or polymerase chain reaction), and the species (ie, C. hominis or C. parvum) was determined. We analyzed data by study year, combined and by species. We performed single-variable analysis, and variables with a P value of <= .10 were included in a multivariable logistic regression model adjusting for age, sex, and season. Results. The study included 609 cases and 1548 frequency-matched controls. C. parvum was the predominant species in the first 2 study years, shifting to C. hominis in the third year. Household person-to-person transmission and eating barbequed food were strongly associated with being a case. Eating tomatoes was negatively associated. When the analysis was stratified by study year, person-to-person transmission was an independent risk factor. Analysis by species identified different risk factors for cases infected with C. parvum and C. hominis. Conclusion. This was the first case-control study examining risk factors for sporadic cryptosporidiosis in the Netherlands. Providing information about Cryptosporidium exposure during outdoor activities and improvements in hygiene within households could prevent future sporadic infections.
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