An evaluation of health protection practices for the investigation and management of Cryptosporidium in England and Wales

Authors:

Chalmers RM, McCarthy N, Barlow KL, Stiff R

Unit Authors:

Noel McCarthy

Abstract:

Background
Cryptosporidium is a major cause of gastroenteritis (cryptosporidiosis). Case and outbreak report rates vary geographically, which may in part reflect public health practice.

Methods
To examine the public health management of cryptosporidiosis, an online questionnaire was administered to the 28 Health Protection Teams (HPTs) in England and Wales in 2014. Practices for investigation and management of cases and outbreaks were compared.

Results
Practice varied among the 24 (86%) respondents in terms of who undertook actions (HPT or Local Authority) to investigate and manage cryptosporidiosis. HPTs without exceedance monitoring detected fewer outbreaks (1/5, 20%) than those with it (13/19, 68%) (P=0.12), and those that always administered a risk-factor questionnaire detected more outbreaks (12/19, 63%) than those who did this only sometimes (2/5, 40%) (P=0.62). Significantly more HPTs with a system to detect common exposures reported at least one outbreak (14/19, 74%) compared to HPTs with no system (0/5) (P=0.01).

Conclusions
Applying exceedance monitoring, using a standardized questionnaire taking into account the incubation period for Cryptosporidium and having a structured system to detect common exposures increased outbreak detection. Information about all cases should be shared between local public health authorities, and current guidance used for the prevention of spread.

Journal:

Journal of Public Health

Year:

2016

Hyperlink:

http://jpubhealth.oxfordjournals.org/content/early/2016/12/29/pubmed.fdw143.full.pdf

Research Themes:

Tracking disease in the population