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Journal of Clinical Microbiology, July 2004, p. 2944-2951, Vol. 42, No. 7
0095-1137/04/$08.00+0     DOI: 10.1128/JCM.42.7.2944-2951.2004
Copyright © 2004, American Society for Microbiology. All Rights Reserved.

Risk Factors for Sporadic Cryptosporidiosis among Immunocompetent Persons in the United States from 1999 to 2001

Sharon L. Roy,1* Stephanie M. DeLong,2 Sara A. Stenzel,3 Beletshachew Shiferaw,4 Jacquelin M. Roberts,1 Asheena Khalakdina,5 Ruthanne Marcus,6 Suzanne D. Segler,7 Dipti D. Shah,8 Stephanie Thomas,9 Duc J. Vugia,10 Shelley M. Zansky,11 Vance Dietz,{ddagger} Michael J. Beach,1 and the Emerging Infections Program FoodNet Working Group{dagger}

Division of Parasitic Diseases,1 FoodNet, Foodborne and Diarrheal Diseases Branch, Division of Bacterial and Mycotic Diseases, National Center for Infectious Diseases, Centers for Disease Control and Prevention,2 Georgia Division of Public Health, Atlanta,9 Georgia Emerging Infections Program, Atlanta VA Medical Center, Decatur, Georgia,7 Foodborne, Vectorborne, and Zoonotic Diseases Unit, Acute Disease Investigation and Control Section, Minnesota Department of Health, Minneapolis, Minnesota,3 Oregon Department of Human Services, Portland, Oregon,4 School of Public Health, University of California at Berkeley,5 Infectious Diseases Branch, Division of Communicable Disease Control, California Department of Health Services, Berkeley, California,10 Connecticut Emerging Infections Program, Yale University School of Public Health, New Haven, Connecticut,6 Maryland Department of Health and Mental Hygiene, Baltimore, Maryland,8 Emerging Infections Program, New York State Department of Health, Albany, New York,11

Received 19 December 2003/ Returned for modification 1 February 2004/ Accepted 28 March 2004

Many studies have evaluated the role of Cryptosporidium spp. in outbreaks of enteric illness, but few studies have evaluated sporadic cryptosporidiosis in the United States. To assess the risk factors for sporadic cryptosporidiosis among immunocompetent persons, a matched case-control study was conducted in seven sites of the Foodborne Diseases Active Surveillance Network (FoodNet) involving 282 persons with laboratory-identified cryptosporidiosis and 490 age-matched and geographically matched controls. Risk factors included international travel (odds ratio [OR] = 7.7; 95% confidence interval [95% CI] = 2.7 to 22.0), contact with cattle (OR = 3.5; 95% CI = 1.8 to 6.8), contact with persons >2 to 11 years of age with diarrhea (OR = 3.0; 95% CI = 1.5 to 6.2), and freshwater swimming (OR = 1.9; 95% CI = 1.049 to 3.5). Eating raw vegetables was protective (OR = 0.5; 95% CI = 0.3 to 0.7). This study underscores the need for ongoing public health education to prevent cryptosporidiosis, particularly among travelers, animal handlers, child caregivers, and swimmers, and the need for further assessment of the role of raw vegetables in cryptosporidiosis.

* Corresponding author. Present address: Education, Information, and Partnership Branch, Immunization Services Division, National Immunization Program, Centers for Disease Control and Prevention, 1600 Clifton Rd., Mailstop E52, Atlanta, GA 30333. Phone: (404) 639-8638. Fax: (404) 639-8828. E-mail: str2{at}cdc.gov.

{ddagger} Present address: Global Immunization Division, National Immunization Program, Centers for Disease Control and Prevention, Atlanta, GA 30333.

{dagger} Contributing members of the Emerging Infections Program FoodNet Working Group are listed in the Acknowledgments.

Journal of Clinical Microbiology, July 2004, p. 2944-2951, Vol. 42, No. 7
0095-1137/04/$08.00+0     DOI: 10.1128/JCM.42.7.2944-2951.2004
Copyright © 2004, American Society for Microbiology. All Rights Reserved.



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