19 April 2007

Cryptosporidiosis in Galway, Ireland

Galway County Council, Ireland, has reported an outbreak of cryptosporidiosis, occurring as a result of contamination of the city’s water supply [1].  The outbreak has also affected other areas of Galway County. As of 28 March 2007, the number of laboratory confirmed cases was 126. Testing of the water supply has detected the presence of both Cryptosporidium parvum and C. hominis.

Cryptosporidiosis

Cryptosporidiosis is a diarrhoeal illness caused by the parasite Cryptosporidium. The disease is transmitted via the faecal-oral route from infected humans or animals. Infection usually occurs following ingestion of contaminated water, but can also be transmitted in food and from person-to-person. Cryptosporidium occurs world-wide.

Symptoms of cryptosporidiosis include watery diarrhoea, abdominal cramps, malaise and low-grade fever, and can last from a few days to three weeks. Some persons may be asymptomatically infected. Symptoms are more severe in the immunocompromised, particularly those with HIV or AIDS, in whom the diarrhoea may be voluminous, prolonged and life-threatening. Treatment is supportive. A new agent, nitazoxanide, may be useful in persons with cryptosporidiosis and no underlying immunodeficiency [2].

Advice for travellers

Travellers are advised to practice food and water precautions to prevent acquiring infection. There is no vaccine or medication available for prevention. Travellers should also ensure strict personal hygiene and wash hands frequently especially before eating or preparing food.

The Health Service Executive (HSE) West has introduced a boiled water notice for the affected areas of Galway. All water intended for drinking or food preparation, including brushing teeth, should be boiled before use. Specific recommendations, together with a list of affected areas, can be found on the HSE website at http://www.hse.ie/en/NewsEvents/Notices/

References

1. Galway County Council Water Services. Boil water alert. 28 March 2007. [accessed 19 April 2007] Available at http://www.galway.ie/en/Services/WaterServices/Water

Contamination/Archives/TheFile,6231,en.pdf

2. Abubakar I, Aliyu SH, Arumugam C, et al. Treatment of cryptosporidiosis in immunocompromised individuals: systematic review and meta-analysis. Br J Clin Pharmacol 2007;63:387-93.

Links and further information

Galway County Council Water Service – Water Contamination

http://www.galway.ie/en/Services/WaterServices/Water

Contamination/

Health Service Executive Cryptosporidiosis information

http://www.hse.ie/en/NewsEvents/Notices/Whatis

Cryptosporidiosis/

NaTHNaC Health Information Sheets. Prevention of food and water borne diseases.

http://www.nathnac.org/pro/factsheets/food.htm

Chen XM, Keithly JS, Paya CV, LaRusso NF. Cryptosporidiosis. N Engl J Med 2002;346:1723-31.