A large cryptosporidiosis outbreak associated with an animal contact event in England: a retrospective cohort study, 2023

Development of gastrointestinal illness after animal contact at petting farms is well described, as are factors such as handwashing and facility design that may modify transmission risk. However, further field evidence on other behaviours and interventions in the context of Cryptosporidium outbreaks...

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Bibliographic Details
Published in:Epidemiology and infection 2024-05, Vol.152, p.1, Article e91
Main Authors: Peake, Lewis, Bardsley, Megan, Bartram, Samantha, Bharuchi, Shireen, Howkins, Josh, Robinson, Guy, Charlett, André, Chalmers, Rachel, Bird, Sarah, Young, Nick
Format: Article
Language:English
Subjects:
Animals
Clustering
Cohort analysis
Cryptosporidiosis
Cryptosporidium
Design factors
Diarrhea
Disease control
Disease transmission
Epidemics
Health risks
Households
Illnesses
Lamb
Original Paper
Outbreaks
Protozoa
Public health
Questionnaires
Regression analysis
Risk
Surveillance
Variables
Vomiting
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Summary:Development of gastrointestinal illness after animal contact at petting farms is well described, as are factors such as handwashing and facility design that may modify transmission risk. However, further field evidence on other behaviours and interventions in the context of Cryptosporidium outbreaks linked to animal contact events is needed. Here, we describe a large outbreak of Cryptosporidium parvum (C. parvum) associated with a multi-day lamb petting event in the south-west of England in 2023 and present findings from a cohort study undertaken to investigate factors associated with illness. Detailed exposure questionnaires were distributed to email addresses of 647 single or multiple ticket bookings, and 157 complete responses were received. The outbreak investigation identified 23 laboratory-confirmed primary C. parvum cases. Separately, the cohort study identified 83 cases of cryptosporidiosis-like illness. Associations between illness and entering a lamb petting pen (compared to observing from outside the pen; odds ratio (OR) = 2.28, 95 per cent confidence interval (95% CI) 1.17 to 4.53) and self-reported awareness of diarrhoeal and vomiting disease transmission risk on farm sites at the time of visit (OR = 0.40, 95% CI 0.19 to 0.84) were observed. In a multivariable model adjusted for household clustering, awareness of disease transmission risk remained a significant protective factor (adjusted OR (aOR) = 0.07, 95% CI 0.01 to 0.78). The study demonstrates the likely under-ascertainment of cryptosporidiosis through laboratory surveillance and provides evidence of the impact that public health messaging could have.
ISSN:0950-2688
1469-4409
1469-4409
DOI:10.1017/S0950268824000591