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Cryptosporidium parvum-specific antibody responses among children residing in Milwaukee during the 1993 waterborne

A C McDonald1, W R Mac Kenzie, D G Addiss

  • 1Division of Parasitic Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia 30341, USA.

The Journal of Infectious Diseases
|April 11, 2001
PubMed

Insights

A 1993 Milwaukee waterborne outbreak of Cryptosporidium parvum (C. parvum) infection was widespread. Antibody levels in children indicated higher infection rates in southern areas served by a specific water treatment plant.

Area of Science:

  • Environmental Microbiology
  • Epidemiology
  • Immunology

Background:

  • A significant gastroenteritis outbreak occurred in Milwaukee in April 1993, affecting over 400,000 residents.
  • The outbreak was linked to Cryptosporidium parvum (C. parvum) oocysts contaminating the public drinking water supply.

Purpose of the Study:

  • To assess the seroprevalence of C. parvum infection among children during the 1993 Milwaukee outbreak.
  • To determine if infection rates varied geographically within Milwaukee based on water treatment plant service areas.

Main Methods:

  • Enzyme-linked immunosorbent assay (ELISA) was used to measure IgG antibody levels against C. parvum antigens in children's plasma samples.
  • Plasma specimens were collected from children aged 6 months to 12 years during routine blood lead level surveillance between March and May 1993.
  • Seroprevalence data was compared between children residing in southern and northern ZIP code areas of Milwaukee.

Main Results:

  • Antibody seroprevalence against C. parvum antigens significantly increased over a 5-week period in children from southern ZIP codes (15% to 82% and 17% to 87%).
  • Smaller increases in seroprevalence were observed in children from northern ZIP codes (20% to 43% and 22% to 46%).
  • The difference in seroprevalence increase between southern and northern areas was statistically significant (P<.0001).

Conclusions:

  • The C. parvum infection was considerably more widespread in Milwaukee than initially recognized.
  • Infection was strongly associated with residence in areas served by the southern water treatment plant, confirming its role in the outbreak's transmission.

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