Cryptosporidiosis Outbreak Investigation in a Canadian Correctional Facility Using Novel Case Finding Tools

Eliminating Cryptosporidium oocysts is particularly challenging in prison environments, and limited information is available on best practices for outbreak control. This report aims to expand the evidence base through the lessons learned from an outbreak at a Canadian federal penitentiary in 2013. The outbreak investigation methods included inmate and staff case finding, hypothesis-generating questionnaires, and environmental investigation. A clear source of Cryptosporidium into the facility could not be identified; however, there were a number of possible sources of ongoing propagation within the facility. There were difficulties obtaining valid data on inmate and staff cases and exposures. This report discusses the novel epidemiological tools used in this investigation to address the complex challenges of a correctional setting.