{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,13]],"date-time":"2026-05-13T20:02:24Z","timestamp":1778702544888,"version":"3.51.4"},"reference-count":24,"publisher":"Cambridge University Press (CUP)","issue":"9","license":[{"start":{"date-parts":[[2014,4,2]],"date-time":"2014-04-02T00:00:00Z","timestamp":1396396800000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/www.cambridge.org\/core\/terms"}],"content-domain":{"domain":["journals.cambridge.org"],"crossmark-restriction":true},"short-container-title":["Epidemiol. Infect."],"published-print":{"date-parts":[[2014,9]]},"abstract":"<jats:title>SUMMARY<\/jats:title><jats:p>Water supply-associated cryptosporidiosis outbreaks have decreased in England since the application of risk reduction measures to public water supplies. We hypothesized that smaller outbreaks were occurring which could be better detected by enhanced surveillance. Rolling analysis of detailed questionnaire data was applied prospectively in a population of 2\u00b72 million in the south of England in 2009 and 2010. Detection of spatiotemporal clusters using SaTScan was later undertaken retrospectively. Together these approaches identified eight outbreaks, compared to an expectation of less than one based on national surveillance data. These outbreaks were small and associated with swimming pool use or, less commonly, direct (e.g. petting-farm) contact with animals. These findings suggest that frequent small-scale transmission in swimming pools is an important contributor to disease burden. Identification of swimming pool-level risk factors may inform preventative measures. These findings and the approaches described may be applicable to many other populations and to some other diseases.<\/jats:p>","DOI":"10.1017\/s0950268814000673","type":"journal-article","created":{"date-parts":[[2014,4,2]],"date-time":"2014-04-02T06:00:49Z","timestamp":1396418449000},"page":"1869-1876","update-policy":"https:\/\/doi.org\/10.1017\/policypage","source":"Crossref","is-referenced-by-count":19,"title":["Approaches to the detection of very small, common, and easily missed outbreaks that together contribute substantially to human <i>Cryptosporidium<\/i> infection"],"prefix":"10.1017","volume":"142","author":[{"given":"A. D. M.","family":"BRIGGS","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"N. 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Drinking Water Directorate Contract Number DWI 70\/2\/201, 2006."},{"key":"S0950268814000673_ref4","doi-asserted-by":"crossref","DOI":"10.2807\/ese.15.48.19731-en","article-title":"Clinical laboratory practices for detection and reporting of Cryptosporidium in community cases of diarrhoea in the United Kingdom, 2008","volume":"15","author":"Chalmers","year":"2010","journal-title":"Eurosurveillance"},{"key":"S0950268814000673_ref13","doi-asserted-by":"publisher","DOI":"10.1111\/1467-985X.00186"},{"key":"S0950268814000673_ref19","doi-asserted-by":"publisher","DOI":"10.1111\/j.1541-0420.2010.01412.x"},{"key":"S0950268814000673_ref3","unstructured":"Health Protection Agency. Investigation of faecal specimens for bacterial pathogens. National Standard Method. BSOP 30. Issue 7. Standards Unit, Health Protection Agency, 2010."},{"key":"S0950268814000673_ref24","first-page":"989","article-title":"Communitywide cryptosporidiosis outbreak\u00a0\u2013\u00a0Utah, 2007","volume":"57","year":"2008","journal-title":"Morbidity and Mortality Weekly Report"},{"key":"S0950268814000673_ref7","doi-asserted-by":"publisher","DOI":"10.1136\/gut.2011.238386"},{"key":"S0950268814000673_ref11","doi-asserted-by":"publisher","DOI":"10.1080\/03610929708831995"},{"key":"S0950268814000673_ref10","unstructured":"Kulldorff M . SaTScan v. 9.1.1. Software for the spatial, temporal, and space-time scan statistics, 2011."},{"key":"S0950268814000673_ref1","doi-asserted-by":"publisher","DOI":"10.1051\/parasite\/2008153372"},{"key":"S0950268814000673_ref12","doi-asserted-by":"publisher","DOI":"10.1136\/jamia.2009.000356"},{"key":"S0950268814000673_ref17","doi-asserted-by":"publisher","DOI":"10.1186\/1476-072X-10-23"},{"key":"S0950268814000673_ref16","doi-asserted-by":"publisher","DOI":"10.1002\/sim.2898"},{"key":"S0950268814000673_ref15","first-page":"59","article-title":"Bivariate method for spatio-temporal syndromic surveillance","volume":"53","author":"Ozonoff","year":"2004","journal-title":"Morbidity and Mortality Weekly Report"},{"key":"S0950268814000673_ref2","first-page":"131","volume-title":"Drinking Water and Infectious Disease\u00a0\u2013\u00a0Establishing the Links","author":"Nichols","year":"2003"},{"key":"S0950268814000673_ref9","doi-asserted-by":"publisher","DOI":"10.1017\/S0950268810001688"},{"key":"S0950268814000673_ref23","doi-asserted-by":"publisher","DOI":"10.1128\/JCM.00066-13"},{"key":"S0950268814000673_ref22","doi-asserted-by":"publisher","DOI":"10.1186\/1476-072X-9-16"}],"container-title":["Epidemiology and Infection"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.cambridge.org\/core\/services\/aop-cambridge-core\/content\/view\/S0950268814000673","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2019,4,21]],"date-time":"2019-04-21T21:21:24Z","timestamp":1555881684000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.cambridge.org\/core\/product\/identifier\/S0950268814000673\/type\/journal_article"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2014,4,2]]},"references-count":24,"journal-issue":{"issue":"9","published-print":{"date-parts":[[2014,9]]}},"alternative-id":["S0950268814000673"],"URL":"https:\/\/doi.org\/10.1017\/s0950268814000673","relation":{},"ISSN":["0950-2688","1469-4409"],"issn-type":[{"value":"0950-2688","type":"print"},{"value":"1469-4409","type":"electronic"}],"subject":[],"published":{"date-parts":[[2014,4,2]]},"assertion":[{"value":"Copyright \u00a9 Cambridge University Press 2014\u00a0","name":"license","label":"License","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}}]}}