{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T03:25:08Z","timestamp":1788405908056,"version":"build-2803163510"},"reference-count":39,"publisher":"IWA Publishing","issue":"6","content-domain":{"domain":["iwaponline.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2017,12,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Drinking water related infections are expected to increase in the future due to climate change. Understanding the current links between these infections and environmental factors is vital to understand and reduce the future burden of illness. We investigated the relationship between weekly reported cryptosporidiosis and giardiasis (n = 7,422), extreme precipitation (&amp;gt;90th percentile), drinking water turbidity, and preceding dry periods in a drinking water system located in greater Vancouver, British Columbia, Canada (1997\u20132009) using distributed lag non-linear Poisson regression models adjusted for seasonality, secular trend, and the effect of holidays on reporting. We found a significant increase in cryptosporidiosis and giardiasis 4\u20136 weeks after extreme precipitation. The effect was greater following a dry period. Similarly, extreme precipitation led to significantly increased turbidity only after prolonged dry periods. Our results suggest that the risk of cryptosporidiosis and giardiasis increases with extreme precipitation, and that the effects are more pronounced after a prolonged dry period. Given that extreme precipitation events are expected to increase with climate change, it is important to further understand the risks from these events, develop planning tools, and build resilience to these future risks.<\/jats:p>","DOI":"10.2166\/wh.2017.100","type":"journal-article","created":{"date-parts":[[2017,9,3]],"date-time":"2017-09-03T00:10:10Z","timestamp":1504397410000},"page":"898-907","update-policy":"https:\/\/doi.org\/10.2166\/iwapcrossmarkpolicypage","source":"Crossref","is-referenced-by-count":37,"title":["Associations between extreme precipitation and acute gastro-intestinal illness due to cryptosporidiosis and giardiasis in an urban Canadian drinking water system (1997\u20132009)"],"prefix":"10.2166","volume":"15","author":[{"given":"Bimal K.","family":"Chhetri","sequence":"first","affiliation":[{"name":"British Columbia Centre for Disease Control, Vancouver, BC, Canada"},{"name":"Faculty of Health Sciences, Simon Fraser University, Burnaby, BC, Canada"},{"name":"8888 University Drive, Blusson Hall 11300, Burnaby, BC, Canada V5A 1S6"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tim K.","family":"Takaro","sequence":"first","affiliation":[{"name":"Faculty of Health Sciences, Simon Fraser University, Burnaby, BC, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert","family":"Balshaw","sequence":"first","affiliation":[{"name":"British Columbia Centre for Disease Control, Vancouver, BC, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Otterstatter","sequence":"first","affiliation":[{"name":"British Columbia Centre for Disease Control, Vancouver, BC, Canada"},{"name":"School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sunny","family":"Mak","sequence":"first","affiliation":[{"name":"British Columbia Centre for Disease Control, Vancouver, BC, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marcus","family":"Lem","sequence":"first","affiliation":[{"name":"School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marc","family":"Zubel","sequence":"first","affiliation":[{"name":"Fraser Health Authority, Abbotsford, BC, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark","family":"Lysyshyn","sequence":"first","affiliation":[{"name":"School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada"},{"name":"Vancouver Coastal Health Authority, North Vancouver, BC, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Len","family":"Clarkson","sequence":"first","affiliation":[{"name":"Vancouver Coastal Health Authority, North Vancouver, BC, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joanne","family":"Edwards","sequence":"first","affiliation":[{"name":"Office of the Provincial Health Officer, Victoria, BC, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manon D.","family":"Fleury","sequence":"first","affiliation":[{"name":"Public Health Agency of Canada, Guelph, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah B.","family":"Henderson","sequence":"first","affiliation":[{"name":"British Columbia Centre for Disease Control, Vancouver, BC, Canada"},{"name":"School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eleni","family":"Galanis","sequence":"first","affiliation":[{"name":"British Columbia Centre for Disease Control, Vancouver, BC, Canada"},{"name":"School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"945","published-online":{"date-parts":[[2017,9,2]]},"reference":[{"key":"2020032619202788800_JWH-D-17-00100C1","doi-asserted-by":"crossref","first-page":"353","DOI":"10.1007\/s00484-010-0345-x","article-title":"The reported incidence of campylobacteriosis modelled as a function of earlier temperatures and numbers of cases, Montreal, Canada, 1990\u20132006","volume":"55","year":"2011","journal-title":"Int. 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