US outbreaks of cryptosporidiosis

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Abstract
An overview of US cryptosporidiosis outbreaks suggests that conventional treatment processes operated at minimum regulatory compliance levels are ineffective at preventing transmission of the disease.Drinking water has been implicated as the mode of transmission in several outbreaks of cryptosporidiosis throughout the United States. This review of US outbreaks describes characteristics of the raw water supply, suspected sources of contamination, water treatment methods, and corrective actions. Of the total number of outbreaks, roughly half were associated with groundwater sources; the majority of affected individuals, however, were served by drinking water drawn from surface water. Wastewater was implicated as the source of contamination of raw or treated water for roughly half of the outbreaks. Nonpoint sources, such as agricultural runoff, were suspected sources of contamination in the remaining outbreaks. The majority of affected individuals were served by treatment plants using coagulant addition, filtration, and chlorine disinfection processes. Although treatment deficiencies and suboptimal operational practices were noted during some of the outbreaks, all treatment plants were complying with federal and local regulations. Existing regulations and water supply systems, especially those utilizing surface water sources, should be reevaluated.

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