Assessing the impact of environmental exposures and Cryptosporidium infection in cattle on human incidence of cryptosporidiosis in Southwestern Ontario, Canada.

Cryptosporidium is a waterborne parasite that causes diarrheal disease in humans and in cattle. Risk factors for human illness include contact with surface water such as lakes and rivers, exposure to contaminated municipal drinking water, as well as zoonotic transmission from livestock and agriculture. The objectives of this study are twofold: 1) to describe the temporal distribution of cryptosporidiosis in Southwestern Ontario; and 2) to determine the distribution of human cryptosporidiosis, in relation to exposures such as cryptosporidium positive cattle farms, weather events, and hydrological factors. Seasonal trends in 214 bovine and 87 human cases were assessed using regression models that predicted monthly case counts in relation to observed monthly case counts. A case-crossover approach was used to evaluate acute associations between daily environmental exposures, such as weather, hydrology, the presence of Cryptosporidium positive cattle farms within the region, and the risk of human Cryptosporidium infection. Annual seasonality was found for both human cases and bovine cases with human cases peaking in mid-summer and bovine cases peaking in late winter to early spring. Bovine cases that occurred 21 days prior to human cases were associated with a three-fold increase in the odds of human case occurrence. At both 9 and 14 days prior to human case onset, the odds of a human case increased twofold per 10-degree Celsius increase in air temperature. These results provide a preliminary hypothesis for the zoonotic transmission of cryptosporidiosis from cattle to humans via the environment and suggest that the timing of environmental conditions in relation to case occurrence is biologically plausible.