Cryptosporidiosis in a hospital-associated day care center.

Cryptosporidium was identified in the stools of infants and toddlers during an outbreak of diarrheal illness at a hospital-associated day care center. Stools from 42 of 54 children were examined for parasites, Salmonella, Shigella, Campylobacter and rotavirus; 27 children (64%) had Cryptosporidium. One child also had Salmonella and two other children were also found to have Giardia. Information regarding the severity and duration of symptoms was obtained from parents by means of a questionnaire. The most frequently reported symptoms included diarrhea, fever, anorexia and malaise. Of 9 children whose stools were examined during the time they were reported by parents to be symptomatic, 8 were positive for Cryptosporidium oocysts. Symptoms lasted from 1 day to 4 weeks and children excreted oocysts for up to 48 days after the onset of symptoms. Staff at the facility and family members were also affected. Cryptosporidiosis should be considered in the differential diagnosis of young children with diarrheal illness, especially those attending a day care facility.