MacKenzie W R, Schell W L, Blair K A, Addiss D G, Peterson D E, Hoxie N J, Kazmierczak J J, Davis J P
Wisconsin Division of Health, Bureau of Public Health, Madison 53703, USA.
Clin Infect Dis. 1995 Jul;21(1):57-62. doi: 10.1093/clinids/21.1.57.
Contamination of the public water supply in Milwaukee during March and April 1993 resulted in a massive outbreak of cryptosporidium infection. We investigated the clinical and epidemiological features of visitors to the Milwaukee area in whom cryptosporidiosis developed, and we conducted a telephone survey of Milwaukee County households to evaluate the risk of recurrent illness and secondary transmission. Cryptosporidium infection during this outbreak generally seemed more severe than cases described in previous reports of large case series. The risk of secondary transmission within a household was low (5%) when the index case involved an adult. The recurrence of watery diarrhea after apparent recovery was a frequent occurrence among visitors with laboratory-confirmed cryptosporidium infection (39%) and among visitors and Milwaukee County residents with clinical infection (21%). The interval between the initial recovery and the onset of recurrence was prolonged (> or = 5 days) in 6%-8% of persons. This pattern of recurrence and its impact on transmission and our understanding of the pathophysiological mechanisms of cryptosporidium infection merit further investigation.
1993年3月至4月间，密尔沃基市公共供水系统受到污染，导致隐孢子虫感染大规模爆发。我们调查了在密尔沃基地区感染隐孢子虫病的游客的临床和流行病学特征，并对密尔沃基县家庭进行了电话调查，以评估疾病复发和二次传播的风险。此次疫情期间的隐孢子虫感染通常似乎比以往大型病例系列报告中描述的病例更为严重。当首例病例为成年人时，家庭内二次传播的风险较低（5%）。在实验室确诊感染隐孢子虫的游客中（39%）以及临床感染的游客和密尔沃基县居民中（21%），明显康复后水样腹泻复发的情况很常见。6%-8%的人在初次康复和复发开始之间的间隔延长（≥5天）。这种复发模式及其对传播的影响以及我们对隐孢子虫感染病理生理机制的理解值得进一步研究。
