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Volume 20, Number 4—April 2014


Large Outbreak of Cryptosporidium hominis Infection Transmitted through the Public Water Supply, Sweden

Micael WiderströmComments to Author , Caroline Schönning, Mikael Lilja, Marianne Lebbad, Thomas Ljung, Görel Allestam, Martin Ferm, Britta Björkholm, Anette Hansen, Jari Hiltula, Jonas Långmark, Margareta Löfdahl, Maria Omberg, Christina Reuterwall, Eva Samuelsson, Katarina Widgren, Anders Wallensten, and Johan Lindh
Author affiliations: Umeå University, Umeå, Sweden (M. Widerström, M. Lilja, M. Ferm C. Reuterwall, E. Samuelsson); Jämtland County Council, Östersund, Sweden (M. Widerström, M. Omberg); Public Health Agency of Sweden, Soina, Sweden (C. Schönning, M. Lebbad, G. Allestam, B. Björkholm, A. Hansen, J. Långmark, M. Löfdahl, K. Widgren, A. Wallensten, J. Lindh); Mid Sweden University, Östersund, (T. Ljung,); Östersund Municipality, Östersund (J. Hitula); and Karolinska Institutet, Stockholm (J. Lindh)

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Table 3

Risk factors for cryptosporidiosis and duration of infection in Cryptosporidium infection outbreak, Östersund, Sweden, 2010 –2011*

Risk factor Infection†
Duration,‡ p value
Adjusted OR (95% CI)
p value
Age, continuous 0.99 (0.98–0.99) <0.0001 <0.0001
Chronic intestinal disease§ 1.86 (0.95–2.63) 0.08 <0.01
Chronic underlying disease# 1.15 (0.73–1.8) 0.55 0.59
Gluten intolerance 4.06 (1.24–13.29) 0.02 0.05
Lactose intolerance 1.40 (0.79–2.46) 0.25 <0.01
No. additional family members with cryptosporidiosis 1.99 (1.70–2.33) <0.0001 NA
No. glasses of water consumed daily 1.07 (1.03–1.11) <0.0001 0.07
No. persons in household 0.98 (0.87–1.07) 0.54 NA
Peptic ulcer or medication 1.26 (0.72–2.22) 0.42 0.43
Smoking 1.01 (0.58–1.75) 0.98 0.40

*OR, odds ratio, adjusted for age, sex, and residence in the water treatment plant area; NA, not applicable.
†Participants with watery diarrhea and/or >3 episodes of diarrhea daily were defined as having cryptosporidiosis.
‡Duration (i.e., time fulfilling the case definition).
§Defined as inflammatory bowel disease, lactose intolerance, or gluten intolerance.
#Defined as cancer, rheumatic disease, cardiac failure, asthma, chronic obstructive pulmonary disease, or diabetes.

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