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The elderly and waterborne Cryptosporidium infection: gastroenteritis hospitalizations before and during the 1993 Milwaukee outbreak.

Naumova EN, Egorov AI, Morris RD, Griffiths JK - Emerging Infect. Dis. (2003)

Bottom Line: A pronounced second wave of these illnesses in the elderly peaked at 13 days.This wave represented approximately 40% of all excess cases in the elderly.Our findings suggest that the elderly had an increased risk of severe disease due to Cryptosporidium infection, with a shorter incubation period than has been previously reported in all adults and with a high risk for secondary person-to-person transmission.

View Article: PubMed Central - PubMed

Affiliation: Department of Family Medicine and Community Health, Tufts University School of Medicine, Boston, Massachusetts 02111, USA. elena.naumova@tufts.edu

ABSTRACT
We used the Temporal Exposure Response Surfaces modeling technique to examine the association between gastroenteritis-related emergency room visits and hospitalizations in the elderly and drinking water turbidity before and during the 1993 Milwaukee waterborne Cryptosporidium outbreak. Before the outbreak, the rate of such events increased with age in the elderly (p

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The temporal exposure response surface plot of the lagged association between daily rate of gastroenteritis-related emergency room visits and hospitalizations in the elderly in south and central water supply areas of Milwaukee, Wisconsin (per 100,000) and water turbidity (Nephelometric Turbidity Units) at the south plant.
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Figure 4: The temporal exposure response surface plot of the lagged association between daily rate of gastroenteritis-related emergency room visits and hospitalizations in the elderly in south and central water supply areas of Milwaukee, Wisconsin (per 100,000) and water turbidity (Nephelometric Turbidity Units) at the south plant.

Mentions: For the pre-outbreak period, we have not found any statistically significant associations between elevated water turbidity and rates of GIH events at any time lag. During the outbreak, statistically significant associations between elevated water turbidity and rates of GIH events were detected at time lags of 5, 6, 7, and 13 days by both the GLM and GAM models. As expected, no association existed between the exposure and the outcome (GIH events) on the same day at a zero time lag. Associations at other lags from 1 to 18 days were positive but not statistically significant (Figure 4). Based on GLM analysis, the 95% confidence interval for the relative risk associated with 1 NTU increase in turbidity at time lags of 5 and 6 days was 1.54 to 4.48.


The elderly and waterborne Cryptosporidium infection: gastroenteritis hospitalizations before and during the 1993 Milwaukee outbreak.

Naumova EN, Egorov AI, Morris RD, Griffiths JK - Emerging Infect. Dis. (2003)

The temporal exposure response surface plot of the lagged association between daily rate of gastroenteritis-related emergency room visits and hospitalizations in the elderly in south and central water supply areas of Milwaukee, Wisconsin (per 100,000) and water turbidity (Nephelometric Turbidity Units) at the south plant.
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC2957964&req=5

Figure 4: The temporal exposure response surface plot of the lagged association between daily rate of gastroenteritis-related emergency room visits and hospitalizations in the elderly in south and central water supply areas of Milwaukee, Wisconsin (per 100,000) and water turbidity (Nephelometric Turbidity Units) at the south plant.
Mentions: For the pre-outbreak period, we have not found any statistically significant associations between elevated water turbidity and rates of GIH events at any time lag. During the outbreak, statistically significant associations between elevated water turbidity and rates of GIH events were detected at time lags of 5, 6, 7, and 13 days by both the GLM and GAM models. As expected, no association existed between the exposure and the outcome (GIH events) on the same day at a zero time lag. Associations at other lags from 1 to 18 days were positive but not statistically significant (Figure 4). Based on GLM analysis, the 95% confidence interval for the relative risk associated with 1 NTU increase in turbidity at time lags of 5 and 6 days was 1.54 to 4.48.

Bottom Line: A pronounced second wave of these illnesses in the elderly peaked at 13 days.This wave represented approximately 40% of all excess cases in the elderly.Our findings suggest that the elderly had an increased risk of severe disease due to Cryptosporidium infection, with a shorter incubation period than has been previously reported in all adults and with a high risk for secondary person-to-person transmission.

View Article: PubMed Central - PubMed

Affiliation: Department of Family Medicine and Community Health, Tufts University School of Medicine, Boston, Massachusetts 02111, USA. elena.naumova@tufts.edu

ABSTRACT
We used the Temporal Exposure Response Surfaces modeling technique to examine the association between gastroenteritis-related emergency room visits and hospitalizations in the elderly and drinking water turbidity before and during the 1993 Milwaukee waterborne Cryptosporidium outbreak. Before the outbreak, the rate of such events increased with age in the elderly (p

Show MeSH
Related in: MedlinePlus