Cryptosporidium data 2008 to 2017
Updated 30 May 2019
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1. Main points for 2017
The highest number of Cryptosporidium spp laboratory reports were reported in the South West of England with 590.
The South West of England had the highest rate of Cryptosporidium spp laboratory reports in England and Wales, with 10.6 laboratory reports per 100,000 population, closely followed by the North East with 10.4 laboratory reports per 100,000 population.
Reporting numbers were highest in children below the age of 5.
In 2017, September was the peak month for Cryptosporidium spp reporting, in keeping with the average seasonal variation in the previous 5 years (2012 to 2016).
There were no foodborne outbreaks of Cryptosporidium spp reported in England and Wales during 2017. However, there were 10 non-foodborne outbreaks reported - the majority of which were in open or petting farm settings.
We would like to remind all laboratories to refer samples of Cryptosporidium to the Cryptosporidium Reference Unit (CRU) in Swansea.
For health protection teams, there is information available on the investigation of Cryptosporidium linked to swimming pools.
2. Cryptosporidium data, 2008 to 2017
All data presented in this report are correct as of 30 July 2018.
2.1 Annual data: 2008 to 2017
Table 1: Annual laboratory reports of Cryptosporidium in England and Wales: 2008 to 2017[footnote 1]
| Year | Number of laboratory reports | per 100,000 population |
|---|---|---|
| 2008 | 4,162 | 7.6 |
| 2009 | 4,831 | 8.7 |
| 2010 | 3,901 | 7.0 |
| 2011 | 2,990 | 5.3 |
| 2012 | 5,765 | 10.2 |
| 2013 | 3,520 | 6.2 |
| 2014 | 4,023 | 7.0 |
| 2015 | 5,222 | 9.0 |
| 2016 | 5,925 | 10.1 |
| 2017 | 4,292 | 7.3 |
Figure 1: Annual laboratory reports of Cryptosporidium in England and Wales (2008 to 2017)
Figure 1: Annual laboratory reports of Cryptosporidium spp in England and Wales (2008 to 2017)
2.2 Regional data: 2017
Table 2: Regional distribution[footnote 2] of laboratory reports of Cryptosporidium in England and Wales: 2017
| Country | Region | Number of laboratory reports | per 100,000 population |
|---|---|---|---|
| England | East Midlands | 378 | 7.9 |
| England | East of England | 539 | 8.7 |
| England | London | 250 | 2.8 |
| England | North East | 275 | 10.4 |
| England | North West | 554 | 7.6 |
| England | South East | 582 | 6.4 |
| England | South West | 590 | 10.6 |
| England | Yorkshire and The Humber | 450 | 8.3 |
| England | West Midlands | 414 | 7.1 |
| Wales | Wales | 260 | 8.3 |
2.3 Age and sex distribution: 2017
Figure 2: Age and sex distribution of laboratory reports of Cryptosporidium spp reported in England and Wales: 2017[footnote 3].
Figure 2: Age/sex distribution of laboratory reports of Cryptosporidium spp in England and Wales (2017)*
2.4 Seasonal variation: 2017
Figure 3: Number of laboratory reports of Cryptosporidium spp in England and Wales by week in 2017, and average number of reports by week in the period 2012 to 2016.
Figure 3: Number of laboratory reports of Cryptosporidium spp in England and Wales by week in 2017 and average number of reports by week in 2012 to 2016
2.5 Outbreak data: 2017
In 2017, there were no foodborne outbreaks of Cryptosporidium reported in England and Wales, however there were 10 non-foodborne outbreaks reported.
Table 3: Non-foodborne outbreaks of Cryptosporidium reported in England and Wales: 2017
| Agent | Total Affected | Laboratory confirmed | Hospitalised | Deaths | Setting | Food Description |
|---|---|---|---|---|---|---|
| Cryptosporidium parvum IIaA17G1R1 | 9 | 8 | 1 | 0 | Open/petting farm | No food identified |
| Cryptosporidium spp. | 5 | 5 | 0 | 0 | Open/petting farm | No food identified |
| Cryptosporidium spp. | 4 | 4 | 0 | 0 | Open/petting farm | No food identified |
| Cryptosporidium parvum | 11 | 11 | 0 | 0 | Open/petting farm | No food identified |
| Cryptosporidium spp. | 3 | 3 | 0 | 0 | Open/petting farm | No food identified |
| Cryptosporidium spp. | 4 | 4 | 0 | 0 | Open/petting farm | No food identified |
| Cryptosporidium parvum IIaA17G1R1 | 5 | 5 | 1 | 0 | Open/petting farm | No food identified |
| Cryptosporidium spp. | 3 | 3 | 0 | 0 | Swimming pool | No food identified |
| Cryptosporidium spp. | 6 | 2 | 1 | 0 | Swimming pool | No food identified |
| Cryptosporidium hominis IbA12G3 | 5 | 3 | 0 | 0 | Swimming pool | No food identified |
3. Data sources
Data sources include:
Public Health England Second Generation Surveillance System (SGSS). This is a live laboratory reporting system, therefore numbers may fluctuate. Data provided in this report are new extractions from this system, and provide updated figures to previously published reports. In 2014, PHE upgraded the laboratory reporting system, so direct comparisons between data reported from the previous system (LabBase2) and the new system (SGSS) may require cautious interpretation.
Welsh data has been provided by Public Health Wales.
Electronic foodborne and non-foodborne gastrointestinal outbreak surveillance system (eFOSS).
4. Acknowledgements
We are grateful to:
- the microbiologists, local authorities and local health protection and environmental health specialists who have contributed data and reports to national surveillance systems
- the epidemiologists and information officers who have worked on the national surveillance of gastrointestinal (GI) infectious diseases
- colleagues in the Gastrointestinal Bacterial Reference Unit (GBRU) for providing the Reference Laboratory Services and laboratory surveillance functions and expertise
- the PHE Information Management Department for maintenance and quality assurance of PHE national surveillance databases for GI diseases
- PHE Local Public Health Laboratories and Food Water and Environmental Microbiology Services for providing a surveillance function for GI pathogens and testing of food and environmental samples routinely and during outbreak investigation
- PHE National Parasitology Reference Laboratory, Department of Clinical Parasitology, University College London Hospital NHS Foundation Trust for their expertise
- Cryptosporidium Reference Unit (CRU) in Swansea (Public Health Wales Microbiology and Health Protection) for providing the Reference Laboratory Services (especially genotyping) and expertise
- all colleagues who have investigated and reported outbreaks to the Electronic Foodborne and Non-Foodborne Gastrointestinal Outbreak Surveillance System (eFOSS)
PHE has a statutory obligation to collect and report outbreaks of foodborne disease. This is aligned to the requirements of the Zoonoses Directive 2003/99/EC. This directive requires that EU member states investigate and report all foodborne outbreaks to the European Food Safety Authority (EFSA).
Additionally, information on other zoonotic disease outbreaks is included in eFOSS, such as non-foodborne outbreaks (mode of transmission covering animal contact, person to person contact and recreational water).
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Incidence rates were calculated using the relevant Office for National Statistics (ONS) mid-year population estimates for each year. ↩
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Regional classification based on place of residence of laboratory reports and classified using Nomenclature of Territorial Units for Statistics 1 (NUTS 1) codes. Incidence rates were calculated using the Office for National Statistics (ONS) mid-year population estimates for each region. ↩
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For laboratory reports where age and sex data were available. There were 5 laboratory reports with unknown data recorded. ↩