Risk Factors for Cryptosporidiosis and Giardiasis Infections in the United States: A Case-Case Comparison in 16 States Pubblico

Abstract

Cryptosporidiosis and giardiasis are common waterborne enteric pathogens. Typical case-
control studies using surveillance data present challenges for identifying risk factors for
enteric illness because < 5% of cases are captured. To combat these challenges, case-case
comparisons have been suggested and used where cases of other enteric illnesses are used
as controls. This study uses cases of cryptosporidiosis, giardiasis, and salmonellosis cases
reported to the National Electronic Disease Surveillance System (NEDSS) to identify risk
factors for cryptosporidiosis and giardiasis. A total of 9,266 cryptosporidiosis, 14,806
giardiasis, and 64,071 salmonellosis cases reported to NEDSS between 2003 and 2010
from 16 states were included in the analysis. Cryptosporidiosis infection was associated
with livestock contact, day care association, drinking untreated water, having a private
well as a water source, knowing another ill person, recreational water exposure and travel
when compared to salmonellosis infection. Giardiasis infection was associated with day
care association, drinking untreated water, knowing other ill persons, recreational water
exposures, and travel when compared to salmonellosis infection. This study determined
that case-case comparisons can be a useful and efficient tool in outbreak investigations
that could lead to more rapid identification of causes and timely implementation of
control measures.

Table of Contents

Table of Contents

Chapter I
Literature Review………………………………………………………………….1
Chapter II: Manuscript

Abstract……………………………………………………………………………8

Introduction………………………………………………………………………..9

Methods…………………………………………………………………………..11

Results……………………………………………………………………………13

Discussion………………………………………………………………………..15

References………………………………………………………………………..18

Tables…………………………………………………………………………….22

Figures…………………………………………………………………………....28
Chapter III

Summary…………………………………………………………………………30
Appendix…………………………………………………………………………………32

About this Master's Thesis

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• Permission granted by the author to include this thesis or dissertation in this repository. All rights reserved by the author. Please contact the author for information regarding the reproduction and use of this thesis or dissertation.

School	Rollins School of Public Health
Department	Epidemiology
Degree	MPH
Submission	Master's Thesis
Language	English
Research Field	Health Sciences, Public Health Health Sciences, Epidemiology
Parola chiave	giardiasis surveillance systems cryptosporidiosis
Committee Chair / Thesis Advisor	Sullivan, Patrick S, Emory University
Committee Members	Yoder, Jonathan, CDC
Partnering Agencies	CDC

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