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Eurosurveillance, Volume 7, Issue 33, 14 August 2003
Articles

Citation style for this article: Galmes A, Nicolau A, Arbona G, Smith-Palmer A, Hernández Pezzi G, Soler P. Cryptosporidiosis outbreak in British tourists who stayed at a hotel in Majorca, Spain. Euro Surveill. 2003;7(33):pii=2275. Available online: http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=2275

Cryptosporidiosis outbreak in British tourists who stayed at a hotel in Majorca, Spain

Antonia Galmes (agalmes@dgsanita.caib.es), Antonio Nicolau, Gabriel Arbona, Eva Gomis, Mercedes Guma, Servicio de Epidemiología, Dirección General de Salud Pública, Islas Baleares, Spain; Alison Smith-Palmer, Scottish Centre for Infection and Environmental Health, Glasgow, Scotland; Gloria Hernandez-Pezzi (ghpezzi@isciii.es), Pilar Soler, Centro Nacional de Epidemiología, Madrid, Spain.

On 22 July 2003, the Scottish Centre for Infection and Environmental Health (SCIEH) reported an outbreak of cryptosporidiosis to the Spanish National Centre of Epidemiology (Centro Nacional de Epidemiología, CNE) (1-3).

This outbreak occurred in a hotel in Majorca, in which about 2000 guests had stayed during the epidemic period (nearly 100% occupation). All the guests at the hotel, which is used by only one tour operator, were British tourists.

The onset date of the first case was 5 July 2003. At present, CNE is aware of 391 cases, 214 of which are known to be positive for Cryptosporidium. The latest numbers of cases reported to CNE by 13 August are:

179 confirmed and suspected in England and Wales (75 confirmed and 104 suspected cases reported to the Health Protection Agency Communicable Disease Surveillance Centre between 1 July and 5 August),
170 in Scotland (112 confirmed and 58 suspected cases reported to SCIEH by 13 August)
42 in Northern Ireland (27 confirmed and 15 suspected cases reported to Communicable Disease Surveillance Centre Northern Ireland by 13 August)

No case has been found either in the Spanish population of Alcudia or among workers at the hotel. The main symptoms include diarrhoea, nausea, vomiting, and fever. CNE is aware of nine cases admitted to hospital.

The regional health authorities in Majorca have carried out an inspection of the hotel and control measures have been taken. The hotel's swimming pool is suspected to be the source of the infection, and was closed on 23 July, and water samples were taken.

Other control measures have been implemented to avoid transmission from ill to healthy people (particularly transmission through babies' nappies) and the hotel's day nurseries have been disinfected.

No failures in the infrastructure of the hotel's water supply have been found. Cryptosporidium oocysts have been found in water from the swimming pool. The swimming pool was emptied and disinfected, and its filters were changed. The local health authorities have allowed the hotel's owners to refill it and use it again. The epidemiological investigation and the control measures are continuing.

References:
  1. SCIEH. Outbreak of Cryptosporidium, Alcudia, Majorca. SCIEH Weekly Report 2003; 37(30): 185. (http://www.show.scot.nhs.uk/SCIEH/PDF/pdf2003/0330.pdf)
  2. SCIEH. Cryptosporidium in Majorca - update. SCIEH Weekly Report 2003; 37(31): 199. (http://www.show.scot.nhs.uk/SCIEH/PDF/pdf2003/0331.pdf)
  3. HPA. Cryptosporidiosis in English and Welsh tourists associated with travel to Spain. Commun Dis Rep CDR Wkly 2003; 13(32): news. (http://www.phls.co.uk/publications/cdr/PDFfiles/2003/cdr3203.pdf)

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