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In August and September 2023, an unusually high number of cryptosporidiosis cases identified by routine German surveillance had travelled to Croatia (n = 23). Nine cases had stayed in the same camping resort and seven further cases had stayed at other camping sites within 15 km. Based on our standardised questionnaires, the most likely source of infection was swimming pools (93%). Further environmental investigations on site might reveal potential common sources of contamination that could be targeted by control measures.


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  1. Cacciò SM, Chalmers RM. Human cryptosporidiosis in Europe. Clin Microbiol Infect. 2016;22(6):471-80.  https://doi.org/10.1016/j.cmi.2016.04.021  PMID: 27172805 
  2. Franceschelli A, Bonadonna L, Cacciò SM, Sannella AR, Cintori C, Gargiulo R, et al. An outbreak of cryptosporidiosis associated with drinking water in north-eastern Italy, August 2019: microbiological and environmental investigations. Euro Surveill. 2022;27(35):2200038.  https://doi.org/10.2807/1560-7917.ES.2022.27.35.2200038  PMID: 36052722 
  3. Mahon M, Doyle S. Waterborne outbreak of cryptosporidiosis in the South East of Ireland: weighing up the evidence. Ir J Med Sci. 2017;186(4):989-94.  https://doi.org/10.1007/s11845-016-1552-1  PMID: 28084584 
  4. Centers for Disease Control and Prevention (CDC). Cryptosporidiosis outbreaks associated with recreational water use--five states, 2006. MMWR Morb Mortal Wkly Rep. 2007;56(29):729-32. PMID: 17657205 
  5. Robert Koch Institute (RKI). Falldefinitionen des Robert Koch-Instituts zur Übermittlung von Erkrankungs- oder Todesfällen und Nachweisen von Krankheitserregern. [Case definitions from the Robert Koch Institute for reporting case of illness or death and evidence of pathogens]. Berlin: RKI; 2023. German. Available from: https://www.rki.de/DE/Content/Infekt/IfSG/Falldefinition/Downloads/Falldefinitionen_des_RKI_2023.pdf?__blob=publicationFile
  6. Peake L, Inns T, Jarvis C, King G, Rabie H, Henderson J, et al. Preliminary investigation of a significant national Cryptosporidium exceedance in the United Kingdom, August 2023 and ongoing. Euro Surveill. 2023;28(43):2300538.  https://doi.org/10.2807/1560-7917.ES.2023.28.43.2300538  PMID: 37883039 
  7. Health Protection Surveillance Centre (HPSC). Statutory Notifications of Infectious Diseases reported in Ireland via the Computerised Infectious Disease Reporting (CIDR) system, 2023. Dublin, HPSC. [Accessed: 21 Dec 2023]. Available from: https://www.hpsc.ie/notifiablediseases/weeklyidreports
  8. Dillingham RA, Lima AA, Guerrant RL. Cryptosporidiosis: epidemiology and impact. Microbes Infect. 2002;4(10):1059-66.  https://doi.org/10.1016/S1286-4579(02)01630-1  PMID: 12191656 
  9. Hlavsa MC, Roberts VA, Anderson AR, Hill VR, Kahler AM, Orr M, et al. Surveillance for waterborne disease outbreaks and other health events associated with recreational water --- United States, 2007--2008. MMWR Surveill Summ. 2011;60(12):1-32. PMID: 21937976 
  10. Braima K, Zahedi A, Egan S, Austen J, Xiao L, Feng Y, et al. Molecular analysis of cryptosporidiosis cases in Western Australia in 2019 and 2020 supports the occurrence of two swimming pool associated outbreaks and reveals the emergence of a rare C. hominis IbA12G3 subtype. Infect Genet Evol. 2021;92:104859.  https://doi.org/10.1016/j.meegid.2021.104859  PMID: 33848684 
  11. Bourli P, Eslahi AV, Tzoraki O, Karanis P. Waterborne transmission of protozoan parasites: a review of worldwide outbreaks - an update 2017-2022. J Water Health. 2023;21(10):1421-47.  https://doi.org/10.2166/wh.2023.094  PMID: 37902200 
  12. Daraei H, Oliveri Conti G, Sahlabadi F, Thai VN, Gholipour S, Turki H, et al. Prevalence of Cryptosporidium spp. in water: a global systematic review and meta-analysis. Environ Sci Pollut Res Int. 2021;28(8):9498-507.  https://doi.org/10.1007/s11356-020-11261-6  PMID: 33150505 
  13. meteoblue. Weather archive funtana. Basel: meteoblue. [Accessed: 21 Dec 2023]. Available from: https://www.meteoblue.com/en/weather/historyclimate/weatherarchive/funtana_croatia_3200806?fcstlength=1m&year=2023&month=8
  14. Croatian Ministry of Environment and Energy. Sea bathing water quality - Croatia. Rijeka: Ministry of Environment and Energy. [Accessed: 21 Dec 2023]. Available from: https://vrtlac.izor.hr/ords/kakvoca/kakvoca_m?p_jezik=eng
  15. European Centre for Disease Prevention and Control (ECDC). Cryptosporidiosis. In: ECDC. Annual epidemiological report for 2018. Stockholm: ECDC; 2021. Available from: https://www.ecdc.europa.eu/en/publications-data/cryptosporidiosis-annual-epidemiological-report-2018

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