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D Casemore

Publications and source records attributed to D Casemore.

8 recordsLinked to original sources
PubMed2001

Uncertainties in risk assessment for the determination of drinking water pollutant concentrations: Cryptosporidium case study.

There is a growing acknowledgement of the need to recognise uncertainties in the estimation of waterborne risks. In this paper, the strength of the science available to characterise Cryptosporidium risks in drinking water is investigated, in particular the determination of oocyst concentrations at various points in the chain of water supply. A recently developed scientific quality audit framework is used as a tool to guide this investigation. The framework systematically reveals the relatively greater strength of the science for the "upstream" elements (estimation of concentrations in environmental reservoirs) than for the "downstream" elements (concentrations in distribution). It is the downstream elements that have greater bearing on human health and public policy issues. It is noted that the adoption of new monitoring Regulations is likely to prompt action to strengthen knowledge of these downstream elements in the future.

Animals↗
PubMed1998

Differentiation between human and animal isolates of Cryptosporidium parvum using molecular and biological markers.

Isolates of Cryptosporidium parvum obtained from infected humans, calves and lambs were typed using arbitrary primed polymerase chain reaction (AP-PCR) and isoenzyme electrophoresis. All animal isolates tested (n = 17) showed similar profiles in AP-PCR and isoenzyme typing. In AP-PCR assays, 9 out of 15 human isolates showed a distinct "human" profile while the remaining 6 isolates showed the "animal" profile. In isoenzyme typing, 5 human isolates which had shown "human" profiles in AP-PCR demonstrated a unique isoenzyme banding pattern, while 2 isolates which had shown "animal" profiles in AP-PCR gave the "animal" banding pattern. In a murine model of infection, all four animal isolates tested were highly infective but only one of four human isolates identified as "human" type in the AP-PCR and isoenzyme typing systems was infective. The good correlation between the data from the different typing systems supports the hypothesis that there are genetically distinct human and animal populations of C. parvum.

Animals↗
PubMed1998

Prevalence of cryptosporidiosis in AIDS patients with diarrhoea in Santa Maria Hospital, Lisbon.

We report the findings of a longitudinal observational study on HIV-infected patients grouped by presumed transmission group, who had diarrhoea. The purpose of this study was to assess the prevalence of and factors associated with Cryptosporidium infection on these patients. Modifiied formol-ether concentration followed by modified Ziehl-Neelsen and phenol-auramine/carbol-fuchsin staining techniques were used to identify Cryptosporidium from 465 patients. Cryptosporidiosis was reported in 36/465 (8% and 95% confidence interval 6, 10) patients. Of the positive patients 30 (83%) were men and 6 (17%) women. Prevalence of infection was higher among HIV-seropositive patients whose exposure category was through sexual contact (69%) than among patients in other HIV exposure categories (9%, Standard Z test, P < 0.001). Median CD4+ cell count/mm3 was 120 (range 3-600). Besides diarrhoea, the main clinical manifestations were fever and weight loss in 14 (39%) and 26 (72%) patients, respectively. Cryptosporidium infection was considered to be the first AIDS defining disease in 31% of the patients followed by tuberculosis in 19%, Pneumocystis carinii pneumonia in 14%, Salmonella sepsis in 6%, isosporiasis in 3%, toxoplasmic encephalitis in 3%, leishmaniasis in 3% and Kaposi's sarcoma in 3% of the patients. There was no significant difference (P = 0.82) in survival times for those given folate antagonists to treat other opportunistic infections. The decrease in prevalence of cryptosporidiosis observed from 1994 until May 1997 is not statistically significant (P = 0.11). Most cases of cryptosporidial infection in AIDS patients in Lisbon occurred in those whose HIV infection was assumed to have been acquired by the sexual route (hetero-, homo- and bisexual), with few cases occurring in drug-abusers.

Animals↗
PubMed1997

Outbreak of cryptosporidiosis associated with a swimming pool in Andover.

An outbreak of eight cases of cryptosporidiosis in Hampshire over a period of eight weeks in the summer of 1996 was linked to use of one swimming pool. Cryptosporidial oocysts were not isolated from samples of backwash, but the presence of enterobius ova indicated faecal contamination and a case control study including the first four primary cases suggested an association with immersion in the pool. Even in small outbreaks case control studies can provide useful supportive evidence as to the possible source of infection.

Adult↗
PubMed1995

Waterborne cryptosporidiosis associated with a borehole supply.

From 1 April to 31 May 1993, 64 cases of cryptosporidiosis were diagnosed within one district health authority. Forty were classified as primary cases, 35 of whom were clustered in an area supplied by a discrete public water supply that supplied the majority of homes in a large town. Most of the water in this supply is abstracted from boreholes and some is filtered before distribution. Households that received mains water from this supply were 15 times more likely to be affected than households nearby that received water from other sources. A case control study demonstrated a dose response relationship between consumption of water obtained from the town supply and risk of illness. Very low concentrations of cryptosporidial oocysts were detected in the water supply on four occasions several weeks after the outbreak. Environmental investigation failed to reveal a likely mechanism for contamination of the water supply.

Adolescent↗
PubMed1991

Cryptosporidiosis in the Isle of Thanet; an outbreak associated with local drinking water.

An outbreak of cryptosporidiosis occurred in the Isle of Thanet during December 1990 and January 1991. A total of 47 cases ranging in age from 2 months to 85 years were identified in residents from the Margate, Broadstairs and Ramsgate areas, with dates of onset of illness from 3 December to 14 January. A case-control study demonstrated a strong statistical association between illness and the consumption of unboiled tap water from a particular source, with evidence of a dose-response relationship. Although no cryptosporidial oocysts were identified in samples of untreated or treated water taken during the investigation, the results were consistent with the view that the source of infection was treated river water which was used to supplement borehole water.

Adolescent↗