Résumé :
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[BDSP. Notice produite par INIST xbdEJR0x. Diffusion soumise à autorisation]. Waterbome transmission of Cryptosporidium parvum is well-established as a source in outbreaks of cryptosporidiosis ; however, the role of tap water in endemic disease is unclear. The authors applied a risk assessment approach incorporating uncertainty analysis to examine the potential role of tap water in the transmission of endemic C. parvum infection. The model had two components : exposure-infection, to relate low-dose exposure to infection ; and infection-outcome, to include the probabilities of clinical outcomes leading to case detection and reporting. The population was divided into four subgroups : adults and children with and without acquired immunodeficiency syndrome (AIDS). Because of the high degree of uncertainty associated with available measures, a plausible baseline concentration of oocysts, 1 per 1,000 liters, was assumed for input to the model. In the non-AIDS subgroups, the predicted median annual risk of infection was approximately 1 in 1,000 (non-AIDS adults : 0.0009 infection/person/year, 95% confidence interval (CI) 0.0003-0.0028), while in the AIDS subgroups the predicted risk was 2 in 1,000 (AIDS adults : 0.0019 infection/person/year, 95% Cl 0.0003-0.0130). When the risks were applied to the 1995 New York City population, more than 6,000 infections were estimated, with 99% occurring in the non-AIDS categories. (...)
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