Infections from the Cryptosporidium parasite are continuing to rise in Europe, according to a report published this month by the European Centre for Disease Prevention and Control (ECDC).
Outbreaks associated with food and drink, such as juice, have been reported. The parasites are microscopic and do not make food smell, look or taste unusual.
For 2018, 20 countries reported 14,299 cryptosporidiosis cases, of which 14,252 were confirmed. The number of confirmed patients was more than the 11,435 in 2017. The notification rate for 2018 was higher than in the previous four years from 2014 to 2017.
Germany, Netherlands, Spain and the United Kingdom accounted for 76 percent of all confirmed cases in 2018, with the UK alone making up 41 percent with 5,820 infections.
Reporting was voluntary in Belgium, Greece and the Netherlands or organized differently like in the UK. No surveillance system exists in Austria, Denmark, France or Italy.
Rates tended to be lower in Eastern Europe than Western and Northern Europe. Increased rates, compared to 2017, were recorded by Belgium, Finland, Iceland and the Netherlands. Greece reported cases and rates of cryptosporidiosis to ECDC for the first time in 2018.
The highest notification rates were in the Netherlands, Ireland and Belgium, likely indicating a higher laboratory testing and reporting capacity, said ECDC. However, 16 countries continue to record hardly any cases, which is an indication of underreporting, according to the agency report.
Young people mainly sick
There was an increase in April and a peak in September. A large proportion of these were attributed to cases from the UK, where this seasonal pattern is predominant.
The highest notification rate was in the age group 0 to 4 years old. The top rate in this age group was reported by Ireland, followed by Belgium and the UK. Notifications were higher among boys aged 0 to 4 as well as among women aged 15 to 24 and 25 to 44 years old.
There was one Cryptosporidium travel-related outbreak reported by Ireland associated with a campsite or resort in southern Europe, which involved six people.
In Europe, infection is mainly acquired through recreational waters such as swimming pools, public paddling pools, water parks or open waters, mass sporting events involving water or mud and contact with animals.
The ECDC said a better understanding of the epidemiology of cryptosporidiosis in Europe, in terms of species and subtype distribution and trends, is needed.
“This requires increased laboratory testing for parasites, pathogen isolation, speciation and subtyping, as well as more complete reporting. The public should also be made aware of how to minimize the risk of getting cryptosporidiosis, including practicing proper hand hygiene and proper handling of raw or minimally processed fruits and vegetables, such as washing, peeling and cooking, if necessary,” according to the report.