1993 Milwaukee Cryptosporidiosis outbreak
The 1993 Milwaukee Cryptosporidiosis outbreak was a significant distribution of the Cryptosporidium protozoan in Milwaukee, Wisconsin, and the largest waterborne disease outbreak in documented United States history. The Howard Avenue Water Purification Plant (see Town of Lake water tower) was contaminated, and treated water showed turbidity levels well above normal. It was one of two water treatment plants for Milwaukee. The root cause of epidemic was never officially identified; initially it was suspected to be caused by the cattle genotype due to runoff from pastures. It was also thought that melting ice and snowmelt carrying Cryptosporidium may have entered the water treatment plants through Lake Michigan. MacKenzie et al. and the CDC showed that this outbreak was caused by Cryptosporidium oocysts that passed through the filtration system of one of the city's water-treatment plants, arising from a sewage treatment plant's outlet 2 miles upstream in Lake Michigan.
This abnormal condition at the water purification plant lasted from March 23 through April 8, after which, the plant was shut down. Over the span of approximately two weeks, 403,000 of an estimated 1.61 million residents in the Milwaukee area (of which 880,000 were served by the malfunctioning treatment plant) became ill with the stomach cramps, fever, diarrhea and dehydration caused by the pathogen. Deaths have been attributed to this outbreak, mostly among the elderly and immunocompromised people, such as AIDS patients.
The outbreak was discussed on Monsters Inside Me (season 1, episode 2, "Outbreak"), an October 2017 episode of "Half in the Bag" by Red Letter Media, and also on Forensic Files (season 2, episode 13, "Deadly Parasites").
- Mac Kenzie WR, Hoxie NJ, Proctor ME, Gradus MS, Blair KA, Peterson DE, Kazmierczak JJ, Addiss DG, Fox KR, Rose JB (July 1994). "A massive outbreak in Milwaukee of cryptosporidium infection transmitted through the public water supply". The New England Journal of Medicine. 331 (3): 161–7. doi:10.1056/nejm199407213310304. PMID 7818640.
- Botkin DB, Keller EA (2005). Environmental Science: Earth as a Living Planet (5th ed.). p. 441. ISBN 978-0-471-48816-3.
- Hoxie NJ, Davis JP, Vergeront JM, Nashold RD, Blair KA (December 1997). "Cryptosporidiosis-associated mortality following a massive waterborne outbreak in Milwaukee, Wisconsin". American Journal of Public Health. 87 (12): 2032–5. doi:10.2105/ajph.87.12.2032. PMC 1381251. PMID 9431298.
- Corso PS, Kramer MH, Blair KA, Addiss DG, Davis JP, Haddix AC (April 2003). "Cost of illness in the 1993 waterborne Cryptosporidium outbreak, Milwaukee, Wisconsin". Emerging Infectious Diseases. 9 (4): 426–31. doi:10.3201/eid0904.020417. PMC 2957981. PMID 12702221.
- Cryptosporidium and public health (Drinking Water and Health Newsletter)
- Cost of Illness in the 1993 Waterborne Cryptosporidium Outbreak, Milwaukee, Wisconsin (CDC)
- Cryptosporidium: A Risk to Our Drinking Water (Wisconsin DNR)
- Graphic Presentation of the Milwaukee Cryptosporidium Outbreak (CDC)
- A Massive Outbreak in Milwaukee of Cryptosporidium Infection Transmitted through the Public Water Supply (New England Journal of Medicine)