Proactive detection of cryptosporidiosis by clinical laboratories. Working Group on Waterborne Cryptosporidiosis.

Laboratories can play a critical and preemptive role as a community's first line of surveillance in detecting waterborne outbreaks when they are aware of increased numbers of stool specimens and suspect or identify Cryptosporidium as the cause of illness. In addition, strong working relationships between clinical laboratories and local or state public health laboratories or agencies can facilitate a meaningful and rapid response related to potential outbreaks. Clinical and public health laboratories potentially play a key role in adding to the limited knowledge of the endemicity and ultimately the natural history of Cryptosporidium. This article addresses the early detection of waterborne outbreaks of cryptosporidiosis and some strategies that could be used to determine endemic levels of Cryptosporidium infections unrelated to outbreaks: to detect Cryptosporidium outbreaks by causes other than potable waterborne sources, e.g., food, surface or recreational waters, pets or farm animals, or sexual contact; or to determine outbreak or endemic levels of other infectious diseases. Strategies for clinical laboratories, which include proactive external and internal planning and a brief overview of laboratory methodologies as they relate to the detection of waterborne cryptosporidiosis, are included.