The epidemiology of sporadic human infections with unusual cryptosporidia detected during routine typing in England and Wales, 2000–2008

SUMMARY Routine typing of 14 469 isolates from human cryptosporidiosis cases between 2000 and 2008 revealed that 7439 (51·4%) were Cryptosporidium ( C .) hominis , 6372 (44·0%) C. parvum , 51 (0·4%) both C. hominis and C. parvum , 443 (3·1%) were not typable and 164 (1·1%) were other Cryptosporidium species or genotypes. Of the latter, 109 were C. meleagridis , 38 C. felis , 11 C. ubiquitum , one C. canis , two horse, two novel and one skunk genotype. C. hominis monkey genotype and C. cuniculus were identified in a separate study. Patients with unusual infections were older than those with C. hominis ( P <0·01) or C. parvum ( P <0·01) and were more likely to be immunocompromised (Fisher's exact P <0·01). Forty-one percent of unusual cases had travelled abroad, mainly to the Indian subcontinent. Significant risk factors in those with unusual species were travel abroad ( C. meleagridis , P <0·01), being immunocompromised ( C. felis , Fisher's exact P =0·02), and contact with cats ( C. felis , Fisher's exact P =0·02).