Ca. Morin et al., WHAT DO PHYSICIANS KNOW ABOUT CRYPTOSPORIDIOSIS - A SURVEY OF CONNECTICUT PHYSICIANS, Archives of internal medicine, 157(9), 1997, pp. 1017-1022
Background: Cryptosporidiosis, an intestinal parasitic infection, has
gained considerable media attention since a 1993 waterborne outbreak i
n Milwaukee, Wis, in which more than 400 000 persons became ill. Howev
er, the incidence of and risk factors for human cryptosporidiosis in t
he general US population are unknown. It has been suggested, but not d
ocumented, that physicians are generally unaware of the need to specif
ically request testing for this organism. Objective: To assess physici
an awareness of cryptosporidiosis and knowledge of laboratory testing
for Cryptosporidium oocysts. Methods: A self-administered questionnair
e was mailed to a stratified random sample of Connecticut physicians.
Specialties were limited to physicians in internal medicine, gastroent
erology, infectious diseases, pediatrics, and family or general practi
ce. Responses were compared among specialties. Results: While most phy
sicians were aware that cryptosporidiosis causes watery diarrhea (rang
e, 67%-98%), particularly inpatients with acquired immunodeficiency sy
ndrome (>85% of all specialties), many did not know the symptoms or fa
iled to identify other groups at increased risk. More than 75% of gast
roenterologists, general or family practitioners, internists, and pedi
atricians never or rarely order diagnostic testing for Cryptosporidium
even when their patients have symptoms consistent with cryptosporidio
sis. More than 30% of physicians assumed Cryptosporidium testing was i
ncluded in a standard ova and parasite examination. Conclusions: Crypt
osporidiosis is likely to be unrecognized and underdiagnosed in Connec
ticut. This may occur because many physicians are unaware of cryptospo
ridiosis, unsure of the symptoms, do not test for it, or do not order
the appropriate test. Unless there is more widespread use of specific
tests, it will be difficult to evaluate specific preventive initiative
s to limit the overall health impact of cryptosporidiosis.