The Milwaukee Cryptosporidium outbreak: assessment of incubation time and daily attack rate

The time course of reported illnesses (epidemic curve) in the 1993 Milwaukee outbreak of cryptosporidiosis was analysed using a dynamic model considering time variant force of infection and incubation time distributions. Different functional forms for the force of infection and incubation time distribution were tested. The resulting model is a coupled integro-differential equation system. These models gave a good fit to the data, although depending upon the functional forms of the underlying distributions, different incubation time and force of infection curves were obtained. However there was reasonable agreement with respect to a baseline illness rate that existed. This demonstrates that useful information may be obtained in this manner, although it should be supplemented with other data (e.g. serology) for a precise assessment of dynamics of disease occurrence during waterborne epidemic conditions.