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 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 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 people with AIDS.