Cryptosporidiosis 
Annual Summary of Reportable Diseases

• August 2023 had the largest number of cryptosporidiosis cases in a single month in Minnesota.
• The first restaurant-associated outbreak of cryptosporidiosis in Minnesota occurred in 2023. The outbreak was associated with fresh produce served at multiple Mexican-style restaurants. 

During 2023, 556 cases of cryptosporidiosis were reported. Of those, 80 were positive only on a rapid antigen screening test and were considered probable cases.  

The 476 confirmed cases of cryptosporidiosis (8.3 per 100,000 population) in 2023 was higher than the median number of confirmed cases reported annually from 2013 to 2022 (median, 364 cases; range, 224 to 439). The median age of confirmed cases in 2023 was 29 years (range, 9 months to 91 years). Children 10 years of age or younger accounted for 21% of cases. Fifty-six percent were female. Of the 468 cases for which race was reported, 422 (90%) were white, 21 (4%) were Black, 8 (2%) were American Indian, 6 (1%) were Asian, 1 (<1%) was Native Hawaiian/Pacific Islander, and 10 (2%) reported being other or multiple races. Seventeen (4%) were Hispanic. The incidence of cryptosporidiosis in the South Central, Southeastern, Southwestern, Central, and West Central districts (16.4, 16.4, 15.9, 10.1 and 9.8 cases per 100,000, respectively) was significantly higher than the statewide incidence. Only 172 (36%) cases occurred among residents of the metropolitan area (5.5 per 100,000). Thirty-eight (8%) cases required hospitalization, for a median of 3 days. One death was reported.

Five confirmed outbreaks of cryptosporidiosis were identified in Minnesota in 2023, accounting for 26 laboratory-confirmed cases. Two outbreaks associated with animal contact accounted for 14 cases (four laboratory-confirmed); these outbreaks occurred in Crow Wing and Scott counties. One outbreak was associated with consumption of raw milk accounted for 13 cases (8 laboratory-confirmed cases) with exposures in Anoka, Benton, Cass, Crow Wing, Isanti, and Morrison counties. One outbreak associated with contaminated fresh produce served at restaurants accounted for 31 cases (11 laboratory-confirmed) with exposures in Dakota, Hennepin, and Ramsey counties. One outbreak of cryptosporidiosis due to person-to-person transmission at a summer day camp in Mower County accounted for 7 cases (three laboratory-confirmed). 

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Cryptosporidium is a parasite that causes the diarrheal disease cryptosporidiosis. During 2022, 528 cases of cryptosporidiosis were reported. Of those, 173 were positive only on a rapid antigen screening test and were considered probable cases. The 355 confirmed cases of cryptosporidiosis (6.3 per 100,000 population) in 2022 was similar to the median number of confirmed cases reported annually from 2012 to 2021 (median, 360 cases; range, 224 to 439). 

The median age of confirmed cases in 2022 was 29 years (range, one year to 89 years). Children 10 years of age or younger accounted for 23% of cases. Fifty-five percent were female. Of the 348 cases for which race was reported, 304 (87%) were white, 26 (7%) were Black, 5 (1%) were Asian American, 3 (<1%) were American Indian, and 10 (3%) reported being other or multiple races. Sixteen (5%) were Hispanic. Sixty-five percent of cases occurred from July through October. The incidence of cryptosporidiosis in the Southwestern, Southeastern, South Central, and West Central regions (19.1, 14.6, 9.9, and 9.4 cases per 100,000, respectively) was significantly higher than the statewide incidence. Only 110 (31%) cases occurred among residents of the metropolitan area (3.1 per 100,000). Thirty (8%) cases required hospitalization, for a median of 4 days. No deaths were reported. 

One confirmed outbreak of cryptosporidiosis was identified in Minnesota in 2022, accounting for two laboratory-confirmed cases. This outbreak was due to animal contact at a petting zoo in Scott County.

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During 2021, 429 cases of cryptosporidiosis were reported. Of those, 56 were positive only on a rapid antigen screening test and were considered probable cases. 

The 373 confirmed cases of cryptosporidiosis (6.6 per 100,000 population) in 2021 is similar to the median number of confirmed cases reported annually from 2013 to 2020 (median, 353 cases; range, 224 to 439). The median age of confirmed cases in 2021 was 26 years (range, 9 months to 85 years). Children 10 years of age or younger accounted for 25% of cases. Sixty-one percent were female. Of the 353 cases for which race was reported, 305 (86%) were white, 28 (8%) were Black, 6 (2%) were Asian American, 1 (<1%) was American Indian, and 13 (4%) reported being other or multiple races. Fourteen (4%) were Hispanic. Sixty percent of cases occurred from July through October. The incidence of cryptosporidiosis in the South Central, Southeastern, West Central, and Southwestern districts (17.5, 17.4, 16.5, and 15.2 cases per 100,000, respectively) was significantly higher than the statewide incidence. Only 86 (23%) cases occurred among residents of the metropolitan area (2.7 per 100,000). Fifty-four (15%) cases required hospitalization, for a median of 2 days. Two deaths were reported. 

Three confirmed outbreaks of cryptosporidiosis were identified in Minnesota in 2021, accounting for 17 cases (5 laboratory-confirmed). All were due to person-to-person transmission in childcare settings. Two of these outbreaks occurred in Hennepin County and one in Dodge County. In addition, 4 laboratory-confirmed cases were part of an outbreak that occurred at a hotel water park in South Dakota.

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During 2020, 365 cases of cryptosporidiosis (6.55 per 100,000 population) were reported. This is similar to the median number of cases reported annually from 2010 to 2019 (median, 367.5 cases; range, 307 to 532) (Figure 2). The median age of cases in 2020 was 27 years (range, 9 months to 86 years). Children 10 years of age or younger accounted for 21% of cases. Fifty-three percent of cases occurred during July through October. The incidence of cryptosporidiosis in the Southwestern, Southeastern, South Central, Northwestern, and West Central districts (28.1, 14.8, 13.7, 8.8, and 8.3 cases per 100,000, respectively) was significantly higher than the statewide incidence. Only 85 (23%) cases occurred among residents of the metropolitan area (2.8 per 100,000). Thirty-eight (10%) cases required hospitalization, for a median of 3 days (range, 1 to 49 days). One death was reported. 

No confirmed outbreaks of cryptosporidiosis were identified in Minnesota in 2020. One laboratory-confirmed case was included in an outbreak identified at a water park in Wisconsin.

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In 2019, 490 cases of cryptosporidiosis (8.73 per 100,000 population) were reported. This is markedly higher than the median number of cases reported annually from 2009 to 2018 (median, 348 cases; range, 307 to 532). The median age was 28 years (range, 5 months to 96 years). Children 10 years of age or younger accounted for 22% of cases. Fifty-six percent of cases occurred during July through October. The incidence of cryptosporidiosis in the Southwestern, Southeastern, South Central, Northwestern, and West Central districts (23.5, 23.5, 17.2, 16.4 and 13.2 cases per 100,000, respectively) was significantly higher than the statewide incidence. Only 132 (27%) cases occurred among residents of the metropolitan area (4.3 per 100,000). Thirty-eight (8%) cases required hospitalization, for a median of 4 days (range, 2 to 190 days). No deaths were reported.

Five confirmed outbreaks of cryptosporidiosis were identified in Minnesota in 2019, accounting for 22 laboratory-confirmed cases. One recreational water outbreak of cryptosporidiosis occurred, accounting for 124 cases (16 laboratoryconfirmed). The outbreak was associated with multiple locations of the same swim school (Hennepin and Ramsey counties) Two outbreaks associated with animal contact accounted for 13 cases (3 laboratoryconfirmed); these outbreaks occurred in Olmsted and Mower counties. Two outbreaks of cryptosporidiosis due to person-to-person transmission in child care settings accounted for 12 cases (3 laboratory-confirmed); these outbreaks occurred in Douglas and Renville counties.

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There were 1,238 culture-confirmed Campylobacter cases reported in 2018 (22.2 per 100,000 population). This is an 18% increase over the 1,049 cases reported in 2017, and a 32% increase from the annual median of 939.5 cases reported from 2008 to 2017 (range, 834 to 1,049) (Figure 3). In 2018, 48% of cases occurred in people who resided in the metropolitan area. Of the 1,178 Campylobacter isolates confirmed and identified to species by MDH, 83% were C. jejuni and 12% were C. coli.

The median age of cases was 36 years (range, 3 months to 95 years). Forty-two percent were between 20 and 49 years of age, and 9% were ≤5 years of age. Fifty-five percent were male. Fifteen percent were hospitalized; the median length of hospitalization was 4 days. Forty-five percent of infections occurred during June through September. Of the 1,126 cases for whom data were available, 233 (21%) reported travel outside the United States during the week prior to illness onset. The most common travel destinations were Europe (n=67), Mexico (n=52), Asia (n=47), Central or South America or the Caribbean (n=36), Africa (n=17), and the Middle East (n=12).

In 2018, 532 cases of cryptosporidiosis (9.54 per 100,000 population) were reported. This is markedly higher than the median number of cases reported annually from 2008 to 2017 (median, 342 cases; range, 235 to 481). The median age of cases in 2018 was 23.5 years (range, 3 months to 92 years). Children 10 years of age or younger accounted for 22% of cases. Sixty percent of cases occurred during July through October. The incidence of cryptosporidiosis in the Southwestern, Southeastern, South Central, and West Central districts (31.8, 26.2, 19.2, and 14.5 cases per 100,000, respectively) was significantly higher than the statewide incidence. Only 142 (27%) cases occurred among residents of the metropolitan area (4.6 per 100,000). Fifty-six (11%) cases were hospitalized, for a median of 4 days (range, 2 to 31 days). Three deaths were reported.

Fourteen confirmed outbreaks of cryptosporidiosis were identified, accounting for 34 laboratoryconfirmed cases. Five recreational water outbreaks of cryptosporidiosis occurred, accounting for 108 cases (15 laboratory-confirmed). Three occurred at campgrounds (Goodhue, Le Sueur, and Waseca Counties), one was associated with a splash pad (Carver County), and one occurred at a municipal pool (Nicollet County). Two outbreaks associated with animal contact accounted for 8 cases (5 laboratory-confirmed); these outbreaks occurred in Rock and Stevens Counties. Seven outbreaks due to person-to-person transmission at child care centers accounted for 30 cases (14 laboratory-confirmed); the outbreaks occurred in Blue Earth (n=2), Kandiyohi (n=2), Carver, Fillmore, and Stearns Counties.

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• Archive of Annual Summary of Communicable Diseases Reported to the Minnesota Department of Health
  Archive of past summaries (years prior to 2023 are available as PDFs).