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ObjectiveTo determine the extent and source of a community outbreak of cryptosporidiosis. DesignQuestionnaire‐based survey and matched case‐control study. SettingSutherland area in southern Sydney, September 1994 to January 1995. Participants70 patients reported by pathology laboratories to have stool specimens positive for Cryptosporidia, of whom 43 were surveyed; 35 were compared with age‐ and neighbourhood‐matched controls. Main outcome measuresDemographic characteristics and potential risk factors in the two weeks before onset of illness. ResultsLaboratories reported 70 cases of cryptosporidiosis between September 1994 and January 1995. We found no association between illness and foods consumed or contact with people with diarrhoea or sick animals in the two weeks before onset. Seventeen of the case group (49%) reported swimming in a particular indoor swimming pool, compared with only seven controls (20%) (odds ratio, 3.7; P=0.015). Cryptosporidial oocysts were detected in water from the swimming pool in January 1995. ConclusionsThe outbreak of cryptosporidiosis was probably associated with ingestion of water from the indoor swimming pool, presumably contaminated by infected bathers. RecommendationsAs it is difficult to eradicate Cryptosporidia from swimming pools by either disinfection or filtration, we recommend that: • People with recent diarrhoea should avoid public swimming pools; and • Non‐toilet‐trained and faecally incontinent swimmers should be provided with alternative swimming facilities with separate water and filtration systems. To enable appropriate public health responses: • Doctors and pathology laboratories should consider cryptosporidiosis in patients with diarrhoea lasting longer than three days; and • Laboratory reporting of Cryptosporidia to local health departments should be mandatory in all States and Territories.

Objectives To determine the prevalence of elevated blood lead concentrations in preschool children in Central and Southern Sydney. Participants and setting Children aged from 9 months to 5 years living in 32 randomly selected geographical areas in Central and Southern Sydney. Methods Venous blood lead concentrations were estimated by atomic absorption spectrometry. Results 953 children were identified and 726 had parental consent to participate. A blood sample for lead estimation was obtained from 718 children. The geometric mean blood lead concentration was 0.34 μmol/L (7.0μg/dL). The proportion of children with elevated blood lead concentrations was: 16.1% (> 0.48 μmol/L [10 μg/dL]), 3.9% (> 0.72 μmol/L [15 μg/dL]) and 0.3% (> 1.21 μmol/L [25 μg/dL]), respectively. The blood lead levels for children living within a 10‐km radius of the Sydney Central Business District were: 25% (> 0.48 μmol/L [10 μg/dL]) and 7% (> 0.72 μmol/L [15 μg/dL]), respectively. Corresponding findings for children living 10 km outside this radius were: 9% (> 0.48 μmol/L [10 μg/dL]) and 1.5% (> 0.72 μmol/L [15 μg/dL]), respectively. Conclusions The proportion of children with elevated blood lead concentrations in Central and Southern Sydney as a whole does not exceed current National Health and Medical Research Council (NHMRC) recommendations. However, in those areas within a 10‐km radius of the Central Business District, NHMRC interventional guidelines for communities where more than 5% of children have blood lead concentrations higher than 0.72 μmol/L (15 μg/dL) should be applied.

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