Another pool closed.
• Falcon Ridge Middle School in Apple Valley will not use its swimming pool for the next three weeks because of an earlier outbreak of cryptosporidium. While swim teams have used the pool since re-opening, the school's physical education classes will not use the pools as a precautionary measure, principal Noel Mehus said.
From http://www.twincities.com/mld/twincities/living/15775863.htm
"School officials closed six middle-school pools in the Rosemount-Apple Valley-Eagan School District on Tuesday, pending a Minnesota Department of Health investigation into a parasitic infection that has sickened students.Two members of a community swim team have been confirmed with cryptosporidiosis recently and another 16 students in elementary and middle school have reported illnesses that indicate infections, said Dr. Joni Scheftel, an epidemiologist at the Health Department.
Symptoms can include diarrhea, cramps, nausea, vomiting, fever, fatigue and weight loss, and can last as long as two weeks.
The illnesses, which began about Sept. 28, were reported late Monday afternoon to the Health Department, Scheftel said.
Swim team members used various pools, but it was too early to identify the source of the infections, she said.
The department had urged the closing of pools at Falcon Ridge, Blackhawk and Dakota Hills middle schools, but school officials closed all six used by middle-school students, she said."
More after the Jump
Pierre - A significant number of outbreaks of cryptosporidiosis, an intestinal illness causing stomach cramps and diarrhea, has health officials urging South Dakotans to practice good personal hygiene. Through September, 86 cases have been reported in 23 South Dakota counties, compared to 31 cases for all of last year.
"Good hand-washing is the single most important thing people can to do to prevent the spread of not only cryptosporidiosis, but other diarrheal illnesses as well," said Secretary of Health Doneen Hollingsworth.
Hand-washing is especially important after using the toilet, changing diapers, gardening, handling pets or other animals, caring for infected persons, and before handling or eating food.
Cryptosporidiosis is caused by a microscopic parasite called cryptosporidium. People become infected by drinking water or eating food contaminated by the parasite. Infection is also transmitted through direct contact with contaminated surfaces or stools of infected animals or humans.
More after the jump.
SAN JOSE, CA – The Santa Clara County Public Health Department is monitoring interactive play fountains around the county after seven children were infected by a Cryptosporidium parasite while playing in a fountain at Plaza de Cesar Chavez, according to an article in The Mercury News.
The Plaza de Cesar Chavez fountain and another fountain in McEnery Park have been shut off, and city officials are expected to meet this week with representatives from the county to review filtration systems for removing bacteria from the water, the story said.
Interactive fountains, which are designed for water play, continuously recirculate water through a series of jets, increasing the opportunity for contaminants to build up, the report noted.
Unlike public pools, hot tubs, spas and water parks, interactive fountains are not monitored by health officials for proper chlorination, according to the article.
To read the full article, click here.
Marler Clark filed a class action lawsuit against the New York Office of State Parks, Recreation and Historic Preservation on behalf of over nearly 4,000 people who became ill with Cryptosporidiosis after visiting the Sprayground at Seneca Lake State Park in June, July, and August, 2005. The Class was recently certified.
The New York State Health Department shut down the Sprayground on August 15 after it was determined that the Sprayground’s water holding tanks, which were used to recycle water, were contaminated with Cryptosporidium.
KIDS' OUTBREAK PUTS SITES ON LIST FOR MONITORING
By Joyce Chen
Mercury News
Santa Clara County health officials said Thursday that they have identified all the interactive fountains in the county for the first time and will take steps to monitor their water to prevent disease outbreaks.
The action came after seven children were infected by a microscopic parasite while playing in a popular fountain at Plaza de Cesar Chavez in downtown San Jose. Tests on the water found Cryptosporidium, which causes nausea, diarrhea and other gastrointestinal distress.
City officials immediately shut off the fountain and closed another, in McEnery Park, as a precautionary measure.
Both work by running the same water through the jets over and over, increasing the chance that Cryptosporidium and other contaminants from human and animal feces will build up. City and county officials will meet next week to review filtration systems that would remove the parasite and other dangerous microbes, according to Ed Bautista, a spokesman for the city parks and recreation department.
Unlike traditional fountains, interactive fountains are designed for water play. The children were apparently infected while playing in the downtown fountain between July 22 and Aug. 21.
The county has never applied the same scrutiny to fountains as it does to public pools, hot tubs, spas and water parks, which are regularly monitored to make sure they're properly chlorinated.
``Up until this incident, we were not considering these fountains as swimming pools'' and evaluating them accordingly, said Richard Fuchs, director of the consumer protection division in the Santa Clara County department of environmental health. ``But in all likelihood, we'll be doing that in the future.''
Although no new cases of cryptosporidiosis have occurred, health officials across the Bay Area acknowledged the need for oversight.
Fuchs said his staff just finished compiling a list of every interactive fountain in the county. The next step would be contacting cities and setting ``some kind of monitoring schedule,'' he said.
The county list was not available Thursday. Bautista said San Jose has seven interactive fountains; the five that remain open work by continually bringing in fresh water rather than recirculating it.
``If water is coming in and it just drains out, then you're not going to be putting yourself at risk, because it's new water every time,'' said Dr. Marty Fenstersheib, the Santa Clara County public health officer.
The best way to prevent ``crypto'' outbreaks is to filter the parasites out of the water, said Michelle Kirian, coordinator of the Cryptosporidiosis Surveillance Project, which monitors cases in Santa Clara, San Mateo, San Francisco, Alameda and Tuolumne counties. The parasites can live for days even in a properly chlorinated pool.
She said that while rashes of cryptosporidiosis have occurred in the past -- most famously in greater Milwaukee, where 403,000 people were infected in 1993 -- the Bay Area hasn't experienced an outbreak since 2003. ``It's not common to see Cryptosporidium infection associated with recreational water exposure,'' she said.
The outbreak has given rise to speculation that the state may step in to regulate fountains -- a crucial step, according to Justin Malan, executive director of the California Conference of Directors of Environmental Health. The organization, which represents 62 county environmental health directors, released guidelines for interactive fountains in 2001, although those measures have not been widely implemented.
Fenstersheib said that while the state should adopt standards for oversight, public health should take precedence.
``The more important thing is to identify the fountains and see which ones are at risk,'' he said. ``We have to take action before we do regulation.''
Contact Joyce Chen at jchen@mercurynews.com or (650) 688-7588.
August 30, 2006
9News.com (Denver, CO)
Jeffrey Wolf
LONE TREE - The Tri-County Health Department is warning people of an outbreak of a bacterium called Cryptosporidium that may be from a pool at the Lone Tree Recreation Center.
The pool was closed because 12 people who went to a birthday party at the center last week came down with diarrhea and stomach cramps, which are symptoms of Cryptosporidium or "Crypto."
There are three confirmed cases of Crypto.
The Tri-County Health Department collected samples from the pool Wednesday morning and the pool workers spent the day chlorinating the pool.
"We want to be precautionary, protect the public, do what we can to be proactive, if there is anything in the pool," said Marc Heirschberg with South Suburban Pools and Recreation.
Authorities plan to reopen the Lone Tree pool Thursday.
The Tri-County Health Department says if your children are experiencing symptoms of Crypto you should not let them go to a pool, school or daycare.
August 31, 2006
San Jose Mercury News (CA)
San Jose has shut down the fountain at the Plaza de Cesar Chavez because health officials suspect as many as 14 people became sick after playing in the water there.
A news release from the city says the fountain ``was the common denominator'' for five confirmed cases of a cryptosporidium infection and eight to nine unconfirmed cases of salmonella. Both are transmitted by contaminated food or water.
The fountain was closed effective Friday and will remain closed until ``health and safety concerns are addressed,'' according to the release.
Local health officials are conducting tests of the fountain water.
Cryptosporidium test results are expected by Friday.
Cryptosporidium is a parasite and salmonella is a bacteria. Both cause flu-like symptoms including diarrhea, nausea, fever and headache.
City officials say the sand filtration and sanitation systems and manual application of cleansing chemicals are ineffective for preventing both cryptosporidium and salmonella. They are developing recommendations to modify the system in order to ``minimize or eliminate'' outbreaks in the future.
August 20, 2006
Daily Herald (IL)
Joseph Ryan
Six Flags Great America's Hurricane Harbor water park in Gurnee was shut down by the state Friday and Saturday after reports of an intestinal illness in four attendees.
Six Flags hoped to have the water park, which includes 26 slides, wave pools, water playgrounds and river raft rides, re-open today after increased chlorination and follow-up testing.
The Illinois Department of Public Health asked Six Flags to close off the water park following the confirmation that two attendees had cryptosporidiosis, which causes vomiting, diarrhea and death in extreme cases.
The disease is caused by microscopic parasites, and is one of the most common waterborne illnesses in the U.S. The parasites are resistant to chlorine.
The state received two confirmed cases and two unconfirmed cases of the illness, said public health spokeswoman Melaney Arnold.
Arnold said the incident was "likely through no fault" of Six Flags.
"Somebody probably came in sick to the park, and that illness was in the water, and someone else was able to pick it up," she said.
The parasites can survive in water that is properly chlorinated, Arnold added.
Six Flags vigorously defended the cleanliness of its water park in a statement Saturday.
"There is no evidence linking this to our water park," the statement says. "We have received no reports or complaints from our thousands of other guests."
Arnold says the state doesn't need proof the illness was picked up at Six Flags, only a suspicion. The four people infected with the illness were part of a group visiting from out of state.
"Obviously we want to error on the side of caution," she said.
The water park contains a computer-controlled chemical system that monitors chlorine levels, the Six Flag statement says.
The chemical levels are tested every hour. The last state inspection occurred on July 24 and found the chemical levels to be acceptable, the statement says.
The two-day shutdown is the first such incident since the water park opened in May of 2005, said Six Flags spokeswoman Katie Goodale.
Two sprayparks in Clay County, Missouri are the source of an ongoing Cryptosporidium outbreak, according to health officials.
Marler Clark represents hundreds of people in litigation resulting from a Cryptosporidium outbreak in central New York last summer (visit www.marlerclark.com for more informtation).
Here's an article from today's Kansas City Star on the current outbreak:
Clay County confirms seven cases of contagious illness
17.aug.06
Kansas City Star
Lindsay Hanson Metcalf
Seven cases of an intestinal parasite have been confirmed in Clay County, officials said today.
Clay County Public Health officials said they were notifying area schools and health- and child-care providers about the presence of Cryptosporidium, a parasite that causes diarrhea. An additional six cases among family members were probable, they said
The common ground among the cases was two water spray parks in Liberty, said Jodee Fredrick, a Clay County Public Health Center spokeswoman. The victims used the public spray grounds near Missouri 291 and Kent Street as well as Ruth Moore Park near the Liberty Square on or after July 20, Fredrick said. The parks were being closed for treatment and laboratory testing.
Symptoms include diarrhea and cramps, weight loss, nausea, vomiting or fever. The disease can be caught by drinking contaminated water, eating fruits and vegetables washed with contaminated water or touching surfaces contaminated with infected feces.
Officials urged metropolitan-area residents who have experienced diarrhea or cramps after visiting a recreational water facility to seek medical assistance.
Residents can prevent the disease with good hygiene, washing hands at least 30 seconds after using the restroom, changing diapers, touching animals or soil and before touching food.
Posted:8/11/2006 5:19:04 PM
Modified:8/11/2006 6:43:53 PM
LAWRENCE, KAN. - The Lawrence-Douglas County Health Department is reporting two cases of cryptosporidium in a child care facility in Douglas County. Crypto is a disease that causes diarrhea because of a microscopic parasite which can live in the intestine of humans and animals. Families of the children attending this child care facility have been notified and are receiving information about the disease with recommendations to contact their doctor if symptoms develop.
What is Crypto?
Cryptosporidium is a diarrheal disease caused by a microscopic parasite, which can live in the intestine of human and animals and is passed in the stool of the infected person or animal.
How is it spread?
The disease is spread by fecal-oral contact. People with cryptosporidium have parasites in their stool. If they do not wash their hands properly after going to the bathroom, their hands can spread the parasites to surfaces, objects, and foods that will be touched by others. Crypto is very hardy; it has a protective capsule or shell and can survive outside the body for up to six months. Persons also can become infected by consuming food or water contaminated with the organism. Outbreaks have also been associated with contaminated swimming pools and lakes.
Symptoms of Crypto
The symptoms of cryptosporidium include diarrhea, loose or watery stool, stomach cramps, upset stomach, and a slight fever. For some people, no symptoms appear. Symptoms generally occur within 2 to 10 days of infection. They last about two weeks, but may go in cycles of getting better then worse before the illness ends. People may excrete the parasite for up to two weeks after the symptoms have passed.
Preventing the spread of crypto
Anyone who is experiencing diarrhea should avoid swimming for two weeks after symptoms are gone, and contact their doctor if symptoms persist. Anyone with an immuno-compromised system should take extra precautions and avoid swimming in water that may be contaminated. Continue to practice good hand washing.
Follow the six PLEAs for Healthy Swimming:
* Don't swim when you have diarrhea. You can spread germs in the water and make other people sick.
* Don't swallow the pool water. In fact, avoid getting water in your mouth.
* Practice good hygiene. Shower before swimming and wash your hands after using the toilet or changing diapers. Germs on your body end up in the water.
* Take children on bathroom breaks or change diapers often. Waiting to hear "I have to go" may mean that it's too late.
* Change diapers in a bathroom and not at poolside. Germs can spread to surfaces and objects in and around the pool and spread illness.
* Wash your child thoroughly (especially the rear end) with soap and water before swimming.
10.aug.06
Missoula Missoulian (MT)
MISSOULA - Six confirmed cryptosporidium cases - two of them more epidemiologically linked - have been received by the Missoula City-County Health Department during the last week and a half.
Crypto is a diarrheal disease caused by a microscopic parasite similar to Giardia. Once an animal or person is infected the parasite lives in the intestine and passes in the stool.
The eight Missoula crypto cases have been exposed to many different recreational water sources during the 2 to 12 days prior to their onset of illness. The health department has been unable to identify a single common source.
The parasite is protected by a tough outer shell that allows it to survive outside the body for long periods of time and makes it very resistant to chlorine-based disinfectants meaning it can survive for days even in swimming pools with adequate chlorine levels. The chlorine levels continue to be effective against bacteria and viruses including norovirus.
Crypto lives in the intestine of infected humans or animals. It is found in soil, food, water or on surfaces that have been contaminated with infected feces. If a person swallows the parasite they become infected. Other sources besides recreational water include accidentally putting something into your mouth or swallowing something that has come into contact with feces of a person or animal infected with crypto; eating uncooked food contaminated with crypto; or accidentally swallowing crypto picked up from surfaces such as bathroom fixtures, changing tables, diaper pails or toys contaminated with feces from an infected person.
The health department is urging residents who play or swim in recreational waters - including streams, rivers, lakes, pools, hot tubs and splash parks - to learn about crypto and take precautions.
During the past two decades crypto has become recognized as one of the most common causes of waterborne disease in humans in the United States. The parasite can be found in recreational water in every part of the country.
The most common symptom of crypto is watery diarrhea. Other symptoms include dehydration, weight loss, stomach cramps or pain, fever, nausea and vomiting. Some people with crypto will have no symptoms at all.
In persons with healthy immune systems symptoms usually last about one to two weeks. Symptoms may go in cycles. People are urged to contact a health care provider if symptoms are severe and last more than a couple of days.
The health department also offered six "pleas" for protection from recreational water illnesses:
do not swim when you have diarrhea, especially kids in diapers; do not swallow recreational water including at splash decks; practice good general hygiene; take kids on bathroom breaks or check diapers often; change diapers in a bathroom and not at poolside or near other recreational water; wash your child - especially the rear end - thoroughly with soap and water before swimming.
According to state pool inspector Jerry Cormier Missoula city pools already exceed state regulations for pool sanitation. Chlorine levels will be increased and shock treatments will be used during pool closure hours to help reduce the risk for crypto.
For more information: health department info line, 258-3500.
On the Web:
http://www.cdc.gov/NCIDOD/DPD/parasites/cryptosporidiosis/factsht_cryptosporidiosis.htm.
The Judge in the Court of Claims recently certified the Cryptosporidium case against the State of New York as a class action. This order officially turns the case into a class action. The certification of the class is a big help in terms of getting the state to deal with these claims. The class members include all those who are existing Marler Clark, Underberg & Kessler, or Dreyer Boyajian clients and have filed a claim against the State. The Judge has also indicated that the Class can be expanded to include others who now come forward and follow the procedures necessary to making a Cryptosporidium claim against the State. Individuals who wish to join the class should contact Marler Clark at marler@marlerclark.com or toll-free at (866) 770-2032.
We are in the process of requesting information from the State concerning the Spray Park in an effort to demonstrate what we believe was the State's obvious negligence in failing to have adequate protections against Cryptosporidia. At the same time, we are assembling basic information about all class members to share with the State in order to establish a basis for compensation. While it is too early to know what course the class action will follow, our goal is to reach a negotiated resolution with the State for monetary compensation for our clients.
Wednesday, July 05, 2006
By CRAIG FOX
Finger Lakes Times
GENEVA - It's going to be a few more weeks before the spraypark at Seneca Lake State Park reopens.
It's taking state Park, Recreation and Historic Preservation work crews longer than expected to install new filtration and ultraviolet systems designed to prevent a recurrence of last summer's gastrointestinal outbreak.
The delay is being caused by a few engineering changes to the new systems and getting the state Health Department to sign off on the changes, Gibson said.
The Health Department must also test "every piece of new equipment" in the system and make sure they work properly before the park reopens, Gibson said.
"We're taking it day by day," Gibson said.
The equipment is required under a set of state Health Department regulations put into place after several thousand park visitors became sick last summer.
The Health Department determined the illness was cryptosporidius, caused by a microscopic parasite and spread through human feces. The sprayground was closed in mid-August.
The improvements -- designed to deactivate any micro-bacterial organisms that form in the sprayground's water supply -- began in March and were expected to be completed by early this month.
But state parks spokeswoman Wendy Gibson said this morning the hope now is to get the spraypark open by the end of the month.
Health Department officials determined the problem was with two filtration system pumps that recycle water. The new ultraviolet system will either kill the micro-organisms or stop them from reproducing.
The spraypark will also be getting a new water filtration system that can filter more water per minute; it's being installed in a small brick building under construction at the site.
It'll be the first spraypark using an ultraviolet system in the state, Gibson said, adding that "it's been a learning process for us."
No other work will be done on the spraypark itself; all the spray gadgets and the existing rubber surface will remain as is, Gibson said.
The cost of the project wasn't available this morning.
In January, the state Health Department drafted regulations to ensure safety at water parks. The facility normally opens for the Memorial Day weekend.
The new regulations are specific to sprayparks that recycle water but not parks that use only fresh water in their filtration systems.
All splash and sprayparks are required to obtain permits from county health departments.
Signs have to be posted telling those with diarrhea to keep out of the water, and the area has to be fenced to keep animals out.
A class action lawsuit representing 663 people who became ill after visiting the spraypark has been filed against the state Parks Department. The lawsuit seeks compensation for damages, including pain and suffering, medical expenses and lost wages.
cfox@fltimes.com
by Seth Voorhees
Published Jun 22, 2006
An Ontario County spray park where more than 4,000 people became ill last summer is preparing to reopen.
The spray park at Seneca Lake State Park shut down in August, after an outbreak of cryptosporidium.
Changes being made this year include an expanded filtration system, and an ultra-violet water treatment system.
"UV is very effective against organisms like cryptosporidium, whereas chlorine isn't," said Jeff McDonald of the state parks department.
Park officials believe the changes will quell people's apprehensions about coming back, following last year's troubles.
"I would come back again," said Amanda Barto of Seneca Falls. "As long as they cleaned everything up and it was safe."
Last summer's outbreak sparked a lawsuit, filed by many of those who became ill. The suit is still pending.
Officials hope to reopen the Geneva spray park by mid-July.
About 800 Crypto Cases In 2005, Officials Say
June 16, 2006
ChannelCincinnati.com
CINCINNATI -- Crypto cases caused hundreds of TriSstate kids to become sick in 2005. This year, however, local pools aren't taking any chances when it comes to dealing with the waterborne disease, News 5 reported.
The parasite, called Cryptosporidium, affected about 800 kids in the area in 2005, according to health officials.
"Last year was extremely scary," said parent Donna West. "We actually stayed away."
"It's something we don't see in great numbers in this part of the region," said Chris Eddy of the Hamilton County Health Department. "We've seen it in other places but this caught us by surprise. This year we're trying to avert that from happening again."
In Hamilton County, officials inspected swimming pools and conducted extensive training sessions with more than six-dozen people in April, regarding pool sanitation and safety procedures.
The health department also contacted the places where people tested positive for the parasite, as well as any pools that didn't have any contact with the outbreak.
Pools have been encouraged to post "little squirt" rules, which say that the content of a child's diaper can create diseases.
"(It's) the most important thing for parents, even if it's embarrassing," said Blue Ash pool manager Jon Corum. "If the child has a problem, let the pool manager know."
"It's a scary thing when they are shutting down pools for five days because they have to clean the filtration system," said parent Michelle Day. "It is a hygiene concern."
For more information about the new rules, visit the Hamilton County Health Department's Web site.
May 24, 2006
WROC8TV.com
Cathy Orosz
The playground at Seneca Lake State Park is the only kids' attraction right now.
That's because the spray park remains dry following last summer's cryptosporidium outbreak.
Debbie Patrick of Geneva hopes her son will soon be able to splash in the water again.
"It's definitely a good place to come with the kids," she said Wednesday.
But it will be a while longer before the spray park is re-opened. A state-mandated makeover is underway to prevent an outbreak like the one that sickened nearly 4,000 people last summer.
A new building has gone up to house a new filtration system. The filters have arrived, but their foundation is still being poured.
A second structure will house something even more unique: an ultra-violet system.
"U-V is very effective against organisms like cryptosporidium," explained Jeff McDonald, one of the park managers.
U-V light can stop microorganisms from multiplying. The system will be the first-of-its-kind in New York State, making a blue print for spray parks all across the country.
"Now every spray ground is looking at what their systems are and what we're trying to accomplish with the U-V, so we'll be the guinea pigs and probably set a new standard," said Ron Stewart, Regional State Parks Director.
The spray park will also be getting new fencing, leaving just one entrance into the venue. Patrons will have to rinse off their feet before entering. And signs will be posted, alerting people about several new rules.
There's public trust to re-gain before the spray park re-opens. The State Health Department has to sign off first.
"I think a lot of people will wait on that factor before they visit," said Patrick.
She has no doubt her family will be back in the water when the spray park re-opens in late June or early July.
05 Apr 2006 18:37:24 GMT
JOHANNESBURG, 5 April (IRIN) - Botswana is struggling to control a diarrhoea epidemic that has claimed the lives of 470 children since January.
"A few adult cases have been reported but mostly children are affected," Colo Boitshoko, spokesman for the Ministry of Health, told IRIN. "We had a lot of rain for this time of the year - normally we have some diarrhoea cases around this time, but it never turns into an epidemic. The rain is the underlying cause."
Kutloano Leshomo, Communications Officer for the United Nations Children's Fund (UNICEF), said laboratory tests of samples from Francistown, conducted by the Centres for Disease Control (CDC) in Atlanta, USA, suggested the outbreak had come from various sources.
"Contaminated water, unhygienic practices at the household level, poor sanitation, infant feeding-bottle contamination with human waste and ongoing person-to-person transmission" had all contributed to spreading the disease.
The tests indicated the presence of Enteropathogenic E. Coli bacteria and Cryptosporidium, a microscopic parasite that lives in the intestines of infected humans and animals, and is found in soil, food, water, or surfaces that have been contaminated with infected human or animal faeces.
Water authorities, "especially in villages, have acknowledged that they do not have capacity and resources for regular monitoring of the quality of water, meaning that sometimes water is not chlorinated," Leshomo said.
Boitshoko pointed out that "we have contamination in the water, mainly in rural areas where the majority of the population lives - village reservoirs and natural ponds have been affected, and people are drinking rainwater".
The reason it has taken so long to control the outbreak, Leshomo suggested, was "first, because the Ministry of Health lacks sufficient capacity to handle an emergency of this nature, especially diarrhoea coupled with malnutrition, but also because some of the issues are outside the jurisdiction of the Ministry of Health ... the water supply authority in the villages, for example, falls under the Ministry of Local Government."
"Even large villages, where infrastructure is relatively good, have not been spared."
According to dr Dorothy Ochola, Project Officer at UNICEF, "severe, acute malnutrition, secondary to diarrhoea, is contributing to the high fatality rate".
Since the onset of the outbreak, a steady increase in cases of malnutrition-related illnesses, especially marasmus and kwashiorkor, have been registered. "It is estimated that approximately 450 to 500 children are in urgent need of therapeutic feeding," she said.
Some patients postpone seeking medical attention, raising the fatality rate. According to one humanitarian official, "children often develop 'phogwana e wetse' [sunken fontanelle] as a result of diarrhoea and malnutrition, but in rural areas that is often attributed to something spiritual and a traditional healer is consulted first, delaying rehydration."
The outbreak is widespread and 23,264 cases have been reported across all of Botswana's districts. Ministry of Health statistics recorded 4,564 cases in the southeastern region of Serowe-Palapye, believed to be the origin of the epidemic, and 4,391 cases in Kweneng East, the areas that have been hit hardest.
With the number of weekly cases on the decline - 1,201 reported last week - Boitshoko said the "epidemic is still not under control but it is going in the right direction".
A concerted effort by the World Health Organisation, UNICEF, the International Red Cross, the CDC, Medecins sans Frontieres and local water authorities, coordinated by the Ministry of Health, has accelerated the response to the outbreak.
"The numbers have been going down due to the various interventions that have been put in place, such as concerted social mobilisation to educate parents," Leshomo noted.
"We are now very hopeful," Boitshoko said. "We should not have to lose so many children to such a disease. Diarrhoea should not have to kill."
By MARCELA ROJAS
THE JOURNAL NEWS
SOUTHEAST - Several more swimmers were sickened by a parasite that may have contaminated an indoor pool on Route 22.
Wings over Water, a center where children take lessons and have birthday parties, closed last week at the recommendation of the Putnam County Health Department after two unrelated people, an adult and a child, were diagnosed with cryptosporidiosis, a gastrointestinal illness caused by a microscopic parasite called cryptosporidium. The organism is found in feces.
Since then, another five individuals, one adult and four children, tested positive for the communicable disease, according to the Putnam County Health Department. A number of people also have called with symptoms but have not been tested, said county Health Commissioner Dr. Sherlita Amler.
"We are working closely with the facility to ensure that they are in line and that everyone is safe," she said.
Officials still are investigating the source of contamination and may never know the cause, Amler said.
The 25-by-60-foot pool is being drained and already has been superchlorinated, a process that thoroughly cleans the filters and other equipment, said Melissa Flannery, program director for Wings over Water. The water was tested for cryptosporidium, and results are pending, she said.
The center is expected to reopen Thursday, Flannery said.
"Our first concern is the health and safety of our swimmers and the community," Flannery said.
More than 1,000 people who use the pool were notified by letter about the matter, and a second mailing is on the way, Flannery said. Swimmers are being asked not to return to the facility until they are symptom-free for at least two weeks, Amler said.
The most common indication of the disease is diarrhea, though nausea, vomiting, fever and headache also may occur. The illness may begin within days of exposure and persist for 14 days or less. Those with weakened immune systems may have more severe ailments.
Cryptosporidium is shed in the feces of infected humans and animals. According to the national Centers for Disease Control and Prevention, people can become infected by swallowing recreational water contaminated with cryptosporidium. The organism can survive for days, even in swimming pools with adequate chlorine levels.
Although they don't suspect the parasite of spreading to other pools, health department officials said as a precaution, they contacted the county's five other indoor swimming facilities - Green Chimneys in Patterson, Carmel Fitness and Racquet Club in Carmel, Jehovah's Witnesses' Watchtower Educational Center in Patterson, Arms Acres in Carmel and St. Basil's Academy in Garrison - to recommend that they superchlorinate their pools. Area doctors and emergency rooms in Putnam and other nearby hospitals also were told to be on the alert for patients with similar symptoms, Amler said.
"We're being very proactive," she said.
Kevin Hupp's 3-year-old daughter, Angela, had taken two swimming lessons at Wings over Water last month before the facility shut down, he said. Fortunately, he said, she has not gotten sick, though they are being cautious.
"We're obviously very concerned," said Hupp, who lives in Southeast. "But they seem to be doing the right thing, about as good as you can ask for. My daughter enjoyed the class very much."
ROCKFORD - Seven children and two employees at a Rockford Health System day-care facility and school contracted a parasite in recent weeks that can cause severe abdominal distress.
None of those who contracted the cryptosporidium parasite, which causes cryptosporidiosis, were hospitalized, according to the Winnebago County Health Department. The center is no longer believed to be at risk for the parasite. The cases were reported Sept. 12 to Oct. 3.
It's unknown how the parasite was spread, but it can happen when children don't wash their hands after using the bathroom. About 300 children, ranging from infants to kindergarten age, attend the day-care center at 2910 Glenwood Ave.
"We notified all the parents of all the kids in the facility," Rockford Health System spokesman Wester Wuori said.
"Obviously, we take this very seriously and want to be proactive when anything like this comes up."
Symptoms of cryptosporidiosis include diarrhea, abdominal cramping, nausea, vomiting, fatigue, weight loss and low-grade fever, according to the Illinois Department of Public Health.
The state reports 75 to 100 cases of cryptosporidiosis each year.
The main ways to protect against the parasite are to wash hands after using the bathroom and handling animals and before preparing or eating food, and water should not be consumed directly from rivers, lakes and streams.
Lauren Stanforth
Staff writer
(October 17, 2005) - New York state Assemblyman Joseph Morelle, D-Irondequoit, was meeting with New York state health and park officials today in Rochester, hoping to learn more about the state's investigation into the parasite outbreak at Seneca Lake State Park's Sprayground this past summer.
Morelle was being joined by Assemblyman Richard Gottfried, D-Manhattan, chairman of the Assembly's committee on health. Morelle is chairman of the committee on tourism, arts and sports development.
A Morelle spokesman this morning said the assemblyman wanted to learn whether the state had figured out how the parasite cryptosporidium had gotten into the Sprayground's water system, and what kind of regulations the state was writing to prevent this kind of outbreak from happening again.
The state health department had said it would propose spray park water regulations by year's end.
The state Attorney General's office was joining the meeting. That office is representing the state in at least two class action lawsuits that have been filed on behalf of some of the 4,000 people who got sick with the gastrointestinal illness "crypto" causes.
The parasite, typically found in infected feces, was found in the Sprayground's water tanks in mid-August. The state health department told the Democrat and Chronicle last week that it had not determined yet how the parasite had gotten into the recycling water system. LSTANFOR@DemocratandChronicle.com
By CRAIG FOX
Finger Lakes Times
cfox@fltimes.com
A lawyer representing about 250 people who became ill after visiting the Seneca Lake State Park spraypark was scheduled to appear in a court of claims in Syracuse this morning to get the state to notify everyone who is eligible to join the suit his firm has filed.
Rochester attorney Paul Nunes wants the state to notify each of the 4,000 people who contacted the Depart-ment of Health because time is running out on the 90 days they have to file a notice of claim to preserve their right to sue.
"This comes in the general heading of: It's the right thing to do," Nunes said.
Nunes, a partner with the Rochester law firm of Underberg and Kessler, is working with a Seattle-based law firm that is an expert in waterborne illness suits. They have filed a suit against the state Department of Parks, Recreation and Historic Places.
An Albany attorney has also filed suit for another set of people who suffered the parasitic illness.
The spraypark was closed in mid-August after about 40 people complained about becoming ill shortly after being there. Reported incidents of the illness quickly spread to more than 20 counties in the state and beyond.
The outbreak of a stomach illness at a spray park in Geneva has now moved into an upstate courtroom and it could soon become a class-action lawsuit. In a Syracuse courthouse Wednesday a Rochester lawyer says he has more than 250 clients who say they got sick from the spray park. But Paul Nunes says he knows there are thousands of other victims out there and he hopes they know their rights. "Giving notice to the department of health is not enough. You have to file a claim against the state of New York to protect your rights and time is running out."
Nunes says many of his clients did not know they had to take that step so he came to the court of claims to ask a judge to require the state to tell all 4,000 people that information.
The attorney generals office, which is defending the state, says it's a ridiculous request.
"What the claimants are looking for today is essentially an invitation from the State of New York to file a lawsuit against it," said Assistant New York Attorney General Winthrop Thurlow.
Thurlow says by now, most people who got sick from the spray park should either know their legal rights and/or have taken legal action.
He says it's an unnecessary step, one that is not within the law and one that would benefit Nunes and his law firm by bringing them more clients.
Nunes says that's not the motivation. He says just look at the paperwork. Some people got so sick; they were hospitalized and missed weeks of work. A wrong he says, that should not go unpunished because they don't understand the legal system.
By CRAIG FOX
Finger Lakes Times
cfox@fltimes.com
GENEVA - A Rochester attorney and a nationally known Seattle law firm have filed a class action suit on behalf of families who became sick after visiting the spraypark at Seneca Lake State Park.
The Seattle law firm of Marler Clark and Rochester attorney Paul Nunes filed the case Tuesday against the state Office of Parks, Recreation and Historic Preservation, which owns and runs the state park.
The four-year-old sprayground was closed Aug. 15 after about 40 people complained of a gastrointestinal illness. In subsequent weeks, reports of the outbreak grew to nearly 4,000 people across the state and nation.
The state Health Department determined the illness was cryptosporidiosis, caused by a microscopic parasite.
The lawsuit was filed with the state Attorney General's office and it names Monroe County residents Timothy and Jacqueline Springer and their three children as the plaintiffs, but Nunes and the Seattle law firm also are representing several other families.
The Springer family became ill with the gastrointestinal illness after visiting the spraypark July 26, said Seattle attorney Bill Marler. Timothy Springer suffered such a severe case of the illness that he was hospitalized for three days, Marler said.
"Thousands of other people suffered the sane fate because the Office of Parks, Recreation and Historic Places failed to ensure the water at the spraypark was safe," Marler said.
Wendy Gibson, spokeswoman for the state parks office, couldn't be reached for comment Tuesday night.
Two weeks ago, Nunes and the Seattle firm took the first step in filing a lawsuit by filing a notice of claim with the state attorney general's office.
The class action lawsuit will proportionately divide any damages awarded to any claimants who become involved in the lawsuit.
The lawsuit is on behalf of people who were:
# Hospitalized for three days and had complications or invasive procedures;
# Admitted to an in-patient unit for hospitalization;
# Received outpatient medical care, including administration of IV fluids and;
# Received minimal medical care.
Last week, an Albany firm also filed a notice of claim involving another class action lawsuit on behalf of other families who became sick after visiting the spraypark.
On Aug. 26, the state Health Department concluded it will rewrite regulations governing water quality at all sprayparks and will implement them by November.
Marler has maintained that there is an ongoing problem with water quality in sprayparks across the country, with about 170 outbreaks at a variety of water recreational venues during between 1989 and 1999.
Many sprayparks across the country have been permanently closed after outbreaks have occurred, Marler said. So far, 33 people have been hospitalized with cryptosporidiosis from the Seneca Lake spraypark outbreak.
By BEN DOBBIN
Associated Press Writer
September 13, 2005, 1:34 PM EDT
ROCHESTER, N.Y. -- The agency that oversees New York's parks and recreation sites was the target of a class-action lawsuit filed Tuesday on behalf of an estimated 3,800 people who developed gastrointestinal illnesses after visiting a popular water park in central New York.
A suburban Rochester couple, Tim and Jackie Springer, and their three young children became ill after spending the day at the state-run Sprayground near Geneva in late July. After caring for his children, the father ended up in the hospital with a secondary infection, the lawsuit alleged.
The Springers were named as plaintiffs in the lawsuit against the Office of State Parks, Recreation and Historic Preservation, but "thousands of other people suffered the same fate because the (agency) failed to ensure the water ... was safe," said attorney William Marler.
A class-action lawsuit is "the most effective way of handling this many ill people," said Marler, who specializes in litigation involving food and waterborne illnesses.
His Seattle-based firm has already been contacted by more than 100 people, he said.
The state agency, which maintains 172 parks, 35 historic sites and thousands of campgrounds, beaches, golf courses, trails and other recreation areas, doesn't comment on pending litigation, said spokeswoman Wendy Gibson.
Of some 3,800 people who reported becoming ill this summer after visiting the Sprayground, which has water jets shooting up from a hardtop surface, at least 33 were hospitalized.
The state Health Department shut down the Seneca Lake Park attraction in mid-August after tests found a common waterborne disease known as cryptosporidium in two storage tanks. The highly contagious disease can cause diarrhea, nausea and fever that can last for weeks. It usually goes away without treatment in healthy individuals.
Sprayground was first closed temporarily on Aug. 16 after officials received more than 100 reports of illnesses dating to early July. Once the outbreak was made public, the number of cases rapidly escalated.
FOR IMMEDIATE RELEASE
Contact Suzanne Schreck
1-800-884-9840 Ext. 1879
sschreck@marlerclark.com
ROCHESTER, NY (September 13, 2005) - Marler Clark and Underberg & Kessler filed a class action complaint today against the New York Office of State Parks, Recreation and Historic Preservation. The lawsuit, which was filed in the State of New York Court of Claims, was filed on behalf of nearly 4,000 people who became ill with Cryptosporidiosis after visiting the Spraypark at Seneca Lake State Park in July and August. The named plaintiffs in the lawsuit are Timothy and Jacqueline Springer, a Monroe County couple, and their three children, who became ill with Cryptosporidium infections after visiting the Spraypark in late July.
"We filed this lawsuit as a class action lawsuit as the most effective way of handling this many ill people, especially children," said William Marler, managing partner of Seattle-based Marler Clark. "The Springer children suffered Cryptosporidiosis after playing at the Spraypark, and Mr. Springer had to be hospitalized after suffering a secondary infection after caring for his children. Thousands of other people suffered the same fate because the Office of State Parks failed to ensure the water at the Spraypark was safe."
Paul Nunes, a partner with Rochester firm Underberg & Kessler, added, "Claims against the Office of State Parks must be brought within ninety days of the injury, or cannot be brought at all. Besides filing a class action, we urge all people sickened to file timely Notices of Claim with the State in order to preserve your rights."
Four sub-classes have been proposed within the class action claim filed today so that any damages awarded will be divided proportionally to the injuries sustained by class members. The sub-classes include:
- Persons hospitalized for more than three days and who had complications or an invasive procedure,
- Persons who were admitted to an inpatient unit for hospitalization,
- Persons who received outpatient medical care, including the administration of IV fluids, and
- Persons who required minimal medical care
"We have taken into account the fact that people's injuries vary greatly, and have tried to come up with a way to compensate all class members as fairly as possible," Marler concluded.
###
Marler Clark and Underberg & Kessler have been contacted by over 100 ill persons. For more information contact Suzanne Schreck at 206-346-1879 or sschreck@marlerclark.com.
Friday, September 02, 2005
By CRAIG FOX
Finger Lakes Times
cfox@fltimes.com
GENEVA - A Rochester attorney and a nationally known Seattle law firm yesterday filed a notice of claim for a class action suit they may bring on behalf of some families who became sick after visiting the spraypark at Seneca Lake State Park.
The law firm of Marler Clark and Rochester attorney Paul Nunes filed the paperwork in the case that could be brought against the state Office of Parks, Recreation and Historic Preservation, which owns and runs the state park.
The 4-year-old sprayground was closed Aug. 15 after about 40 people complained of a gastrointestinal illness. In subsequent weeks, reports of the outbreak grew to more than 3,869 people in 35 counties -- with 612 cases confirmed.
The state Health Department determined the illness was cryptosporidiosis, caused by a microscopic parasite.
Filed with the state Attorney General's office, the notice of claim names Rochester resident Tricia Van Putte and her two young children as plaintiffs, but Nunes and the Seattle law firm are also representing several other families.
"This is just the first step," Nunes said Thursday, adding they had only 90 days to file this paperwork before the statutes of limitations would have run out.
Nunes said that days after their Aug. 11 visit to the spraypark, Van Putte and her two young children, Grace and Tyler, came down with diarrhea, abdominal cramping, nausea, vomiting, fever, headache and loss of appetite.
The attorneys will now start gathering information, conducting research and reviewing evidence before deciding whether to proceed with the lawsuit, they said.
Wendy Gibson, a spokeswoman with state parks office, said she could not comment on potential litigation.
Earlier in the week, Gibson said that the state still has not found what caused the cryptosporidium parasite to contaminate two water-holding tanks connected to the sprayground's filtration system.
Before the notice of claim was filed Thursday, Albany attorney Don Boyajian, a partner with Dreyer Boyajian, LLP, in Albany, was already soliciting clients, saying his firm could file a class action lawsuit to sue for the pain and suffering and lost wages. Boyajian has been running ads in the Finger Lakes Times as recent as Wednesday, looking for clients.
The Seattle firm has been involved in some of the country's most high-profile lawsuits involving food-and waterborne contamination, E. coli, hepatitis and salmonella. Its biggest case involved children who were contaminated with E. coli at several Jack In The Box restaurants on the West Coast in 1993. The family of a 12-year-old girl who was hospitalized for several months was awarded $15.6 million.
The firm has also represented several people contaminated with E. coli at a petting zoo in Florida three years ago.
In 2002, Seattle attorney Bill Marler and Nunes also worked together on a case in which more than 75 people got salmonella during a function at the Brook-Lea Country Club in Rochester.
Contacted in his Seattle office, Marler said there must have been "a design or functional flaw" in the spraypark system because the outbreak lasted several weeks and so many people got sick.
"It's not a logical explanation" that feces from a child whose diaper was changed near the water park could have been the source of the contamination, he said.
On Aug. 26, the Health Department concluded it will rewrite regulations governing water quality at all sprayparks and will implement them by November.
But Marler contended there's an ongoing problem with water quality in spray parks across the country, with about 170 outbreaks at a variety of water recreational venues during between 1989 and 1999.
Many sprayparks across the country have been permanently closed after outbreaks have occurred, Marler said. So far, 33 people have been hospitalized with cryptosporidiosis from the Seneca Lake spraypark outbreak, he said.
An unidentified family of four sisters, their eight children and their parents all became ill last month, and the husband of one of the women was hospitalized for three days with dehydration, Nunes said.
"It can affect people in different ways," said Nunes, an attorney with the firm of Underberg & Kessler.
By AARON E. LOONEY
The Ascension Citizen
As of Monday, the popular spray ground at Jambalaya Park remained temporarily closed, after recent claims that visitors became ill after visiting the park.
The illness was found to be caused by cryptosporidium, a parasite believed to be contracted while the children were at the park, according to DHH officials.
The parasite may be found in drinking water and recreational water in every region of the United States and throughout the world, according to information from the CDC. It causes a condition known as Cryptosporidiosis, which has symptoms including diarrhea and vomiting.
DHH officials were on hand Friday morning to investigate the matter, Berthelot said. He added that while there was no conclusive evidence to show that the infections came from the park, all of the victims involved reported becoming ill after visits to the park.
Gonzales Mayor Johnny Berthelot said he closed the spray park Thursday on a suggestion from DHH until the matter could be rectified.
"I thought that it would be in the best interest of everyone involved if we just closed the spray park until this is resolved," Berthelot said.
The spray park, an outdoor area featuring numerous spouts in its base which spray water, was opened last year. The park itself opened in 2002.
The spray ground sits idle until a visitor enters and sets off an infrared censor, triggering water to spray, pour and erupt from various spots within its confines. It has become a popular summertime attraction for children in the area.
The city spent $360,000 last year overhauling the park, which sits near Gonzales City Hall.
The chain of events began Monday, Berthelot said, when a parent called and said her child had become ill after playing at the spray ground. Berthelot said tests run on the spray ground's water tank both Monday and Tuesday showed no problems.
"Everything looked fine," Berthelot said, "but we wanted to be sure. So we cleaned it twice."
Tuesday, city workers drained the tank and cleaned it with a solution composed of 50 percent Clorox bleach, Berthelot said. They then let the tank dry, refilled it and cleaned it using the city's regular chemicals.
"We took the initiative and tackled this problem as soon as we could," Berthelot said. "What we're doing is simply a precaution because I don't want to put anyone at any risk if there should happen to be a problem."
Berthelot said that while the spray ground is closed, the rest of the park will remain open, including the swimming pool and fountain areas.
"If the test results show there's even the slightest hint of a problem, the spray park will remain closed until DHH unlocks it themselves," Berthelot said.
Notice filed against state over Sprayground outbreak
Lauren Stanforth
Staff writer
(September 2, 2005) - Two lawyers filed a notice Thursday with the state Attorney General's Office that they intend to pursue a class action lawsuit against the state for the massive parasitic outbreak that struck Seneca Lake State Park's Sprayground this summer.
Tricia Van Putte of Greece is the only individual named in the notice of claim. She appears in the notice on behalf of herself and her two small children who attended the Sprayground on Aug. 11 and contracted cryptosporidiosis, a gastrointestinal illness caused by the parasite cryptosporidium.
But the notice also alerts the state of the attorneys' intentions to file a lawsuit involving more clients. Rochester lawyer Paul Nunes, one of the lawyers who filed the notice, said he has been contacted by about three dozen people interested in getting retribution for illness associated with the park.
"One family talked about not being able to enjoy their back yard pool during this beautiful weather," Nunes said. But also, "we've got a husband of a family in the hospital this evening," with symptoms from cryptosporidiosis.
In one of the nation's largest waterborne parasitic outbreaks, the parasite somehow infiltrated the Sprayground's water supply, which is recycled daily.
More than 3,800 people from 35 New York counties have reported becoming ill after having contact with the Sprayground between June and mid-August. At least 33 people have been hospitalized.
The state closed the Sprayground near Geneva, Ontario County, in mid-August after finding cryptosporidium in the park's water tanks.
The state Health Department is still investigating the incident.
The state Attorney General's Office, which defends lawsuits against the state, said this was the first notice of claim filed in the incident. Marc Violette, a spokesman for the office, had no further comment. Wendy Gibson, spokeswoman for the state Office of Parks, Recreation and Historic Preservation, which is named in the notice, also would not comment.
Nunes filed the notice of claim with William Marler, a Seattle lawyer known for litigation involving food and waterborne illness.
LSTANFOR@DemocratandChronicle.com
Lauren Stanforth
Staff writer
(September 1, 2005) - Rochester and Seattle attorneys together filed a notice today with the state attorney general's office that they intend to pursue a class action lawsuit against the state for the massive parasitic outbreak that struck Seneca Lake State Park's Sprayground last month.
Tricia Van Putte of Greece is the only individual named in the lawsuit. She appears in the lawsuit on behalf of her two small children who attended the Sprayground on Aug. 11 and contracted cryptosporidiosis, the gastrointestinal illness that is caused by the parasite.
The state found the parasite in the Sprayground's two water tanks in mid-August. The state has said its investigation into how the parasite got there is continuing. More than 3,200 people have reported becoming ill after attending the spray park between June and mid-August.
The notice said a class action lawsuit involving other clients could be started through Van Putte's claim. A notice of claim is not a lawsuit; it is a document that allows attorneys more time to file a lawsuit.
The Seattle attorney specializes in public health outbreak cases.
FOR IMMEDIATE RELEASE
ROCHESTER, NY (September 1, 2005) - Marler Clark and Underberg & Kessler filed a notice of claim today against the New York Office of State Parks, Recreation and Historic Preservation. The notice indicates the intent to file a class action lawsuit on behalf of over 3,200 people who became ill with Cryptosporidiosis after visiting the Sprayground at Seneca Lake State Park in July and August. The notice was filed on behalf of Tricia Van Putte and her two young children, who will be the named plaintiffs in the class action lawsuit, and who became ill with Cryptosporidium infections after visiting the Sprayground. Marler Clark and Underberg and Kessler have been retained by several other families.
The New York State Health Department shut down the Sprayground on August 15 after it was determined that the Sprayground's water holding tanks, which were used to recycle water, were contaminated with Cryptosporidium. On August 26, the Health Department issued an update on its investigation into the outbreak, announcing that 3,297 cases of Cryptosporidium had been reported in 33 New York counties. Of those cases, 415 were confirmed cases reported to the State Health Department. Thirty-three people had been hospitalized with Cryptosporidiosis.
In 1997, 369 people, mostly children, became ill with Cryptosporidiosis after playing in a water fountain at a Minnesota zoo. In 1999, at least 38 people became ill with Cryptosporidium or Shigella infections after playing in a spray fountain at a beachside park in Florida.
"Whether they are publicly or privately operated, all water parks should have sanitation measures in place to prevent outbreaks. The majority of people who play in sprayparks and pools are children -- the most vulnerable population to parasites and pathogenic bacteria," said William Marler, managing partner of Seattle-based Marler Clark, who represented twelve of 26 children who became ill with E. coli O157:H7 infections after visiting an Atlanta, Georgia, waterpark in 1998.
Ms. Van Putte and their two children became ill with Cryptosporidiosis days after visiting the Sprayground. Symptoms included diarrhea, abdominal cramping, nausea, vomiting, fever, headache, and loss of appetite. The children's illnesses were confirmed as Cryptosporidiosis by the State Health Department.
On August 26, the Democrat & Chronicle reported that the state Health Department will rewrite regulations governing water quality at all sprayparks and will implement them on an emergency basis by November. Paul Nunes, a partner in the Rochester firm Underberg & Kessler, added, "You would think that after the Washington County Fair E. coli outbreak in 1998 there would be higher standards for all water supplies in the State of New York. It's a shame that there had to be another outbreak to make water safety a priority."
Together, Marler Clark and Underberg & Kessler represented 75 victims, several of them children, of the Brook-Lea County Club Salmonella outbreak of 2002. The two firms also represented two Orangeburg, NY girls who became ill with E. coli O157:H7 infections after eating contaminated ground beef from BJ's Wholesale Club in 2002. For more information on Cryptosporidium, see www.CryptosporidiumBlog.com.
Contact Suzanne Schreck
1-800-884-9840 Ext. 1879
sschreck@marlerclark.com
Health agencies urge precautions against 'crypto' parasite
By Ryan Clark
Cincinnati Enquirer staff writer
Thursday, September 1, 2005
Area health officials are urging the public to help prevent the spread of an illness found in local pools.
Cryptosporidiosis, or crypto, is a diarrhea-causing parasite that can cause stomach cramps, nausea and fever, and is passed person-to-person, said Tim Ingram, Hamilton County health commissioner.
Authorities said Wednesday that more than 180 probable and confirmed cases have been identified in Southwest Ohio and Northern Kentucky. The Ohio Department of Health and Centers for Disease Control and Prevention have sent staff members to assist in the disease investigation.
Last week, the Hamilton County Health Department linked nine cases of the parasite to swimming pools at the Powel Crosley Jr. YMCA in Springfield Township. The pools were later super-chlorinated to rid them of the parasite.
But the Hamilton County Health Commission is now teaming up with the Northern Kentucky Independent Health District to make the public aware of the issue just in time for the end of the summer.
"We want people to have a good time over the Labor Day weekend," Ingram said. "But we want people to understand it's up to them to help stop this disease."
To do so, he said, requires those who are showing symptoms of the disease to stay out of public pools. Frequent hand-washing is also encouraged.
"And swimming pools (are) not the only place the disease can be spread," Ingram said. "It is also spread through day-care centers and homes."
The parasite's symptoms generally begin two to 10 days after being infected and can last one to two weeks.
August 26, 2005
www.channelcincinnati.com
CINCINNATI -- The crypto outbreak is spreading around the Tri-state, but one local health official suggests the approaching end of summer will keep it from becoming a big problem, News 5's John London reported.
Cases of the parasitic illness have now been reported in Clermont County and Northern Kentucky. The first reported local cases -- in seven kids and one adult -- were traced to a YMCA pool in Hamilton County. Now, there are 65 cases in a three-county area. All but two involve children.
Here's a rundown:
# Six confirmed cases in Clermont County. These developed before the cases in Hamilton County but were not reported immediately. They include three children whose illnesses were traced to the water spray at Woodland Mound Park.
# Seven confirmed cases in Northern Kentucky, not linked to any one pool.
# Nine confirmed cases in Hamilton County linked to the Powel Crosley YMCA in Springfield Township, plus 41 probable cases and two pending cases.
Clermont County Health Commissioner Janet Rickabaugh said the end of summer works in everyone's favor.
"The possibility of further people becoming ill is growing less and less. The weather is going to be cool and there's not as many people going to be swimming. And the news is helping to inform people. That's a very good thing," Janet Rickabaugh said. "My concern is less than it would be if this had happened at the beginning of August," she said.
Crypto, formally known as cryptosporidium, will give you cramps and severe diarrhea that can last up to two weeks. People with weakened immune systems are at even greater risk.
Crypto is spread by fecal matter. Swallowing contaminated pool water will do the trick.
The Hamilton County Health District has set up a special hot line at (513) 347-3273. People who swam at Powel Crowley after Aug. 1 are asked to call. It is staffed from 1 p.m. to 5 p.m.
The best ways to avoid crypto:
- Wash your hands often.
- Avoid swimming.
Anyone who is infected can be contagious for up to two weeks. They are advised not to swim and not to work in day cares or restaurants during that time.
Thu Aug 25, 5:43 AM ET
A potentially deadly disease is rapidly growing in Hamilton County, and it's hitting mostly pre-school children, News 5 reported.
After News 5 reported Tuesday on the cryptosporidium outbreak at a local YMCA pool, parents of sick kids and others with symptoms started calling the Health Department.
The Health Department is now investigating at least 24 cases ? three times the number of confirmed cases as of Tuesday. The cases involve 21 children under the age of 5.
A woman in her 40s is in the hospital and seven kids under 5 have been diagnosed with the parasite, which has been traced to the Powel Crosley YMCA pool in Springfield Township. Officials are mailing letters to every day care in Hamilton County to warn them that crypto is in the community.
Crypto will give you cramps and severe diarrhea that can last up to two weeks -- or even worse.
A severe outbreak in Milwaukee in 1993 killed 100 people when crypto spread into the water supply. About 400,000 people were infected.
The local water supply has been tested and given the all-clear, but health officials are worried that swimmers might have unknowingly spread the outbreak to other pools. The bug is spread by ingesting fecal matter.
The Hamilton County Health Department mailed letters to 320 pool operators, asking them to put up a "No Swimming" sign for eight hours and super-chlorinate the water.
The health department is trying to track the outbreak. If you were in the Powel Crosley pool after Aug. 1 and you've had diarrhea, call health officials at (513) 347-3273 between 1 p.m. and 5 p.m. This number is not for general questions.
The best ways to avoid "crypto:"
- Wash your hands often.
- Avoid swimming.
Anyone who is infected can be contagious for up to two weeks. They are advised not to swim and not to work in day care or restaurant facilities during that time.
Nine People Fall Ill, One Hospitalized
August 24, 2005
The Cincinnati Channel
SPRINGFIELD TOWNSHIP, Ohio -- A dangerous parasite prompted the closing of hundreds of Hamilton County swimming pools Tuesday, and at least nine people are already sick, News 5 reports.
Eight children are ill and an adult has been hospitalized after an outbreak of cryptosporidium at Powel Crosley Y.M.C.A. in Springfield Township, health officials said.
"Crypto" will give you cramps and severe diarrhea that can last up to two weeks --- or even worse.
A severe outbreak in Milwaukee in 1993 killed 100 people when "crypto" spread into the water supply. About 400,000 people were infected.
The local water supply has been tested and given the all-clear, but Hamilton County health officials are worried that swimmers could spread the outbreak to other pools, News 5 reports. The bug is spread by ingesting fecal matter.
The Hamilton County Health Department mailed letters to 320 pool operators, asking them to put up a "No Swimming" sign for eight hours and super-chlorinate the water.
"You can't kill it with normal does of chlorine and that's what we do when we ask people to super-shock their pools," said Kathy Lordo of the Hamilton County Health Department.
At Powel Crosley, they used 10 times the normal amount of chlorine, just to be sure, and they cleaned the slides and railings, trying to reassure members.
The symptoms can be tricky, and victims and doctors may not suspect "crypto."
"You can have diarrhea for a day or two and it kind of goes off for a little bit and it may flare up again," Lordo said.
The health department is trying to track the outbreak. If you were in the Powel Crosley. pool after Aug. 1 and you've had diarrhea, call health officials at (513) 347-3273 between 1 p.m. and 5 p.m. This number is not for general questions.
The best ways to avoid "crypto:"
- Wash your hands often.
- Avoid swimming.
Anyone who is infected can be contagious for up to two weeks. They are advised not to swim and not to work in daycare or restaurant facilities during that time.
Public Should Take Precautions to Prevent Further Spread of Illness, 1738 Cases Reported
ALBANY, NY, August 19, 2005 - State Health Commissioner Antonia C. Novello M.D., M.P.H., Dr.P.H. and State Parks Commissioner Bernadette Castro today issued an update concerning the gastrointestinal illnesses which has been linked to the spray park attraction at Seneca Lake State Park. The dates of onset of illness range from June to the present and many people have since recovered.
Persons who visited the Seneca Lake State Park or family members and/or close contacts of ill individuals who visited the park since late July and are experiencing gastrointestinal illness should contact their medical provider and their local health department (phone numbers below).
Tests conducted by the Health Department have confirmed the presence of cryptosporidium in two storage tanks that supply water to the popular water attraction. For precautionary reasons, the State Office of Parks has closed the spray park attraction for the remainder of the 2005 season.
Additional test results of water samples from the Seneca Lake State Park beach show no health concerns with the water quality and the beach will remain open to patrons. The State's investigation is ongoing.
The number of reported illnesses possibly linked to the park has grown to 1738 cases in twenty counties, prompting the Commissioner to again stress precautionary measures people should take to keep the illness from spreading further. The 1738 cases have been reported by the following counties: Allegheny (5 case), Cayuga (79 cases) Chemung (6 cases), Erie (5 cases), Genesee (5), Lewis (1 case), Livingston (71), Monroe (143 cases), Oneida (3 cases), Onondaga (62 cases), Ontario (596 cases), Orleans (5 cases), Rensselaer (4 cases), Schuyler (10 cases) Seneca (224 cases), Steuben (5 cases), Tompkins (23 cases), Wayne (400 cases), Wyoming (2 cases), and Yates (89 cases).
The most common symptoms reported are diarrhea, abdominal cramping, nausea, vomiting, fever, headache and loss of appetite.
To date, 13 of the cases have been confirmed as cryptosporidiosis: Cayuga (6 cases), Monroe (1 case), Ontario (2 cases), and Wayne (4 cases). Additional tests for other possible causes of illness are pending. Of the 1738 cases reported, many people have since recovered and those who are ill are instructed to see their physician. The reported dates of illness range from early July to the present.
The following precautions should be taken by the public to prevent further spread of illness:
Health care workers with patient contact and food workers who are experiencing gastrointestinal illness should notify their employer and stay home from work until they have recovered and are showing no signs or symptoms.
Children and staff with stomach/intestinal illness should refrain from attending day care. Day care centers should consult with their local health department for recommendations on the timing for return to the day care setting. Children should not be transferred to another day care center.
People should take action to minimize the chances of acquiring and spreading illness, including thoroughly washing hands after using the toilet, changing diapers or coming in contact with fecal material in any way. Also, swimmers should avoid swallowing water, especially in lakes, ponds or rivers.
To help prevent the spread of illness, individuals who are experiencing gastrointestinal illness should not swim while they are sick and for two weeks after their symptoms subside.
Individuals or family members who visited the State Park and are experiencing gastrointestinal illness should contact their health care provider and call their local county health department at the following numbers:
Allegheny 585-268-9250
Cayuga 315-253-1560
Chemung 607-737-2028
Erie 716-858-7697
Genessee 585-344-2580
Lewis 315-376-5453
Livingston 585-243-7270
Monroe 585-274-6079
Oneida 315-798-6400
Onondaga 315-435-3236
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Sickening bug suspected at Spraypark in Geneva
Jack Jones
Staff writer
(August 18, 2005) - GENEVA- The number of people sickened after visiting The Spraypark water sports playground at Seneca Lake State Park has risen to 746 in an eight-county area.
The park has been closed since Monday as a precaution after health officials identified it as the possible link between a suspected bacterial infection that has caused gastrointestinal illness in people who had visited the park, said Wendy Gibson, a spokeswoman for the state Department of Parks, Recreation and Historic Preservation.
The possible contamination was reported by an unidentified day care center after at least one child fell ill following a field trip to the park. The cases, by county, are as follows: Ontario, 309; Seneca, 130; Wayne, 97; Monroe, 75; Cayuga, 56; Livingston, 50; Onondaga, 24; and Tompkins, 5.
State Parks officials are working with the state Health Department and the Monroe and Ontario counties health departments to find out, if the water at the Spraypark was the source of the illness, how it became contaminated, Gibson said.
"The Spraypark will remain closed until we identify that source," Gibson said.
The state Health Department reported that five of the cases have been confirmed as cryptosporidiosis. A Web site of the Centers for Disease Control and Prevention describes cryptosporidiosisas "a diarrheal disease caused by microscopic parasites." The parasite lives "in the intestine and passes in the stool."
The CDC said the parasite can survive outside the body for "long periods of time" and is "very resistant to chlorine-based disinfectants."
State Health Commissioner Antonia C. Novello has issued an advisory in connection with the outbreak, including recommendations that people who visited the Spraypark and may have experienced gastrointestinal problems since late July contact their doctors and county health departments.
Novello also recommends action to minimize the chances of acquiring and spreading illness, including thoroughly washing hands after using the toilet, changing diapers or coming in contact with fecal material in any way. Also, swimmers should avoid swallowing water, especially in lakes, ponds or rivers.
About 187,000 people visit Seneca Lake State Park each year, Gibson said.
August 17, 2005
13WHAM-TV
(Geneva, NY) -- It's now officially an outbreak.
The number of stomach illnesses linked to the sprayground water park at Seneca Lake Park in Geneva has grown to 800 cases; about 100 of those cases are children from Monroe County; others are from surrounding counties, other states, Mexico, and Canada.
On Wednesday, the state announced that the sprayground part of the park was closed for the season.
Officials are still testing water from the spray park and the filtration system and from the lake to determine what made people sick. The Ontario County Health Department is urging anyone with a sick child who had visited the spray park to see their doctor and report the illness.
Most of those who are sick are children who played in the park and ingested the water. Their parents said they thought it was simply a case of the stomach flu, until they heard about the other illnesses.
One mother said she was surprised the illnesses were linked to water from the spray park rather than the lake, because the park water is chlorinated. The concessions in the park are also closed until they rule out any link to the food.
Health officials are looking at other common denominators, but so far, it appears the spray park connects most of those who got sick.
Dr. Andrew Doniger, director of the Monroe County Health Department, said "Almost everyone that is ill says that they were in the spray, so that seems to be the culprit, but we don't know for sure."
The health department is urging all families who visited the park and have sick children to report the illnesses.
By The Citizen
Wednesday, August 17, 2005 10:07 AM EDT
The New York State Department of Health reports that more than 100 cases of gastrointestinal illness may be linked to a water spray area at Seneca Lake State Park.
State Health Commissioner Antonia Novella said in a news release Tuesday that people who attended the park spray grounds since late July and are experiencing diarrhea, abdominal; cramping, nausea, vomiting, fever, headache or loss of appetite should contact their health care provider. Health care workers with patient contact and food service workers should notify their employers if they are experiencing gastrointestinal illness, and children and staff should refrain from attending day care if they show symptoms.
There has been one confirmed case of Cryptosporidiosis in Wayne County and additional tests are pending to determine the cause. The spray grounds at Seneca Lake State Park have been temporarily closed.
Since 1989, approximately 170 outbreaks associated with recreational water venues (e.g., swimming pools, waterparks, fountains, hot tubs and spas, lakes, rivers, and oceans) have been reported, with almost half resulting in gastrointestinal illness (1--5). This report summarizes the investigation of an outbreak of gastroenteritis in Florida during 1999. The findings indicated that Shigella sonnei and Cryptosporidium parvum infections caused illness in persons exposed to an "interactive" water fountain* at a beachside park.
During August 23--27, the Volusia County Health Department (VCHD) received reports of three children with S. sonnei infection whose common exposure was play in an interactive water fountain at a beachside park that had opened August 7. To determine risk factors for gastrointestinal illness, VCHD and the Florida Department of Health (FDH) conducted a case-control study among a convenience sample of park attendees, including 34 members of a teenage group that had attended a beach party near the park on August 14 and 52 family members of persons who had reported illness to VCHD. A case of gastrointestinal illness was defined as abdominal cramps or diarrhea (three or more loose stools within a 24-hour period) in a person who visited the park during August 7--27, with illness onset <12 days after the visit. Study participants were contacted by telephone and interviewed using a standard questionnaire.
Of 86 park visitors interviewed, 38 (44%) had illness that met the case definition. Onsets of illness occurred during August 15--September 2 (Figure 1). The median age of ill persons was 8 years (range: 2--65 years); the median age of well persons was 15 years (range: 5--47 years). Twenty-five (66%) ill persons were male. The most common symptoms reported included diarrhea (97%), abdominal cramps (90%), fever (82%), vomiting (66%), and bloody diarrhea (13%). S. sonnei was isolated by culture of stool specimens from five (36%) of 14 ill persons tested. C. parvum oocysts were identified in stool specimens from two persons by light microscopy using an acid-fast stain. All 38 ill persons, compared with 32 (67%) well persons, had entered the fountain (odds ratio [OR]=undefined; 95% confidence interval [CI]=4.1--undefined). Other associated risk factors for illness included fountain water ingestion (OR=52.5; 95% CI=9.8--377.0) and consumption of food or drink at the interactive fountain (OR=4.7; 95% CI=1.6--14.3). As all ill persons entered the fountain, and all but two ingested fountain water, the independence of these exposures was not established.
On August 27, investigators conducted an environmental assessment of the park, a paved area of approximately 2--3 acres adjacent to the beach in Daytona Beach, which included bathrooms, outdoor showers, vending machines, and the interactive water fountain. The fountain used recirculated water that drained from the wet deck/play area floor (no standing water) into an underground reservoir. The volume of recirculated water was 3380 gallons, and the minimum flow rate through the recirculation system was 115 gallons per minute; the turnover rate was 30 minutes, as required by state code for interactive water features. The recirculated water passed through a hypochlorite tablet chlorination system before being pumped back to the reservoir and then to several high-pressure fountain nozzles at ground level throughout the play area. No filtration system had been installed. Investigators identified several potential opportunities for water contamination. The fountain was popular with diaper- and toddler-aged children who frequently stood directly over the nozzles. Chlorine levels were not monitored, and the hypochlorite tablets that deplete after 7--10 days of use had not been replaced after the park opened August 7.
An estimated 4800 persons attended the park during August 7--27, when the fountain was closed by VCHD. The fountain reopened December 12 after several control measures were implemented. First, a cartridge filtration system was installed, and a chlorine monitor was installed to halt fountain operation automatically when residual chlorine levels fall below 3 ppm. Second, a sign was posted advising visitors to shower before entering the fountain and to avoid fountain water consumption. Third, children in diapers were excluded from entering the fountain. No further illness has been associated with the fountain.
Reported by: P Minshew, Volusia County Health Dept, Daytona Beach; K Ward, MSEH, Z Mulla, MSPH, R Hammond, PhD, D Johnson, MD, S Heber, DrPH, R Hopkins, MD, State Epidemiologist, Florida Dept of Health. Div of Bacterial and Mycotic Diseases and Div of Parasitic Diseases, National Center for Infectious Diseases; Div of Applied Public Health Training, Epidemiology Program Office; and an EIS Officer, CDC.
Editorial Note:
This report documents the second recorded outbreak of gastroenteritis associated with an interactive water fountain (1) and highlights the risk for transmitting diarrheal illness in recreational water activities other than a traditional water-filled pool. Outbreaks of gastroenteritis associated with recreational water exposure are recognized with increased frequency (1). Interactive fountains using recirculating water are new to traditional waterpark amusements (i.e., slides and wave pools). Because these fountains are attractive to diaper- and toddler-aged children, recreational water may be at high risk for contamination by enteric pathogens through overt fecal accidents or rinsing of contaminated bodies in the water.
In this outbreak, S. sonnei and C. parvum were identified in stool specimens from ill persons. Both pathogens have a low infectious dose (6,7), and C. parvum is resistant to chlorine (7); however, removal of pathogens may be enhanced by filtration of fecal material from recirculated water. The recirculated fountain water described in this report was unfiltered and inadequately chlorinated, increasing the risk for contamination and disease transmission. The association between illness with S. sonnei and ingestion of recreational water has been described previously (8,9). The association between illness and consumption of food or drink at the fountain may represent contamination of food and drink by fountain water, or the potential for increased fountain water ingestion among those consuming foods and beverages at the fountain.
Most bacterial outbreaks in recreational water could be prevented if pool and interactive fountain operators maintained mandated chlorine levels at all times and monitored levels more frequently during times of heavy patronage. Although effective chlorination should reduce the risk for S. sonnei transmission, disinfection is not instantaneous, as pathogens may be temporarily sheltered from chlorine when presented as a large bolus of fecal material, resulting in transient contamination. The prevention measures instituted by FDH underscore that water treatment alone does not guarantee illness prevention. The public also should be informed that swimming or playing at recreational water venues is communal bathing and can lead to diarrheal disease transmission when the water becomes contaminated and is swallowed.
To reduce risk for contamination and disease transmission, persons visiting recreational water venues should 1) avoid entering a traditional pool or playing in an interactive fountain if they have diarrhea; 2) avoid swallowing pool or fountain water; 3) practice good hygiene by taking a soap and water shower at home or at the pool, especially after a bowel movement and before entering the water; 4) escort young children to the toilet frequently and clean their bottoms thoroughly before allowing them to resume play; 5) avoid sitting on or over fountain jets because this can increase the risk for water contamination; and 6) take precautions not to contaminate foods or beverages consumed in or near the bathing area with pool or fountain water. Parents should be aware that no diaper (including swim diapers or swim pants) completely prevents stool leakage. If diapered children are to play in waterparks, diapers should be changed immediately after a bowel movement in restrooms where hands and bottoms can be washed thoroughly with soap and water.
Although interactive fountains may not require health department review in some states, waterpark or water attraction operators should recognize that the lack of a pool in these attractions does not necessarily reduce the risk for waterborne disease transmission. States should examine existing regulations for all public recreational water venues and for fountains not intended for interactive water play (10), and should ensure that all public recreational venues and fountains using recirculated water receive appropriate oversight by public health officials. Additional information for bathers, parents, and pool operators on recreational water safety can be obtained on the World-Wide Web at http://www.cdc.gov/ncidod/dpd/parasiticpathways/swimming.htm.
Cryptosporidiosis associated with recreational water exposure is becoming recognized more frequently (1). This report summarizes the investigation of a large outbreak of cryptosporidiosis associated with exposure to a water sprinkler fountain at the Minnesota Zoo. The initial cases were not diagnosed as cryptosporidiosis by the health-care system despite patients seeking care, underscoring the need for increased awareness of cryptosporidiosis and routine laboratory diagnostic practices among health-care providers.
On July 10, 1997, the Minnesota Department of Health (MDH) was notified by a parent about four cases of gastroenteritis among a group of 10 children whose only common exposure was a birthday party at the Minnesota Zoo on June 29. The zoo provided MDH with a list of registered groups that had visited the zoo during June 28-30; group members were contacted and interviewed about illness and zoo exposures. Initially, cases were defined as vomiting or diarrhea (defined as three or more loose stools during a 24-hour period) in persons who visited the zoo. Of 120 zoo visitors identified through the registered groups, 11 (9%) had illnesses that met the case definition. All had played in a water sprinkler fountain at the zoo, compared with seven (6%) of 109 controls (relative risk=undefined; p less than 0.001). Cryptosporidium oocysts were identified in nine of 10 stool specimens of case-patients tested at MDH. Two of the laboratory-confirmed case-patients had submitted stool samples previously for ova and parasite examination to their health-care providers; both samples were reported as negative for parasites.
The fountain was closed on July 11, and MDH issued a public statement advising persons who had visited the zoo and subsequently developed diarrheal illness to contact their physician and MDH. The public statement also stated that children who developed diarrhea after exposure to the fountain should not visit swimming beaches, swimming and wading pools, and other recreational water facilities until at least 2 weeks after recovery from diarrheal symptoms. MDH requested that all clinical laboratories in Minnesota specifically test all stools submitted for ova and parasite examination for Cryptosporidium, particularly during the outbreak.
A standard questionnaire was used to document illness history and zoo exposures in persons responding to the public statement. A revised case definition included persons with vomiting or diarrhea persisting at least 3 days, with onset 3-15 days after exposure to the zoo fountain. A total of 369 cases were identified, including the initial 11 cases; 73 (20%) were laboratory confirmed. Petting zoo exposure was reported by 191 (58%) of 332 case-patients, including 37 (55%) of 67 laboratory-confirmed cases. Age data were available for 351 case-patients; the median age was 6 years (range: 0-65 years), and 333 (95%) case-patients were aged less than or equal to 10 years. All but one of the 369 patients reported diarrhea; 317 (86%), abdominal cramps; 287 (78%), vomiting; 233 (63%), fever; and 11 (3%), bloody stools. The median duration of illness was 7 days. Six (2%) patients were hospitalized.
Reported dates of fountain exposure for case-patients were from June 24 through July 11 (Figure_1). Exposure dates for confirmed case-patients were from June 28 through July 1, with 68 (93%) exposures occurring from June 29 through July 1 (Figure_1). The median incubation period after fountain exposure was 6 days. In addition to case-patients with fountain exposure, nine laboratory-confirmed cases of cryptosporidiosis were identified among household contacts of case-patients with fountain exposure.
The implicated water sprinkler fountain was designed and built as a decorative display in 1994. The fountain is comprised of 14 nozzles arranged in five rows and submerged beneath metal grates. The nozzles sprayed jets of water vertically approximately one to six feet. The water drained through the grates, collected in trenches, passed through a sand filter, was chlorinated, and then recirculated. The zoo routinely replaced the water every Monday, Wednesday, and Friday, but the filter was not flushed. Environmental health inspectors from MDH recommended the fountain not be used as an interactive play area. The zoo subsequently erected a fence around the fountain plaza and reopened it as a decorative display only. Water samples collected on July 14 were negative for Cryptosporidium oocysts.
The source of contamination of the fountain was not established, but contamination by a child wearing a diaper and playing in the fountain was suspected. Animals (including ruminants) in a petting zoo approximately 50 yards from the fountain tested negative for Cryptosporidium before being placed in the petting area and again during the outbreak investigation.
A 1997 survey of all clinical laboratories serving Minnesota residents indicated that 13 (22%) of 59 laboratories that perform ova and parasite examinations on site routinely test for Cryptosporidium as part of ova and parasite examinations (i.e., without a specific request from a physician). In a 1997 survey of physicians in Minnesota, 44 (79%) of 56 physicians who thought that their laboratory always tested for Cryptosporidium as part of an ova and parasite examination were incorrect.
Reported by: VC Deneen, MS, PA Belle-Isle, CM Taylor, LL Gabriel, JB Bender, DVM, JH Wicklund, MPH, CW Hedberg, PhD, MT Osterholm, PhD, State Epidemiologist, Minnesota Dept of Health. Div of Parasitic Diseases, National Center for Infectious Diseases; Div of Applied Public Health Training, Epidemiology Program Office; and an EIS Officer, CDC.
Editorial Note
Editorial Note: The findings in this report document a novel recreational water source for cryptosporidiosis. Outbreaks of cryptosporidiosis have been documented in a variety of other recreational water settings in the United States since 1988, including a lake, community and hotel pools, a large recreational water park, a wave pool, and a water slide (1). As in several other outbreaks, there was no evidence in this outbreak that inadequate chlorination or filter malfunction contributed to transmission of Cryptosporidium. However, Cryptosporidium oocysts are resistant to disinfection by chlorine at levels generally used in recreational water, and recreational water filtration units that use sand filter media are not effective in removing the 4-6-micron oocysts (1). The zoo fountain in this outbreak was designed as a decorative display and not an interactive play area. However, the fountain was a popular attraction for children on hot summer days. Children would commonly stand directly over the jets and soak their entire bodies, a practice which could explain contamination of the fountain and subsequent transmission associated with ingestion of water. Consumption of foods while walking in the fountain plaza was also a common practice.
Measures that might have reduced the risk for Cryptosporidium contamination of the fountain (e.g., showering before entering the fountain, excluding persons with diarrhea or incontinence, excluding children wearing diapers, and restricting food consumption in the fountain area) were not required or encouraged. Exclusion of persons from decorative water displays not designed for interactive use should be instituted and enforced. For recreational water facilities designed for human use, improved filtration may reduce risk.
Waterborne cryptosporidiosis is probably underrecognized and underreported (1). Laboratory and physician surveys conducted in Minnesota indicate that most laboratories do not routinely test specifically for Cryptosporidium as part of ova and parasite examinations, even though many physicians assumed that they did. Even though cryptosporidiosis is reportable in Minnesota, this large outbreak probably would have remained undetected if not for the parent reporting the cases to the health department. Two of the original ill children had seen physicians, who ordered ova and parasite examinations; however, cryptosporidiosis remained undiagnosed until stool samples were examined specifically for Cryptosporidium at MDH. Because of their small size, Cryptosporidium oocysts can be difficult to detect by routine ova and parasite examination. The magnitude of this outbreak was probably determined only because of the public statement and the request that laboratories test all stools submitted for ova and parasite examination specifically for Cryptosporidium.
To better understand the magnitude of cryptosporidiosis, health-care providers should specifically request testing for suspected cryptosporidiosis. Laboratories should consider routinely testing for Cryptosporidium as part of their ova and parasite examination protocol. Alternatively, when reporting test results back to health-care providers, laboratories should specifically indicate when Cryptosporidium is not tested for as part of a requested ova and parasite examination. Cryptosporidiosis is reportable in 41 states; interpretation of national data would be facilitated by mandatory reporting in all states
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