Jump in! Water's fine (you hope)

SAN JOSE, Calif. -- On hot, sticky days, there's nothing more refreshing than jumping into a cold pool. But how can you tell if the water is clean and safe?

It's not easy, say experts in pool health and safety. Even clear, sparkling pools can harbor bacteria. And a strong chlorine smell, often followed by stinging eyes and coughing, doesn't necessarily mean swimmers are safe: It's a noxious byproduct of chlorine binding to mass amounts of urine and sweat, said Michael Beach, an epidemiologist for the Centers for Disease Control and Prevention.

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Something in the water

How safe is your drinking-water? Warning - this report may leave an unpleasant taste in your mouth!

  • In 2005 102,000 people were served by registered supplies with water containing unacceptable levels of E. coli.
  • 84,000 were exposed to greater risk of disease as the supplier did not take immediate steps to correct the problem once E. coli was found.
  • In 111 schools the water supply was contaminated with E. coli during 2005.
These are just three of the findings of the Ministry of Health's Annual Review of the Microbiological and Chemical Quality of Drinking Water in New Zealand. The document covers the 2005 year and was published on 30 January 2007.

The review measures water quality against the Drinking Water Standards for New Zealand: 2000.

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Innovative new on-line particle sensor

Analytical Technology (ATi) has introduced the innovative laser-based C10/77 Particle Sensor, for the continuous on-line monitoring of particle counts in raw water, filter influent and filter effluent

Analytical Technology (ATi) has introduced the innovative new C10/77 Particle Sensor, for the continuous on-line monitoring of particle counts in raw water, filter influent and filter effluent.

Based on a laser light blocking principle, this novel sensor can provide particle count data over size ranges from two to 200 microns, with three 4-20 mA analogue outputs and an RS-232/485 digital output supplied as standard. ATi currently has over 75 of these monitors working in various water companies in the UK.

Turbidity monitoring of filtered potable water provides an excellent indicator of water clarity as well as a reliable measure of general filter efficacy.

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Asahi Kasei's Microza Hollow Fiber Filter Membrane Technology Chosen for US Waterworks

The Microza™ hollow-fiber membrane filtration system has been selected for a new waterworks facility to serve the metropolitan area of Minneapolis, Minnesota, with full-capacity operation scheduled to begin in January 2011. Located in Fridley, the plant will have a water treatment capacity of 360 thousand m3/day. This will make it one of the largest drinking water plants in the US, and among the largest plants anywhere to utilize a pressurized membrane filtration system for water purification. Selection was concluded after extensive testing and evaluation by the Minneapolis Water Works, confirming the outstanding performance of the Microza™ system.

Membrane filtration offers many advantages over conventional water treatment by sedimentation and sand filtration, notably the ability to efficiently and reliably achieve high rates of removal of pathogenic microorganisms such as cryptosporidium. With stringent regulations for removal of cryptosporidium from drinking water supplies scheduled to come into effect in the US, the adoption of large-scale membrane filtration systems for water treatment is projected to grow substantially.

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EPA Awards $5 Million in Safe Drinking Water Grants

10 universities received grants from EPA for research to develop better methods for detecting harmful organisms in drinking water, including viruses, bacteria and protozoa. The grants, awarded through EPA's Science to Achieve Results (STAR) research grants program, are aimed at ensuring that the United States has the safest drinking water in the world.

"These five million dollars in grant money are an example of how EPA puts science to work to protect human health," said Dr. George Gray, EPA's assistant administrator for research and development.

Every year, there are cases of gastrointestinal (GI) illnesses in the United States associated with drinking water. EPA's sponsored research will result in faster and more sensitive tests for local drinking water facilities to use in detecting pathogens. The sooner a contaminant is identified, the faster a facility can act to contain the problem, and thereby reduce any health risks to the public.

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Pure H2O Bio-Technologies, Inc. Announces Testing Results For New Microbial Drinking Water Contaminant Disinfectant

12/6/2006 Boca Raton, FL — Pure H2O Bio-Technologies, Inc. recently announced the results from three successful studies focused on potable water disinfection treatment for two major microbial threats to human health. The microorganisms, Escherichia coli (bacterium) and Cryptosporidium parvum (protozoan parasite of humans), were responsible for 9,877 and 7,212 human cases, respectively, during 2005 according to a March 2006 American Waterworks Association review article by P. Rochelle and J. Clancy. Testing conducted for Pure H2O Bio-Technologies, Inc., by Clancy Environmental Consultants, Inc. showed that activated tetrasilver tetraoxide (TTO) was effective as a disinfectant for both organisms. TTO is a unique divalent silver compound, which is produced in a crystalline form, with disinfectant properties superior to the common forms of silver.
 
Joseph P. Doxey, president of Pure H2O Bio-Technologies, Inc. said: "The results show that the company can use this disinfectant as an alternative to those which are in current municipal and commercial use for drinking water treatment. Moreover, these studies on tetrasilver tetraoxide (patent pending) reported on July 1, 2005, Sept. 8, 2006 and October 25, 2006, respectively, are significant because Cryptosporidium oocysts are resistant to halogens such as chlorine and this pathogen has been known to escape state-of-the-art municipal water treatment systems and result in many human health outbreaks. E. coli although more easily disinfected, also has special significance as a waterborne and foodborne pathogen involved in recent outbreaks."

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How we coped when water turned muddy

With the boil-water advisory still in effect in Vancouver, Burnaby and the North Shore, stores are being stormed by people looking for water treatment systems. But consumers need to look around to determine what's best for their health and their pocketbook.

The cheapest solution is boiling water, and that means a rolling boil for at least one minute, Vancouver Coastal Health's manager of health protection, Richard Taki, said in an interview.

But boiled water tastes pretty flat so Taki suggests letting it cool and then transferring the water back and forth between containers to give it some flavour.

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Reclaimed water usage is a bad idea

Do not drink from the toilet to the tap, citizens of West Palm Beach.

One decade has passed by with no improvements in the quality of recycled sewage water called reuse.

The Palm Beach County Department of Health made Boca Raton put up 50 signs at Mizner Park. There is one left today and it is unreadable. Signs were at all entrances at Mizner Park, and most signs throughout the city are in complete disarray. But now the Florida Department of Environmental Protection is going to let the city of West Palm Beach use recycled sewage water (reuse) for indirect potable reuse; in other words, FDEP is going to let people drink the water, bathe in it, shower, wash hands and face in this water. This will be a first for the state of Florida, and you can imagine FDEP protecting the public health from this indirect potable reuse when they can't control signs.

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Battle over bottled water

Bottled water is increasingly the top choice of young people who have grown up unscrewing a cap instead of opening a tap for drinking water.

That’s a misguided, costly and wasteful attitude, says Port Coquitlam Mayor Scott Young, who chairs the Greater Vancouver Regional District’s water committee.

“Many of us complain about the price of gasoline,” he said. “But on a litre-to-litre basis you’re paying more for bottled water. And it’s completely unnecessary.”

The GVRD is planning a campaign to promote tap water and swim upstream against what has been a triumph of marketing for water bottlers.

Canadian sales of bottled water climbed 17 per cent last year.

Critics say the bottled water industry is profiting by subtly fostering the belief tap water is unsafe or undesirable.

Young said many young people he’s talked to see bottled water as the main source of drinking water.

“We find that somewhat troubling,” he said. “We have the very best drinking water in the world.”

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Health Authority asks to protect water supply

Wednesday, 04 October 2006
BY ANDRU MCCRACKEN
Robson Valley Times

The Northern Health Authority is asking Valemount to upgrade its water system to be able to guard against cryptosporidium. Bruce Gaunt, the man in charge of drinking water with the health authority, wants the village to take the next step in water treatment.

“Despite the good quality of the water source, almost firsthand from the mountain, there is a risk of waterborne protozoa. Giardia is one that has been well identified. There is another one called cryptosporidium,” said Gaunt.

Gaunt said that Valemount suffered an outbreak of giardia in 1996. However the present system doesn’t guard against cryptosporidium.

He said that Valemount has done some work in preparation for the outbreak, now he’s asking them to take the next step.

Cryptosporidium is resistant to chlorination and it is only in recent years that there are treatments that can eliminate it.

“This is still a risk factor for the municipality and the need to deal with that as well,” he said.

He said that cryptosporidium is a pathogen in temperate water systems that can cause diarrhoea and cause a crippling illness to those with suppressed immune systems.

Cryptosporidium is endemic, meaning that just about any surface water source in the province likely contains it.

“If you ever been on a farm and had calves with scours, that is an attack of cryptosporidium,” he said

He said that so far, there hasn’t been an outbreak in northern B.C., but prior to 2000 there were outbreaks in Kamloops and Kelowna. He said that there was a widely known attack in North Battleford in 2001 and that Victoria and Kamloops are bolstering their water supply against the organisms.

“There comes a point when chlorination needs to be augmented,” he said.
He said that the number of tourists coming to Valemount is a good reason to treat the pathogen.

“We have rather a high preponderance of hotel rooms when we consider the population. It’s not like we’re just considering the population of Valemount. We have people coming enroute from Edmonton to Vancouver. Some of those travellers are not used to an organism challenge if they were to receive it,” he said.

“When you are dealing with drinking water more than with any other kind of intervention, you affect more people in a more profound way than anywhere else.”

He said that a dirty restaurant only affects people who eat there, but anybody who stops into town, especially if they stay overnight, are going to be impacted by the town’s water supply.

“How do you quantify what is relatively less risky when you are dealing with people from all walks of life and different communities passing through? If you have the ability to deal with a pathogen, a disease-causing organism, and we’re not doing it, we make ourselves vulnerable to having an outbreak,” he said.

He said that the village would be able to obtain substantial assistance for this.

“We have such cheap water anyhow; we tend to think that it is free. It isn’t free. There comes a cost to have water delivered to your tap under pressure.”

When municipalities begin to become concerned about the costs, Gaunt compares the cost of treating water to other utilities elsewhere in the country.

“It’s a good news story for Valemount. It’s a worthwhile program,” he said.
The Village of Valemount is taking the request seriously. At last Tuesday’s meeting councillors resolved to ask Urban Systems to pursue a planning grant for water system enhancements. Urban Systems had been developing a proposal for the village square concept under the provinces Infrastructure Planning Program; however, they will try to use another fund to continue that process.

HEALTH OFFICIALS SCRUTINIZE FOUNTAINS

September 2, 2006

Knight-Ridder Tribune
James Hohmann, San Jose Mercury News, Calif.

Health officials across the Bay Area acknowledged Friday that public fountains are not inspected for the dangerous microbes that sickened at least seven people who played in the water at San Jose's Plaza de Cesar Chavez. In fact, they said, they d on't even know where all those fountains are.

A day after San Jose announced the closure of the popular downtown water feature because the city cannot assure its safety, it became clear that dozens of fountains in at least four counties are also falling through the regulatory cracks. And officials promised to move swiftly to close the gap -- although it is not clear what they need to do or how long it will take.

Health officials have long known of the danger of Cryptosporidium -- a parasite that sickened seven children who played in the plaza fountain this summer -- in public swimming pools, and those bodies of water are subject to inspection. But fountains are n ot -- even though the new generation of interactive fountains, like the one at the plaza, invite water play.


"There has not been any oversight or inspections or testing of the fountains," said Dr. Marty Fenstersheib, Santa Clara County's public-health director. Officials in Alameda County, San Mateo County and San Francisco echoed his comments.

Meanwhile, San Jose on Friday closed a second fountain, the one located at McEnery Park on San Fernando Street, because it has no better filtration system than the one at the plaza. Some of the newest fountains do include systems that can remove Cryptospo ridium.

"We have no indication to show that this parasite has been found in this particular water attraction area, but just to err on the side of caution, we'll turn it off for the time being," said Ed Bautista, a spokesman for the city parks and recreation depar tment.

Senior health officials from Santa Clara, Alameda and Santa Cruz counties, and San Francisco, acknowledged that they don't know where the fountains are located or even how many exist within their jurisdictions.

But they told the Mercury News that they would rethink their guidelines and rules -- and would consider requiring warning signs, meeting with operators and creating an inventory of how many and what kinds of fountains there are. Other possible changes cou ld include stricter rules about allowing babies in the fountains or more stringent policing to prevent animals -- and their feces -- from contaminating the water source. Fecal contamination is the main source of Cryptosporidium.
A first step for the counties will be identifying every interactive fountain and figuring out whether its filtration system is adequate to resist "crypto."

Friday, representatives from the Santa Clara County public and environmental health departments met with city, water district and San Jose Water Company officials to talk about responding to recent cases of infection, which also causes nausea and cramps.

"It's a case of finding out what is required, what the costs are and what the options are to see where we go from here," said Lindsey Wolf, a representative of the city's environmental-services department.

Test results were confirmed Friday; the plaza's fountain water was probably infected by a human or animal. After the water was contaminated, it was circulated over and over again by the fountain's recycling system.

Centers for Disease Control and Prevention epidemiologist Dr. Michael Beach compared the water in the fountain to communal bathing water. He said the fountains are just like swimming pools.
"We've got a number of Cryptosporidium outbreaks going on across the country," he said.

In Alameda County, supervising environmental-health specialist Cynthia Bartus Jepsen said the latest outbreak will cause her agency, which has no records of fountains, to be far more proactive.
"Sometimes these parks install fountains and because there's no requirement for them to have a permit, we don't know about it," she said.

Since the Chavez fountain was built in 1989, filtering technology has improved dramatically. New micro-filters can strain out more particles, Beach said.

A fountain in San Jose's Willow Glen area has a system that continually pumps in and out fresh, potable water. But this method uses more water and is more expensive to operate.

When hundreds became infected with crypto in New York last year, the state enacted new rules requiring all fountains to treat the water returning through the pumps with ultraviolet light that can destroy potentially dangerous bacteria.

The California Conference of Directors of Environmental Health released guidelines for fountains in 2001, but they have not been widely implemented. Richard Fuchs, director of the consumer protection division in the Santa Clara County department of enviro nmental health, said he understood that those guidelines are supposed to be included within the new swimming pool regulations that the California Department of Health Services is working on. Officials there did not immediately respond to requests for comm ent.

Parents expressed concerns about the news that the water could have been infected for nearly a month.

Pamela Emanuel said she brought her 5-year-old son, Morris, to the fountain for his birthday July 24 and had to take him to the hospital a few days later with symptoms largely matching cryptosporidiosis. She said he was ill for weeks and speculated that t he fountain might have been a cause.

Even after hearing about the dangers, Mike Calise said he just couldn't say no to his 4- and 7-year-old girls when they wanted to play in the fountain at the Los Gatos town plaza. But he said he hopes regulations are beefed up soon.

"Where it happens once, it can happen again," he said. "We'd certainly like to see regular testing. We look forward to a more widespread investigation about whether this problem exists in different areas."

Lake Erie Water Danger

Dated: 08/03/2006

Lake Erie swimmers are finding more and more signs popping up on the beach warning of unsafe water. The Ohio Environmental Council says the bacteria levels have gotten out of control and something has to be done.

Already this summer at Camp Perry Beach, which is just a few miles West of Port Clinton, nine warning signs have been put up that the water isn't safe.

"It's very important for residents to know because you're swimming in raw sewage," said David Celebrezze, Ohio Environmental Council. "Some of this bacteria includes E.Coli, Hepatitis A, Cryptosporidium, and Giardia. They're parasites and bacteria and can be very harmful to us."

Celebrezze says the parasites and bacteria are coming from combined sewage overflow.

"What that is... is after a heavy rain or a quick snow melt our sewer infrastructure can't handle that amount of water coming through," said Celebrezze.

So it overflows into the tributaries of Lake Erie, and ends up at beaches just like Camp Perry. Dozens of others have also been affected, including Maumee Bay State Park where there's been 10 warning signs this summer. Celebrezze says the scary thing is those signs can take up to 24 hours to post.

"So while you are out swimming or your kids are swimming they could be swimming in raw sewage," said Celebrezze.

"We're concerned about that obviously from a health perspective but also an environmental perspective because Lake Erie is also a habitat for thousands of animals," said Celebrezze.

So the Ohio Environmental Council is lobbying Washington for funding to help fix the problem. The money would update area sewer systems and help clean-up beaches.

Ottawa County has already been given a 2.6-million dollar grant which Western Lake Erie Waterkeeper, Sandy Bihn, says gives hope.

"These are just great waters to be in and great waters to enjoy and many people come here and we want to share it with them," said Bihn. "We want to clean-up these problems so they can have access to the water and have fun."

You can find a complete list of Lake Erie beaches and the bacteria levels at this website: www.odh.ohio.gov/odhPrograms/eh/bbeach/beach_samplemonitoring.aspx

To find out more about the effort to clean-up Lake Erie you can find information on both of these websites:
www.TheOEC.org and www.WesternLakeErie.org

Public swimming areas have cleanliness rules for a reason

By Elizabeth Neff
The Salt Lake Tribune

Shirleen Tingey, a lab technician, analyst, and sampler for Davis County's Health Department in Farmington, looks for bacteria Friday in samples of pool water. (Trent Nelson/The Salt Lake Tribune )

In his years helping to police water quality in Davis County pools, Delane McGarvey has seen changes for the better.

Since the mid-1990s the state has required public pools to have certified operators - a measure that includes mandatory water safety testing, training and record keeping.

Even so, McGarvey says the county closed a record number of pools last year due to water standard violations. In 2005, 78 pools were closed, well above annual numbers in the 20s in years past.

A Salt Lake Tribune review of Davis County pool water inspection records from the past 18 months shows the best water quality is at public pools and swim schools, where just over one-quarter of facilities had water quality violations.

The worst: private gyms and health facilities, where eight of the 10 facilities monitored had violations. Hotels and motels followed, with 73 percent of all facilities having violations. Private community pools at apartment complexes and condominiums had a 44 percent violation rate.

Chlorine alone doesn't protect the public from water-borne illnesses. McGarvey, the county's environmental health director, said proper levels of disinfectant are required and even then pool water can change hour to hour, based on factors such as the number of people in the pool or the weather.

"Each pool is a dynamic environment," he said.

Hitting the showers: The reason for those "Please shower before using the pool" signs? Most recreational water illnesses enter water through fecal matter. They can also spread through contact or swallowing contaminated water.

Exposure to the five most common bugs - cryptosporidium, E-coli, giardia, shigella and Hepatitis A - usually results in diarrhea, according to the Centers for Disease Control and Prevention (CDC). But it can also mean skin rashes and ear or respiratory infections.

The CDC says that from 1984 to 2002 it recorded an increase in reported diarrheal outbreaks, resulting in about 19,000 water-related illnesses over that time period. Officials attribute the rise to increased recreational water usage and improved detection.

Utah tracks the number of cases of the five most common causes of water-related illnesses, but determining how they were transmitted is difficult, officials say. Most of the cases stem from contaminated food or human contact, such as sexual contact.

Last year's increased numbers of violations might be a result of better training and more experience given to inspectors in recent years, McGarvey speculated. He said complaints from the public about pool water to the health department are few.

Public facilities monitored: Even Clearfield's new Aquatic Center, which opened in 2005, had high bacterial counts in the pool's splash pad and other areas earlier this year.

But most, like Kristee Malan of Layton, say they and their kids enjoy the pool with little fear. As she visited the aquatic center last week, she recalled one occasion when someone had an accident.

"Someone's diaper leaked and they cleared the pool for 45 minutes while they cleaned the pool," said Malan. "They caught on to the problem quickly and did a good job taking care of it, so it didn't bother me at all."

Cheryl Roman of West Haven has been a nurse for 28 years and is aware of the dangers of bad pool water. She takes her kids to the Clearfield Aquatic Center three or four times a year, but keeps an eye on how a pool is run. "You can tell your kids not to swallow the water and inevitably they do," she said, "but I feel like this pool's probably cleaner than any other pool I've been to."

Aquatic supervisor Donna Russell said the areas in question were superchlorinated afterward and that her facility tests the water every two hours, more than required by state rules. She noted the pool is equipped with a special system that sanitizes the water each time it is filtered.

"We are doing everything the health department tells us to do at these levels," she said. "Whenever you pull a sample out of a pool, you never know what you're going to pick up. We keep our water at levels as best we can."

One unusual source of violations was the pool at Bountiful's Lakeview Hospital, mainly used for water aerobics. It had four violations between February of 2005 and June of 2006, according to county records.

Troy Wood, an assistant administrator at the hospital, said if any problems are found, immediate action to correct the problem is taken and patients cannot use the pool.

"Because it's not easy to get perfect, it's heavily monitored by the state," he said. "That's a good thing."

In hot water: In shallow baby pools and hot whirlpools, warm temperatures and small spaces create a perfect environment for germs to multiply.

Men's whirlpools at the Sport Forum in Woods Cross, which closed in April, and Xcel Spa & Fitness in Bountiful were both cited during the past 18 months.

Ryan Forsey, club manager for Xcel, said the club tests the spa water at least four times a day and has digital equipment installed to monitor chemical levels in the spa. Even so, after the morning or afternoon rush levels can be thrown off.

"Maintaining a hot tub or any body of water is a constant challenge due to traffic and basic hygiene," he said. "We post signs saying please shower and rinse off before using it, but you can only police things so much. We do as much as we possibly can."

Forsey and his staffers often close the hot tub at the pool to drain the water if problems are found.

McGarvey said crowded pools present the greatest risk.

"The threat on a swimming pool is you can have a lot of people in a small body of water."
---

Tribune correspondent Dana Rimington contributed to this report.

Unclean pools prove hazardous

By ELIZABETH NEFF and CAREY HAMILTON
Salt Lake Tribune

In triple-digit temperatures, there are few things more appealing than a dip in a crystal-clear pool.

Focused on cooling down and keeping the kids occupied for a few hours, many don't think twice about skipping the showers and just jumping in. But federal health officials say they should -- the spread of recreational water illnesses is on the rise nationally.

Most recreational water illnesses enter water through fecal matter, and spread through contact or swallowing contaminated water.

Exposure to the five most common bugs -- cryptosporidium, E-coli, giardia, shigella and Hepatitis A -- usually results in diarrhea, according to the Centers for Disease Control and Prevention (CDC). But it can also mean skin rashes and ear or respiratory infections.

The CDC says reports from 1984 to 2002 indicate an increase in reported diarrheal outbreaks, resulting in about 19,000 water-related illnesses over that time period. Officials attribute the rise to increased recreational water usage and improved detection.

On a blisteringly hot day earlier this month, Juneal Wilding of the Salt Lake City area joined other mothers and children leaving a public swimming pool en masse after the pool was closed in an all-too-commonplace occurrence.

"Someone had an accident, and they told us it would take an hour to clean up," said Wilding. "It's disgusting."

The ill-fated outing was the first time Wilding and her twin boys visited the recreation center pool. But they had joined a relatively length list of people sharing the same fate.

Tod Bean, recreation facilities director, said most violations resulted from the kids' wading pool

"We've really stepped things up there," he said. "We shock it twice a week, drain it once a month and test the water every two hours."

Wilding, however, said she hadn't thought much about pool water standards before that day. "I'll probably ask about violations in the future," she said.

Shallow baby pools and hot whirlpools, sources of warm temperatures and small spaces, create a perfect environment for germs to multiply.

That means more problems at hotels, apartments, condos and gyms, which don't have staff check the water as frequently.

Swimming with germs?

No laws regulate cleanliness of Tuscaloosa County's public pools

By Lydia Seabol
Staff Writer

July 27, 2006

TUSCALOOSA | On a sweltering day, it's not likely that many swimmers think about what germs lurk in public pools before taking the plunge.

Perhaps they should.

According to the Centers for Disease Control and Prevention, recreational water illnesses can spread quickly in swimming pools that aren't properly maintained.

Serious diseases caused by such bacteria as cryptospordidum, giardia, E. coli and shigella can be contracted by ingesting water contaminated with fecal matter. While symptoms can be as minor as diarrhea or skin, ear or eye infections, these illnesses can be fatal in people with weak immune systems.

But swimmers who want to be sure of a pool's cleanliness often must put their faith in the owner or operator. No state or local laws regulate the cleanliness of public pools in Tuscaloosa County. Federal regulations are in place, but there is no local enforcement, said Randy Dixon, assistant director of the Tuscaloosa County Park and Recreation Authority. There are no government pool inspectors, and it is up to the operators or owners of the pools to ensure the water is kept clean.

"We do not regulate pools or inspect pools, and I really don't know who does," said Greg Utley, environmental supervisor at the Tuscaloosa County Health Department.

While PARA follows the federal rules, in 2004 it installed a more stringent automated testing system at its four public pools, based on Jefferson County's regulations.

"We took the federal guidelines and adapted other processes to make sure that the community at large is safe when they visit one of our facilities," Dixon said. "I assume that Tuscaloosa County will have to step up to the plate in the future and adopt some sort of regulations."

According to CDC recommendations, a pool should have chlorine levels continuously between 1 and 3 parts per million and maintain a pH level between 7.2 to 7.8. The pH and disinfectant levels should be tested at least twice per day, or hourly when the pool is heavily used.

Having clean bathrooms with diaper changing areas at the pool facility is also important because many of the germs causing waterborne illnesses come from swimmers or infants with diarrhea. A single fecal accident can contain thousands of disease-causing germs and could contaminate an entire pool or water park, causing hundreds of cases of illness.

The number of diarrheal outbreaks linked to swimming pools is relatively low, averaging about 10 per year, according to the CDC. But that number is likely a tiny fraction of the cases that actually occur because most diarrheal illnesses are not reported to health officials.

The four PARA-run pools at Bowers Park, Freeman Park, McAbee Activity Center and Phelps Activity Center have never had a reported recreational water illness, Dixon said.

He attributes the pools' cleanliness to the automated system that was installed at the PARA pools. The computerized systems test the water's chlorine and pH levels hourly and automatically inject more chemicals when needed. All the water in the pool is re-circulated through a filter every six hours to make sure the pool is clean, Dixon said.

At the Indian Hills Country Club pool, the water is tested twice a week to make sure the chemical levels are what they should be. Pool manager Jamie Griffin said he takes the water samples to a private company to be tested. If more chlorine needs to be added, he does that manually.

Other publicly used pools, such as those at many hotels and apartment complexes, have their pool water tested by a private company or are maintained by the owners.

Spraypark opening delayed

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

Health Officials Prep To Stop Summer Pool Parasites

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.

Some germs in pool resist chlorine

By LIBBY KEELING, Health Scope
The Courier & Press

June 12, 2006

Please don't put "the P" in our "...ool."

Those words sent me into fits of giggles the first time I saw them on a strategically placed sign at the neighborhood swimming pool when I was a youngster.

But swimming hygiene and waterborne illnesses really aren't laughing matters.

Last year, nearly 4,000 people in New York contracted the gastrointestinal disease cryptosporidiosis at a state-run water park. Caused by microscopic parasites (genus Cryptosporidium), "crypto's" symptoms include diarrhea, stomach cramps, nausea and vomiting.

The parasites have protective outer shells that make them chlorine-resistant and enable them to live outside the body for a long time, according to the Centers for Disease Control and Prevention. In the body, they typically hang out in the intestines before passing in the stool. Crypto infection occurs when a person swallows the parasites, which can be found in soil, food and water, as well as on surfaces contaminated by the infected feces of a human or animal.

OK. Now that's the other "P-word" and that's even more disgusting. Finally, I know why my mother always told me not to drink the pool water.

Crypto - also found in untreated drinking water - is able to survive in swimming pools for days. Outbreaks of waterborne disease occasionally occur in the Hoosier state, according to the Indiana Department of Health. Poorly maintained recreational water venues, chlorine-resistant germs and contaminated runoff to lakes or other bodies of water can infect unsuspecting swimmers. Crypto's symptoms usually last from one to two weeks. Young children, pregnant women, the elderly and people with weakened immune systems are at the greatest risk for more serious illness.

"Water safety is not just about safe swimming," said Lynae Granzow, a health department enteric epidemiologist. "It's about following proper hygiene, whether you're in a lake, community pool or even the backyard family pool.

The Department of Health recommends several healthy swimming behaviors:

# Don't swallow pool or lake water and avoid getting the water in your mouth.

# Don't swim if you have diarrhea. You could spread germs in the water.

# Shower before swimming, and wash your hands after visiting the bathroom or changing diapers.

# Before swimming, wash children thoroughly with soap and water.

# Take children on regular bathroom breaks and change diapers often.

# Change diapers in the bathroom, not poolside. When you're planning a summer swim outing, keep health and safety in mind, and don't forget the sunscreen.

Swimming Safety Tips From Local Health Officials

6/5/2006
Eyewitness News Memphis

Now that most municipal and public swimming pools are open, it's officially swimming season in the Mid-South. Here are some safety tips for your family from the Memphis and Shelby County Health Department.

To prevent drowning: -Always have an adult supervise children when they are swimming or playing in the water.
-Never swim alone in locations without a lifeguard.
-Never drink alcohol when swimming, boating, water skiing or supervising children.

Swimming in contaminated water can spread some serious illnesses. Recreational water illnesses are spread by swallowing, breathing, or having contact with contaminated water from swimming pools, spas, lakes, rivers, or oceans.

One particular bacterium called Cryptosporidium can be life threatening in people with weakened immune systems. Many other waterborne illnesses (eye, skin, ear, and respiratory infections) are caused by germs that live naturally in the environment.

In the pool or hot tub, if disinfectant is not maintained at the appropriate levels, these germs can thrive and cause illness in swimmers.

Healthy swimming behaviors help prevent the spread of waterborne illness:
-Don't swim when you have diarrhea. This is especially important for kids in diapers. You can spread germs in the water and make other people sick.
-Don't swallow the pool water.
-Take a shower before swimming and wash hands after using the toilet or changing diapers. Germs on your body may end up in the water.

Shedding light on water quality

by Susan E. Rice
May 24, 2006
The Chetek Alert

The recent flushing of the water system caught the attention of many Chetek residents, but the practice is standard operating procedure. What is new to Chetek's water treatment is the use of UV light treatments and the city's participation in a study.

In the last few weeks a rumor concerning the city's tap water began circulating. Claims that the city was forgoing chlorine treatments in place of UV light treatments had people questioning the safety of their water.

According to Director of Public Work Dan Knapp, the city of Chetek does not use a chlorine based water treatment system.

"We use chlorine only when we have been working on the lines to eliminate any potential bacteria that may have entered the system during repairs," stated Knapp.

Following the repairs to the water tower, chlorine was used to remove any bacteria that may have developed. The chemical was then flushed through the system, which resulted in a strong chlorine smell whenever the tap water was turned on. The flush of the system is also the reason behind the running hydrants spotted by residents.

What should be catching the attention of the city's residents is Chetek's participation in a unique water treatment study, which examines the risk of acute gastrointestinal illness and fever in children who drink water from municipal systems that use groundwater.

All city residents were informed my mail of the study which uses UV light purification in addition to the city's current methods of treatment. The WAHTER study, which is being conducted by the Marshfield Clinic Research Foundation and funded through federal dollars as part of the Safe Drinking Water Amendments in 1996, is the first of its kind in the world.

According to Mark Borchardt, the study's principal investigator and a scientist with MCRF's National Farm Medicine Center, the Environmental Protection Agency (EPA) commissioned the study after it was acknowledged that no one knew exactly how safe the surface and groundwater supply was under current treatment methods.

"When Congress approved the amendments they asked the EPA to conduct studies to estimate the incidence of waterborne disease in the United States.

This study is designed to estimate the proportion of illness in children due to drinking groundwater," Borchardt said. "It is amazing to think that no real studies have been completed until now."

In fact, the Federal Drug Administration has done extensive studies on the safety of food, but when it came to the nation's water supply the government had "no clue," stated Borchardt.

Groundwater has been perceived as pure, but between 1991-2000, more than two-thirds of the 163 waterborne infectious disease outbreaks in the U.S. were attributed to groundwater contaminated by viral, bacterial or disease-producing agents. While disease outbreaks are alarming, there are far more sporadic individual cases, and the source of these infections is not always clear.

The water sources identified as needing to be studied were ground and surface water. The federal governmental set aside $3 million for the research. The studies on surface water began first because it was believed that the greater source of contamination would be found here.

"The study was held in Davenport, Iowa. What they found is that there was only a small risk of contamination," Borchardt noted. "Considering the source of water is the Mississippi River, this was very good news."

Borchardt says that the findings are reassuring because it gave scientific proof to the fact that standard water treatment methods are being effective. However, the study used all of the funds the government had set aside delaying the groundwater studies.

Last year, Borchardt was awarded $1.8 million by the EPA for his proposal.

Lighting up Chetek's water

"Instead of installing a UV light system on individual household taps and asking people to only take water from this one source, we realized that people are exposed to water through many sources," the scientist explained. By treating a community's entire water supply with a Wedeco UV light system, the Marshfield researchers could better assess the impact of the treatments.

"I think one of the reasons this approach hasn't been taken before is because nobody believed they could get entire communities to participate, but they don't know Wisconsin," stated Borchardt.

Fourteen Wisconsin communities from a pool of 40 were selected to participate in the program. Criteria for selection was based on three factors: the city's water must come from a sand/gravel or sandstone aquifer, the number of wells feeding the communities was limited, and a sufficient number of families with children would be available to participate in the study.

"Test communities are being given a chance to use key technology free of charge," stated Borchardt. "This is equipment that is expensive to purchase and install, but it is being made available through federal funding."

The plan is that after six months, the two sets of communities will "cross over," meaning the ultraviolet light units will be moved to the original control communities. All 14 communities will be tracked for another six months.

Taking part in the study

After speaking with Knapp, Borchardt determined that Chetek would be one of the test communities because it met the main criteria. Currently, every person in the city is using and consuming UV light treated water. Seven control communities will continue current water treatment practices.

Surveillance for gastrointestinal illness and fever will be conducted among children in participating households.

In Chetek families are still needed to participate directly in the study by completing a health symptoms checklist four times over the next 12 months. Only 30 of the 62 families needed to produce statistically viable results have registered to be active participants in the study.

"Among the 14 communities in this study, over 1,780 people have already agreed to participate," Borchardt said. "In Rice Lake we had to turn people away."

The researchers are looking for households using city water with at least one child who is at least 6 months old and less than 13 years old. Participants are paid $100 per family if all study procedures are completed. In addition, at the end of the study a drawing will be held for one family from each study community to win a free two-night get-away at a Wisconsin Dells hotel and water park.

"You can't pay people enough for their time. We find that people participate because they are concerned about their kids and their health," noted Borchardt.

Borchardt added that the communities need to understand that there is no danger associated with the level of UV light being used in the study.

Ultraviolet disinfection uses a UV light source, which is enclosed in a transparent protective sleeve and placed in a water flow chamber. When ultraviolet energy is absorbed by the reproductive mechanisms of bacteria and viruses, the genetic material (DNA/RNA) is rearranged and they can no longer reproduce. The organism is then considered dead, eliminating the risk of contamination.

UV treatments disinfect water without adding chemicals. It does not create new chemical complexes, produce any bi-products, alter the taste, pH, or other properties of the water, or remove any beneficial minerals in the water.
For this reason, UV light treatments are also considered environmentally friendly. Studies show that ultraviolet devices are most effective when the water has already been partially treated, and only the cleanest water passes through the UV flow chamber.

In the U.S., chemical treatment with chlorine remains the primary method for disinfecting drinking water. However, chlorine can produce chemical by-products that have been linked to cancer. Such byproducts are also coming under stricter regulations in the new EPA rules for drinking water.

"If we were to try to introduce chlorine today with the protections in place from the EPA, we couldn't do it," Borchardt added. The EPA started including UV disinfection as an approved water treatment method in 1998.

When chlorine gas or sodium hypochlorite are used to disinfect water, they react with organic compounds in the water to form potentially harmful levels of the chemical by-products trihalomethanes (THMs) and haloacetic acids, both of which are carcinogenic and regulated by the U.S. EPA. Chlorine also fails to kill some infectious microbes, such as the protozoan parasite Cryptosporidium. Known as "Crypto," in the last two decades the parasite has become recognized as one of the most common causes of waterborne disease among people in the U.S., according to the Centers for Disease Control and Prevention. The organism, Cryptosporidium, caused a major epidemic infecting 400,000 people in Milwaukee through the drinking water in 1993.

Families wishing to become an official part of the study have until Wednesday, May 31, to contact the Marshfield Clinic Research Foundation toll-free at 1-877-233-7533 between the hours of 7:30 a.m. and 4 p.m.

How to get involved

What is it? A water treatment study looking at the risk for gastrointestinal illness and fever in children who drink water from municipal systems.

Who can participate? Families with at least one child between the ages of 6 months and 13 years.

What must be done? Families complete a health assessment form four times over a 12-month period.

Is there reimbursement? Families who complete all the forms will be paid $100 and be eligible for a Wisconsin Dells vacation drawing.

Contact: The Marshfield Clinic Research Foundation toll-free at 1-877-233-7533 between the hours of 7:30 a.m. and 4 p.m.

Deadline date: All families must be registered by Wednesday, May 31.

Kansans Urged to Avoid Illnesses at Swimming Pools, Water Parks and Beaches

May 22, 2006

Kansas City Star

May 22-29 is National Recreational Water Illness Prevention Week

Topeka, Kan. - infoZine - Memorial Day marks the traditional start of recreational water activities in Kansas. Pools, water parks and swimming beaches typically open for business. With these water activities comes the threat of contracting a waterborne illness. The Kansas Department of Health and Environment (KDHE) wants Kansans to be aware of the risks and take steps to avoid illness.

Recreational Water Illnesses (RWIs) are spread by swimming in water that has been poorly maintained and is contaminated with chlorine-resistant germs or from run-off to lakes or beaches.

Diarrhea is the most commonly reported illness associated with recreational water, and is usually caused by parasites such as Cryptosporidium and Giardia or bacteria such as Shigella and E. coli 0157:H7. However, recreational water illnesses also include skin, ear, respiratory, eye, and wound infections.

"On occasion, we get reports of swimmers who have become ill after swimming at a public pool or beach area," said Dr. Howard Rodenberg, KDHE Division of Health Director. "As long as the public follows some basic guidelines to prevent the spread of harmful germs, we can greatly reduce the risk of a waterborne illness outbreak---and keep the focus on fun and fitness at the swimming pool."

Healthy swimming behaviors that prevent the spread of illness include the following:

* Don't swim if you have diarrhea. Germs are easily spread in the water and can make other swimmers sick.

* Don't swallow pool water, and avoid getting pool water in your mouth.

* Shower before you swim and wash your hands after using the bathroom. Germs on your body will end up in the water.

* Take children to the bathroom and change diapers often.

* Change diapers in the bathroom to avoid spreading germs to the pool area.

* Wash your child thoroughly with soap and water before swimming to avoid spreading fecal matter.

May 22-29 is also National Recreational Water Illness Prevention Week, a week dedicated to educating the public about the spread of waterborne illnesses.

Article link: http://www.infozine.com/news/stories/op/storiesView/sid/15240/

LA County Aquatics Warns Commercial & Residential Swimming Facilities about Pool Health and Illness

5/11/2006
To: Metro Desk, Health and Features reporters
Contact: LA County Aquatics, 866-966-7665

LOS ANGELES, May 11 /U.S. Newswire/ -- Even the best maintained pools can spread illness. Since 1988, Recreational Water Illnesses (RWIs) connected with swimming pool have been on the rise. Last summer the splashpad-associated outbreak of Crypto affected almost 3,000 people in Seneca Lake, N.Y. In 1998, the waterpark outbreak of E. coli O157:H7 resulted in seven children having kidney failure, and one death.

The week proceeding Memorial Day has been designated as National Recreation Water Illness Prevention Week by the Centers for Disease Control and Prevention. LA County Aquatics will participate in this year's observance, which takes place May 22 - 29. The focus will be on operation and prevention tips for pool operators and pool patrons to encourage a healthy swimming experience.

Swimmers may wonder -- doesn't chlorine kills germs? It does, but it doesn't work immediately, and it takes time, says L.A.C. Aquatics. The good news is that outbreaks caused by E. coli O157:H7 appear to be rare if free chlorine levels are maintained at recommended levels throughout the pool. However, germs like "Crypto" (Cryptosporidium) are resistant to chlorine and can live in swimming pools many days. Crypto can be life-threatening and sometimes fatal in persons with compromised immune systems, persons who have received an organ transplant, patients taking certain immunosuppressive drugs or those who are receiving certain types of chemotherapy. Recreational Water Illnesses like Giardia, Shigella and E. coli O157:H7 are usually spread by accidentally swallowing water that has been contaminated with fecal matter. Even spas can spread a variety of germs (e.g., Legionella and Pseudomonas) that can cause skin and respiratory illnesses if disinfectant levels are not properly maintained. Furthermore, patrons may not associate their symptoms such as diarrhea and skin rashes, the most common RWIs, because the illness can appear days after swimming.

Having a Certified Pool Operator servicing your aquatic facility can be beneficial. However, many are not aware that all facilities serviced, public or private, located in the County of Los Angeles, are not only required to have a Certified Pool/Spa Operator or other approved certification, but are also required to be a certified Los Angeles County Pool Service Technician or Swimming Pool Apprentice Technician. Many health clubs, hotels, and residential facilities are not aware and may be in violation, according to L.A.C. Aquatics. Patrons should remember to ask questions of the pool staff. Are chlorine and pH levels checked at least twice a day? Are trained operation staff available during the weekends when the pool is most heavily used? What was the health inspector's grade for the pool after its last inspection? Also, says LAC Aquatics, patrons should remember to avoid swallowing or getting pool water in your mouth. Refrain from swimming when you have diarrhea. Take children to bathroom breaks and do not change diapers at poolside.

In recognition of National Recreation Water Illness Prevention Week, L.A.C. Aquatics is offering a free pool inspection including water balance analysis to facilities until May 31 (a $75 value). For more information call 866-966-7665 or visit: http://www.lacountyaquatics.com/poolsafety.htm

NY rules: UV disinfection at pool "spraygrounds"

Water Technology Daily

05.10.2006

SARATOGA SPRINGS, NY - As municipalities prepare to open public pools for the summer, the New York State Department of Health (DOH) has enacted a regulation that requires recirculated water in recreational pool "spraygrounds" to be treated with ultraviolet (UV) light, according to a May 9 report in The Saratogian.

Last year, the DOH forced small-city wading pools to renovate spraygrounds after an outbreak of Cryptosporidium sickened 1,800 people who had visited Seneca Lake State Park in Geneva, NY, as reported by Water Tech OnlineĈ in August 2005.

Officials in Saratoga Springs said they will not install a separate UV disinfection system at their four sprayground areas, but they plan modifications that will spray fresh, unrecirculated water from the city system, the report said.

Because the water will not recirculate, officials will install replacement nozzles to keep water use down, the report said.

Cryptosporidium causes intestinal illness with symptoms that include diarrhea, abdominal cramping, nausea, vomiting, fever and headache.

City faces new regulations for spraygrounds

CHRISTOPHER DIAKOPOULOS

The Saratogian

SARATOGA SPRINGS - The Department of Public Works is working to get the city's four "spraygrounds" open for play this year, despite new regulations from the New York State Department of Health requiring an additional water treatment system.

New regulations from the state Department of Health forced the city to close its four wading pools last year and renovate them as spray fountains. But with the outbreak of the bacteria cryptosporidium last summer at Seneca Lake State Park that resulted in more than 1,800 illnesses, the DOH changed the regulations again to include ultraviolet water treatment in addition to the chlorine system the city installed last year.

"We're trying to get ready for our opening and to meet the state standard," said WilliamMcTygue, director of Public Works. "We're not prepared to put in a separate UV disinfection system, but we are modifying our system to spray fresh water."

McTygue said the changes will bypass the chlorination system put in last year at the city's four parks at the West Side Rec fields, East Side Rec fields, South Side Rec and Geyser play area.

"It will be fresh water off the city system," McTygue said. "The DOH said that because we were recirculating the water, we couldn't do it without the UV and they didn't want to bend their new rule."

Assistant City Engineer Debbie LaBreche said the city required the bidder for the job last year, Concord Pools, to design the system to easily accept these changes in the future.

"We had input from DOH and we made sure we kept them abreast of what we were doing last year," LaBreche said. "We required Concord Pools to address DOH's suggestions, so when the regulations changes, this wasn't a big surprise."

Since the new design will be spraying fresh water off the city system, and then draining it to a waste pipe, the designs will use more water compared to the previous chlorination/recirculation system (similar to a swimming pool's system), but LaBreche said the replacement of some of the nozzles at the parks will keep the water use down.

"As long as we don't have any water restrictions, this will work," McTygue said.

According to the national Center for Disease Control, Cryptosporidium is a very common cause of waterborne disease. The intestinal illness caused by the bacterium, Cryptosporidiosis, carries symptoms including diarrhea, abdominal cramping, nausea, vomiting, fever, and headache. Until last year, New York had between 400 and 500 cases reported annually, according to the Department of Health.

Water compliance runneth low

Few public sources keep up with testing regulations
By Dan Stockman

The Three Rivers Filtration Plant has had just one minor violation from the federal Environmental Protection Agency in the past five years.

More than 300,000 people in Allen County depend on clean, safe water coming out of their taps every day for drinking, cooking and cleaning, but only a small minority of public water systems have complied with water testing requirements in the last five years to ensure water quality.

Of the 101 public water sources in Allen County, 75 systems in the last five years have had at least one monitoring or reporting violation, an analysis by The Journal Gazette found. Forty-six systems have had monitoring or reporting violations the U.S. Environmental Protection Agency deems "significant."

Twenty-four systems had health violations, according to the EPA, meaning contaminants in the water posed an imminent health risk.

Though most people think of public water systems as large, city utility systems, the state and federal government regulate nearly 5,000 systems in Indiana, including wells that serve mobile home parks, small schools and tiny cafes.

The violators included large systems such as Fort Wayne City Utilities' Three Rivers Filtration Plant and tiny ones such as churches and restaurants. One, St. Joseph Hessen Cassel Catholic School, racked up 55 significant violations in five years.

Cedar Creek Church of Christ Day Care in Leo-Cedarville had 29 significant violations; other systems had dozens of violations each.

Water systems are responsible for ensuring the testing is done, either through the Indiana Department of Environmental Management or a certified laboratory. For most small systems, this consists of filling bottles with water and sending them in.

If a test is not performed or the water does not pass the test, a violation is issued. Some tests must be performed monthly, others quarterly and some yearly. A large system such as Fort Wayne City Utilities must test daily.

The violations are issued and tracked by IDEM, then reported to the EPA. The Journal Gazette analyzed the data held by the EPA, which is available at www.epa.gov/safewater.

Experts said the number of violations may sound high, but not when you consider they are spread over five years.

Al Lao, section chief for compliance in the Indiana Department of Environmental Management's Office of Water Quality, said that although his office views every violation as "significant," on a monthly basis there are relatively few systems that are not monitoring their water properly.

At any one time, he said, there are usually fewer than 5 percent of the nearly 5,000 public water sources in the state that are not testing properly, he said.

"We require every system that has any violation ... to notify their customers what violation they have and what they are planning to do to correct the violation," Lao said.

Some of the violations accumulate quickly, Lao said, because an entire group of contaminants is monitored by one test. St. Joseph Hessen Cassel Catholic School, for example, in the third quarter of 2003 did not test for volatile organic compounds. Since that category covers 21different contaminants, the water system was deemed by the EPA to have 21 violations. IDEM does not view it that way, Lao said.

"We consider them to be one violation, because they missed one test procedure," he said.

Robert Herber, the principal of St. Joseph, pointed out that the violations were because tests were missed, not because of contaminated water. The school had one violation related to ensuring there is no lead in the water, but that has been resolved since 2003.

Herber said his concern is that parents will see the large number of violations and assume the water is unsafe, when that is not the case. Ensuring the water is safe is a top concern, he said, but just one of many responsibilities he has. Forty-two of the violations were from twice missing a 21-contaminant test.

"You're talking about children, and we should be extraordinarily safe in trying to protect them," Herber said. "As a parent, I want them to be safe when they go to school."

Cedar Creek Child Care, run by Cedar Creek Church of Christ, had 29 significant monitoring or reporting violations, all of them related to missed tests in 2004.

Jon L'hommedieu, a church member who oversees the testing, said he does not believe the EPA data showing 29 significant violations are correct.

"You start messing around with databases, anything can happen," L'hommedieu said. "I really do think something's been lost in the translation."

The violations were verified by IDEM, but some point out that sometimes the violation is IDEM's fault, saying that test results sent to the agency electronically sometimes get lost in IDEM's system -- resulting in a violation.

If there were problems at Cedar Creek Child Care, L'hommedieu said, they were all testing or reporting problems, as no contamination has ever been found in the water.

"That's key -- we've never detected a problem," he said. "As far as I'm concerned, the thing's totally safe."

He said there had been problems with "amateurs" trying to do the sampling before he took over and had it handled by a certified lab. The violations, which all occurred in 2004, could have come during the switchover, he said.

Phillippa Cannon, spokeswoman for the EPA's Region 5 office in Chicago, said ensuring the safety of the nation's drinking water rests upon self-testing. If those tests aren't done, there's no way to know the water is not contaminated.

"It's a self-monitoring system, and we rely on these systems to submit accurate and timely reports so we know their water is safe to drink," Cannon said. "That's just how the system works."

Ridgeview Mennonite Church in Woodburn has had three significant monitoring or reporting violations, and three non-significant violations in five years. The importance of that testing became clear when testing found coliform bacteria in the water, resulting in three health violations. The presence of coliform bacteria is a sign that the water may be contaminated with potentially harmful bacteria from feces. That requires chlorinating the well and flushing pipes to ensure the water supply is safe.

"We definitely don't want to do anything that's going to cause problems with anybody," the Rev. Lester Zehr said. "You definitely don't want your people getting sick."

On the other hand, while he wants to ensure the safety of his 75 church-goers, Zehr said the hassle and expense of meeting state and federal requirements is a burden.

For a while, the testing was free, he said, but is now about $30 per test. When tests have to be repeated, the cost adds up quickly, he said.

The EPA says a health violation, such as the three at Ridgeview Mennonite Church, does not mean those who drank or used the water got sick but that they were exposed to an "unreasonable risk of illness" or that the water wasn't treated to the extent EPA requires to prevent illness.

The federal Centers for Disease Control and Prevention statistics show 419 outbreaks of illness from contaminated drinking water between 1980 and 1998. But most of the estimated 511,000 people sickened in those outbreaks were from one case: the 1993 Cryptosporidium outbreak in Milwaukee.

Experts say the risk of thousands or even hundreds of thousands of people being sickened by one source is what makes testing so important. They also believe the number of people sickened is underestimated, because most healthy adults who contract a waterborne illness will have only mild symptoms and not report it.

AquaIndiana's north system, which serves 30,900 customers on the north side of Fort Wayne, had one health violation when coliform was detected in the water in September 2004, and one significant monitoring violation, in 2003.

Fort Wayne City Utilities, which serves 250,000 customers, garnered a non-significant violation in 2001 when it sent a certification in late.

Other systems with violations included the state-run rest areas on U.S. 30 near Arcola, both of which have had seven significant violations in the last five years. The Indiana State Police Post in Fort Wayne has had five significant violations and 12 non-significant violations in the last five years.

dstockman@jg.net

Cryptosporidium outbreak linked to interactive water feature, UK: importance of guidelines

Eurosurveillance Monthly Release
volume 11, issue 4 April 2006

M Jones1, D Boccia2,3, M Kealy4, B Salkin5, A Ferrero6, G Nichols3, JM Stuart1

1. Health Protection Agency South West, Stonehouse, United Kingdom

2. European Programme for Intervention Epidemiology Training

3. Health Protection Agency Centre for Infections, London, United Kingdom

4. Peninsula Health ProtectionUnit, Dartigton, United Kingdom

5. Royal Devon and Exeter Hospital, Exeter, United Kingdom

6. East Devon Council, Sidmouth, United Kingdom

A need for national guidelines relating to interactive water features was highlighted following three outbreaks of cryptosporidiosis in the United Kingdom, all of which were related to public water features. In August 2003 the Health Protection Agency South West of England was notified of an outbreak of cryptosporidiosis associated with an interactive water feature designed for water play within an adventure park. The water feature was implicated following samples with a high coliform count and the presence of faecal coliforms.

A case was defined as any child (younger than 16 years of age) who had visited the park during August and who subsequently had gastrointestinal symptoms and a faecal sample positive for cryptosporidium. Seventy one children were identified in the cohort.

This outbreak of cryptosporidiosis was characterised by a very high attack rate (89%), relatively severe in duration (median 8 days) and had a relatively high hospital admission (16% of cases). The epidemic curve was consistent with a point source of infection, which corresponded to the date 80% of the cohort visited the park. This outbreak has similarities to two other cryptosporidiosis outbreaks reported in England in 2003 that involved public water features. These outbreaks raise issues about the operation and maintenance of water-based recreational attractions that very often involve children. The paper reflects on the basic control measures that can be taken and highlights the need for guidelines, especially since such attractions are becoming increasingly common. The Pool Water Treatment Advisory Group has now produced guidelines.


Introduction

In recent years there has been an increase in reported outbreaks of infectious diseases associated with public water features [1-6]. Cryptosporidium has been the principal pathogen in outbreaks in England and Wales [1,2]. However, Shigella sonnei [3], norovirus [4] and Legionella pneumophila [5, 6] have been implicated in similar outbreaks in other countries.

In August 2003 an outbreak of cryptosporidiosis was identified in children who had recently visited an adventure park in southwest England. The adventure park contained a number of activities involving contact with water (boats, log flume, interactive water features) and contact with farm animals. Following an earlier complaint from a visitor about the water quality of one of the interactive water features designed for water play, water sampling had revealed a high coliform count (2100 coliforms, 40 E.coli per cu mm). A cohort study was implemented to check whether there was any epidemiological evidence for a particular source within the adventure park.

Methods

The cohort population included all children (aged less than 16 years) among household members or friends of a probable or confirmed case who had visited the park with a case during August 2003. A probable case was defined as any child who had visited the park during August 2003 and who subsequently had gastro-intestinal symptoms including diarrhoea, blood in stools, vomiting, nausea, or abdominal pain. A confirmed case was defined as a probable case with a faecal sample positive for cryptosporidium. Children who had travelled abroad in the two weeks before the onset of symptoms were excluded from the study.

Cases were identified from laboratory reports to the Health Protection Agency (HPA). A standardised questionnaire was administered over the telephone with an adult in the family of a case. Exposure data included water exposure (contact duration, type of contact, type of water source), animal contact and food consumption. Data were analysed using Epi Info 6.04 [7]. A univariable analysis was run to assess the association between exposures investigated and onset of disease. As only one variable showed an association and as the numbers were small, multivariable analysis was not performed.

Ten-litre grab samples were taken from the various water features within the park for cryptosporidium oocyst detection by South West Water Ltd. Faecal samples from the farmyard animals were also submitted. Oocysts were detected by light microscopy. Positive specimens were sent to the HPA Cryptosporidum Reference Laboratory for genotyping.

Results

Ninety one children were identified in the cohort, of whom 71 were contacted, giving a 78% response rate. Sixty three children (89%) met the case definition (27 confirmed and 36 probable cases). The sex distribution was even. Median age was 6 years (range 1-15). The most common symptom was diarrhoea (94%), followed by vomiting (64%), abdominal pain (62%), and nausea (51%). None of the children reported blood in stools. The median duration of illness was 8 days (range 1-18) and more than 30% of the children were still ill at the time of interview. Ten children (16%) required hospital admission.

Forty-six of the children who were cases (73%) had visited the park on 8 August, the date of symptom onset for the first case. Of the 51 children whose date of illness onset was known, 45 (88%) had a date of onset within one incubation period (1-10 days) of visiting the park [FIGURE].

Dates of onset were between 8 and 29 August, and the outbreak peaked on 13 and 14 August. For two of the four cases with date of onset more than 10 days after visiting the park, other household members had had gastrointestinal symptoms in the 10 days before onset. The two probable cases with onset date on date of visit became ill during the evening after leaving the adventure park.

The exposure yielding the strongest association with illness was contact with the interactive water feature [TABLE] (RR= 1.8, CI 95% 0.45 to 7.31, p=0.06). No specific type of contact with this source of water was significantly associated with illness. This feature involved being sprayed with recirculated water. Children often entered the feature fully clothed and with their shoes on. Nineteen children drank the recycled water and one parent reported that the water 'smelt like drains'. The filtration and disinfection systems were not adequate to cope with high levels of contamination, and the water feature was closed on 21 August, soon after the start of this investigation.

Samples from 23 of the 27 confirmed cases were sent for genotyping. Sixteen yielded a result and 14 of these were Cryptosporidium parvum genotype 2. The initial sample from the interactive water feature contained a single oocyst that could not be genotyped. Although a subsequent sample from this feature when not in operation was positive and identified as Cryptosporidium parvum genotype 2, there was insufficient DNA for subtyping. Due to a failure of communication, faecal samples taken from animals resident in the park were not tested for cryptosporidium.

Discussion

This outbreak of cryptosporidiosis was characterised by a high attack rate (89% in the cohort studied), long duration of illness (median 8 days) and high proportion admitted to hospital (16%). The dates of onset were consistent with a common source of infection from an exposure in the adventure park. The analytical study showed an association between exposure to water in the interactive water feature and illness. Although the strength of the evidence was reduced due to the small numbers in the unexposed group, the finding was supported by the microbiological results and environmental observations. No association with other water sources or animal contact was detected. It seems likely that water in the interactive water feature became contaminated with faeces containing cryptosporidium oocysts, either from the footwear of users or from an unidentified primary case. These oocysts then continued to circulate in a viable condition as a result of ineffective filtration and disinfection.

In response to the outbreak, the park reviewed and revised health and safety risk assessments to manage and control the risk from protozoan parasites. The design of the water treatment and disinfection system was improved. The park also provided additional drinking fountains around the park and asked children to remove footwear before entering the interactive water feature. They improved signage, instructing visitors at all water-related attractions not to drink the water.

This outbreak has similarities to two others reported in England in 2003 involving public water features. The first, which also occurred in southwest England, involved four cases of cryptosporidiosis in children who had played in a fountain. The water feature comprised two separate water bodies with separate holding tanks and water treatment systems using bromide and sand filtration. A large pool with water to a depth of 20cm was used as a paddling pool, although it was not intended for this purpose. Cryptosporidium oocysts were isolated from all four cases and detected in water samples taken from the fountain.

The second outbreak, which occurred in central England, was linked to a newly opened purpose-built interactive water feature, and involved 122 cases. More than 80% (102) of those infected were under 15 years old. Thirty five (85%) of 41 cases tested for cryptosporidium were positive. Indicator organisms of faecal contamination were identified from the water but no cryptosporidium oocysts were recovered.

These outbreaks raised issues about the lack of national guidance on operation a