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Nearly one-third of recreational water-related disease outbreaks linked to pools
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Of the 81 recreational water-related disease outbreaks reported for 2009-2010, 30% were caused by Cryptosporidium and were linked to treated recreational water facilities such as pools, according to findings published in MMWR.
The incidence of outbreaks for 2009-2010 was obtained through reports from public health officials from 28 states and Puerto Rico. Of the 1,326 outbreaks reported, at least 62 (5%) patients were hospitalized. There were no outbreak-related deaths.
The report found that, overall, the number of outbreaks reported for a given year (range: 6-84 outbreaks) has significantly increased since recreational water-associated disease outbreak reporting in began 1978 (P<.001). Causation was determined for 49 (60%) of the 2009-2010 outbreaks, and in 27 outbreaks (55%), the cause was Cryptosporidium. Additionally, the number of Cryptosporidium outbreaks in 2009-2010 (0-40 outbreaks) has significantly increased since 1988, the year the first Cryptosporidium outbreak was identified in US-treated recreational water (P<.001).
This increase in Cryptosporidium outbreaks may account in part for the significant overall increase in recreational water-related disease outbreaks (P<.001), according to the researchers.
Of the 81 outbreaks reported, 57 (70%) occurred in treated recreational water. These outbreaks accounted for 78% all outbreak cases (at least 1,030 cases) and 65% (n=40) of hospitalizations.
More than half of these 57 outbreaks in treated water were linked to hotel (33%) or water park (25%) environments. Outbreaks related to a hotel environment that predominantly occurred in February, March or April (58%) involved dermatologic illness either known or suspected to be caused by Pseudomonas aeruginosa (47%) and were associated with a hot tub or spa (58%).
The report advocated compliance with the Model Aquatic Health Code (MAHC), a guidance document to be released this summer. The MAHC is designed to provide uniformity in swimming pool and spa regulations.
“Guidance to prevent and control recreational water-associated disease outbreaks, such as the MAHC, can be optimized when directed by national outbreak data as well as laboratory data and environmental data,” the researchers wrote.
Disclosure: The researchers report no relevant financial disclosures.
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