Cryptosporidium outbreaks in Ohio, Arizona linked to recreational water

Hundreds of people have been infected in community outbreaks of Cryptosporidium linked to recreational water facilities in Ohio and Arizona, according to public health officials.

In Ohio, more than 200 people have been sickened by the chlorine-tolerant parasite in Columbus, Franklin and Delaware counties, with many of the patients reporting multiple exposures at numerous facilities, according to Columbus Public Health (CPH).

The number of cases is larger than the last 4 years combined, the CPH said.

Meanwhile, more than 100 patients have been infected by Cryptosporidium parvum in Maricopa County, Arizona, according to the Maricopa County Department of Public Health (DPH), which said it has notified more than 20 facilities about possible exposure.

Cryptosporidium, which can survive for long periods outside of the body, is responsible for most waterborne disease outbreaks in the United States and often is associated with health violations at public pools. The parasite causes the diarrheal disease cryptosporidiosis.

Patients are commonly infected by swallowing water contaminated with fecal matter containing the parasite, such as while they are swimming. The most common symptom is watery diarrhea that begins generally 1 week after exposure.

Cryptosporidium parvum in a stool smear micrograph.

Source: CDC/ Peter Drotman

“Unfortunately, there is no reliable test for [Cryptosporidium] in water, so there is no way to know which pools are contaminated with this parasite,” Rebecca Sunenshine, MD, medical director for the DPH, said in a statement.

“Right now, this outbreak is communitywide, and there is an increased risk to those swimming at recreational water facilities. The most important thing the public can do to prevent spread of this disease is to stay out of the water if you have diarrhea, until at least 2 weeks after symptoms resolve.”

Swimmers also are urged to take showers before and after swimming, to avoid swallowing water while they swim and to wash their hands thoroughly with soap and water before preparing food and after going to the bathroom or changing a diaper. Alcohol-based hand sanitizer does not work against Cryptosporidium, according to the CPH.

Further, children with diarrhea should be kept out of child care facilities while their symptoms persist.

Health departments in both states are recommending that any facilities that may have been exposed to infected swimmers follow CDC guidelines for decontamination. – by Gerard Gallagher

Disclosure: Sunenshine is medical director for the Maricopa County Department of Public Health.