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Most recreational water-based outbreaks caused by Cryptosporidium
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Data show that Cryptosporidium, a chlorine-tolerant parasite, causes the majority of waterborne outbreaks of illness in treated recreational water, according to a recent study published in MMWR.
“Outbreaks of illness associated with recreational water use result from exposure to chemicals or infectious pathogens in recreational water venues that are treated (eg, pools and hot tubs or spas) or untreated (eg, lakes and oceans),” Michele C. Hlavsa, MPH, of the National Center for Emerging and Zoonotic Infectious Diseases at the CDC, and colleagues wrote. “For the years 2011 and 2012, public health officials from 32 states and Puerto Rico reported 90 recreational water-associated outbreaks, which resulted in at least 1,788 cases, 95 hospitalizations, and one death.”
Cryptosporidium caused 54% of the outbreaks created by infectious pathogens, and in treated waterborne illness, it was responsible in 52% of cases. Furthermore, all but one case of Cryptosporidium reported to the CDC’s Waterborne Disease and Outbreak Surveillance System, were contracted in treated recreational water. During the peak summer months, Cryptosporidium accounted for 94% of reported gastrointestinal illness outbreaks.
While 77% of outbreaks reported were associated with treated recreational water, infectious outbreaks also were reported from untreated sources such as lakes and oceans. The most prevalent parasites associated with untreated recreational water were Escherichia coli (33%).
The researchers wrote that the Model Aquatic Health Code’s recommendation to use ultraviolet light or ozone in recreational bodies of water at a high risk for Cryptosporidium be used as a possible means to reduce outbreaks. They also suggested that more research is required to determine the epidemiology of causal parasites.
“In the United States, codes regulating public treated recreational water venues are independently written and enforced by individual state or local agencies; the consequent variation in the codes is a potential barrier to preventing and controlling outbreaks associated with these venues,” Hlavsa and colleagues wrote. – by David Costill
Disclosure: The researchers report no relevant financial disclosures.
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