3 sick: Crypto outbreak in Tenn.

Some Scott County parents are on edge after two local children have been hospitalized with a gastrointestinal illness caused by a common microscopic parasite.

crypto.Public-Pool-Dangers-800Cryptosporidiosis is being blamed for at least three illnesses in Scott County children this week, creating a sense of alarm on social media as news of their sickness has spread.

The first local child to be admitted to the hospital was a young girl from Oneida. Initially fearing an appendicitis attack, her mother, Tracy Shoopman, drove her to East Tennessee Children’s Hospital in Knoxville on Tuesday. There, doctors admitted her for testing, and on Wednesday confirmed a diagnosis of cryptosporidiosis.

The same day, another child from Scott County — a student at Huntsville Elementary School — was also diagnosed with cryptosporidiosis by doctors after being hospitalized at Children’s Hospital. Her mother, Mindy Wagaman, told the Independent Herald that her daughter was hospitalized late Tuesday night after she started vomiting blood.

Both children remained hospitalized Thursday.

Also on Wednesday, a third child, also a student at Huntsville Elementary, was diagnosed with the illness by Children’s Hospital doctors. However, she was treated in the hospital’s emergency room and released.

A fourth child, a student at Huntsville, was being tested for the illness.

At first glance, there was no apparent connection between the four cases of the illness — which health officials say is most commonly caught from contaminated water sources. According to the CDC, the illness can be caught by swimming in contaminated bodies of water, which can include streams or lakes but can also include treated water sources, such as pools or splash pads. Because the parasite is resistant to common water treatment methods, it can survive in pools after being unknowingly introduced to the water by someone who is sick.

Knoxville’s WBIR reported last week that East Tennessee health officials are seeing a major spike in crypto cases this year. The story quoted Darci Hodge, Children’s Hospital’s director of quality and infection control, as saying the hospital has confirmed 29 cases of crypto this year — far higher than the next highest single-year number of five cases.

Crypto cases spike in Tenn.

East Tennessee health officials are seeing a major spike in reported cryptosporidium cases, a water-dwelling parasite that most commonly contaminates public water sources.

diaper.pool“It is a parasite that lives in the bowels of people who are infected with it,” said Darci Hodge, director of quality and infection control at East Tennessee Children’s Hospital. “It can live in animals and it can be passed on by people or animals in living water for a short period of time, and that’s often how you and I will get it.”

Hodge said Children’s Hospital confirmed 29 reported cases of cryptosporidium this year, the biggest number of cases it’s seen in years.

Within the past five years, the second highest number of reported cases of the disease at Children’s Hospital was only five.

“It was significant enough because the Health Department and we, here, really talked a lot about it because it was odd to see so many cases,” Hodge said.

The Knox County Health Department has 34 reported cases on record this year.

“It only takes one person with this illness to have a little spill in the pool, you might say,” said Connie Cronley, an epidemiology nurse at the Health Department. “It could infect lots of folks.”

Cronley said the parasite comes with many symptoms, but not all of them may appear serious enough to contact a doctor.

Crypto compensation: United Utilities faces £15m bill

United Utilities accepts it is facing a colossal compensation bill for the first cryptosporidium contamination of drinking water in the North West UK this century.

poop-in-poolBut the company has reassured consumers the payouts – estimated already at £15m and mounting – will not be offset by a rise in water bills.

“Bills will not increase to cover the cost of compensation,” insisted a spokesman.

“This cost will be borne by the company.”

With more than 300,000 households and businesses hit by the scare, now into its third week, United Utilities has declined to put a figure on how much the crypto invasion will amount to.

But in a recent case in Bolton, where consumers had to boil their drinking water for five days after supply problems, the company paid out £15 per house to cover the cost.

With the inconvenience to customers in Preston, South Ribble, Chorley, the Fylde Coast and villages like Samlesbury, Mellor and Mellor Brook at least three times that already, claims could amount to at least £45 a household, or £13.5m in total.

With businesses set to lodge much higher demands for compensation after providing bottled water to all employees during the scare – BAE Systems is thought to have spent more than £100,000 already on keeping its 10,000-strong workforce in Lancashire hydrated – the bill is estimated to be rising by £1m a day.

At least 3 sick with crypto from Kansas pool

Johnson County is taking some protective measures at specific pools after multiple residents were recently diagnosed with cryptosporidiosis, the Johnson County Department of Health and Environment (JCDHE) said in a news release.

caddyshack.pool.poop-1“At this time, we have three confirmed cases and are tracking a few more possible cases in the community,” said Lougene Marsh, JCDHE director, in the news release. “We encourage everyone to wash their hands frequently and ensure their children take frequent breaks from the pool to prevent accidents.”

JCDHE is working closely with pool operators in Overland Park and Shawnee for cautionary measures to close and/or treat swimming pools with which infected individuals had contact.

UV equipment brought in to kill off crypto

Water bosses are bringing in ultra violet ray equipment to help kill off cryptosporidium in the water supply which has affected over 300,000 Lancashire residents.

United Utilities is to use the portable UV rigs at three sites on the Fylde which it says should make a difference and help kill off cryptosporidium. The equipment, which consists of powerful fluorescent UV lights shining in a tank through which water passes, will be used on water leaving the Warbreck, Weeton and Westby service reservoir outlets.

The UV C rays attack the DNA of the parasite killing it rapidly. It also works on other potentially harmful microbes such as e-coli. John Butcher, UU’s regional supplies manager, said: “Cryoptosporidium is very vulnerable to this UV C light. The normal treatment process at Franklaw deals with it and the water coming out of there is clear, but we have brought this in to deal with the water now going through the system.”

Gary Dixon UU’s customer services director said they had identified a possible source for the contamination but had to wait for the Drinking Water Inspectorate’s official report.

Crypto in UK water supply, 300K homes affected

More than 300,000 homes in Lancashire have been told that they may have to boil their drinking water after a microbial parasite was discovered in their supply.

Lancashire.waterUnited Utilities, which provides water and sewage services to around seven million people in North West England, found traces of the parasite cryptosporidium at Franklaw water treatment works near Preston, during routine tests.

Cryptosporidium can cause gastrointestinal illness with diarrhoea in humans. The parasite can cause acute, short-term infections, but symptoms can become severe in children and people with low immune systems.

The alert was initially issued by United Utilities last Thursday but the company have advised customers in Blackpool, Chorley, Fylde, Preston, South Ribble and Wyre to continue carrying out precautions till at least Wednesday as “low” levels of the parasite still remain in the supply.

Dead calves source of cryptosporidiosis in veterinary medicine students — Philadelphia

My former vet colleague partner in hand washing studies and I used to chat about the microbial risks faced by veterinarian students when we were both at Kansas State University and, based on anecdotal observational studies, we were surprised students sucked at hand washing.

crypto1Especially after dealing with animals.

The U.S. Centers for Disease Control and Prevention reports that on February 20, 2015, a northeastern U.S. university’s student health center was notified of five veterinary medicine students with gastrointestinal symptoms. An investigation was conducted to establish the existence of an outbreak, determine the etiology, evaluate risk factors, and recommend control measures.

All five students had attended a training session at the university’s bovine obstetrics laboratory on February 13, which included the handling of two euthanized calves. Patient symptoms, date of onset, and history of calf exposure suggested cryptosporidiosis. Infection with Cryptosporidium, a protozoa that causes watery diarrhea and is transmitted by infectious oocysts via the fecal-oral route (1), is common among calves (2). Symptoms in humans typically begin 7 days (range = 2–10 days) after infection and include intermittent abdominal cramps, nausea, vomiting, fever, and weight loss, lasting approximately 1–2 weeks (3).

Two calves used in the training sessions had been euthanized and frozen at -1.4°F (-17.0°C) on February 11. Approximately 28 hours later, the calves were thawed and detergent-washed by laboratory staff in accordance with standard protocols. Necropsies were performed on both animals on February 23, and revealed Cryptosporidium oocysts on an acid-fast stain of an intestine smear from one of the calves.

Interviews revealed that 22 students had attended the training session. Sixteen students reported symptoms, including diarrhea (13 students), abdominal cramps (13), nausea (12), fatigue (eight), vomiting (seven), anorexia (five), headache (four), and chills or sweats (four), lasting 2–10 days. Among the 16 symptomatic students, the median age was 25 years (range = 24–30 years), and 13 were female.

Four symptomatic students submitted stool specimens. One case was confirmed by detection of Cryptosporidium oocysts using direct fluorescent antibody testing; the other 15 were classified as probable cases, based on CDC case definitions (1). To account for the possibility of other infectious etiologies, stool specimens were also tested for Giardia, Cyclospora cayetanensis, Isospora, Salmonella, Shigella, Escherichia coli, and Campylobacter; all tests were negative. The positive acid-fast stain from one of the calves and one of the students with a confirmed case implicated the obstetrics laboratory as the source of the outbreak.

The bovine obstetrics laboratory personal protective equipment (PPE) protocol includes donning of gloves and coveralls before animal handling and cleaning boots and doffing of gloves and coveralls after animal handling, followed by 30 seconds of hand washing with warm water and soap. Face protection is not included in PPE protocols for this laboratory. Although all of the 22 students wore gloves during the training session, the number of students who removed their coveralls or washed their hands afterwards is unknown. At least four of the symptomatic students reported that they did not immediately doff their coveralls.

Cryptosporidiosis outbreaks have been reported among veterinary students (4), usually through contact with infected calves, and are associated with lapses in hygiene (5). In this outbreak, students were infected through contact with euthanized calves that had been frozen and thawed before the training session. Cryptosporidium oocysts can survive various environmental pressures, including extended exposures at temperatures as low as -7.6°F (-22.0°C) for >700 hours (6). This cluster highlights the importance of appropriate hygiene and proper animal cadaver handling. Since the likelihood of calves being infected with cryptosporidiosis is high, veterinary medical institutions should ensure that recommendations for PPE and proper hygiene techniques for students and staff are fully implemented.

1University of Pennsylvania.

Corresponding author: Lauren N. Drinkard, drinkard@upenn.edu, 215-746-0806.


CDC. National Notifiable Diseases Surveillance System (NNDSS): Cryptosporidiosis (Cryptosporidium spp.) 2012 case definition. Available at http://wwwn.cdc.gov/nndss/conditions/cryptosporidiosis/case-definition/2012.

Santín M, Trout JM, Xiao L, Zhou L, Greiner E, Fayer R. Prevalence and age-related variation of Cryptosporidium species and genotypes in dairy calves. Vet Parasitol 2004;122:103–17.

CDC. Parasites: Cryptosporidium (also known as “Crypto”). Available at http://www.cdc.gov/parasites/crypto/illness.html.

Preiser G, Preiser L, Madeo L. An outbreak of cryptosporidiosis among veterinary science students who work with calves. J Am Coll Health 2003;51:213–5.

Gait R, Soutar RH, Hanson M, Fraser C, Chalmers R. Outbreak of cryptosporidiosis among veterinary students. Vet Rec 2008;162:843–5.

Robertson LJ, Campbell AT, Smith HV. Survival of Cryptosporidium parvum oocysts under various environmental pressures. Appl Environ Microbiol 1992;58:3494–500.

2 sick from crypto linked to raw milk in Tenn

The Tennessee Department of Health is investigating multiple cases of residents who fell ill from consuming raw milk.

colbert.raw.milkThe health department launched the investigation after confirming two Chattanooga-area cases of cryptosporidiosis, a gastrointestinal disease from a parasite that lurks in contaminated water or unpasteurized milk. Both cases are linked to a dairy cow share program, which the state legalized in 2009, allowing greater access to raw milk.

“Consuming raw milk in the belief it’s healthier than pasteurized milk is a perilous risk that shakes off the possibility of a range of serious and occasionally fatal illnesses for the individuals and anyone they share it with,” John Dreyzehne, TDH commissioner, said in a news release. “Our best choice for healthy, nutritious milk is the pasteurized kind. Even if one believes there are health benefits, an upside, is it worth gambling on the downside risk of a serious illness, especially in a child?”

Since the state legalized cow share programs, reports have increased of disease and outbreaks linked to raw milk consumption. In 2013, nine Tennessee children became extremely sick with E. coli after drinking raw milk. Five of those required hospitalization and three developed severe, life-threatening kidney problems.

Crypto and giardia take $5 billion bite out of NYC

Two tiny organisms present a big problem for New York City’s water department: cryptosporidium and giardia.

crypto.waterThe city has spent $5 billion over the last five years combatting these organisms, which can cause fatal illnesses in the sick and elderly and gastrointestinal problems for those with healthy immune systems.

“In the city’s east-of-Hudson Croton watershed, where development has encroached on watershed land, federal regulators forced the city to filter the water; hence the $3 billion Croton filtration plant that recently opened,” City Limits reported.

The plant itself was a giant, politically fraught project.

40 sick in Sweden from Cryptosporidium at kosläpp (letting the cows out)

Apparently it’s a thing in Sweden to go and watch the cows being let out; so is Cryptosporidium.

kosläppSome 40 people have fallen ill after being infected by Cryptosporidium, reports Skovde News.

It is associated with kosläpp, a Hjo and one in Skövde, two outbreaks occurred in May.

Infectious disease doctors in the area now warning parents to let young children petting calves at kosläpp and immediately afterwards eat food or refreshments, writes Skovde News. Then they risk getting upset stomach with abdominal pain and diarrhea.