Don’t poop in pools: when it happens, take action

Posted on October 26, 2015 by Douglas Powell

The incidence of recreational water-associated outbreaks in the United States has significantly increased, driven, at least in part, by outbreaks both caused by Cryptosporidium and associated with treated recreational water venues.

Because of the parasite’s extreme chlorine tolerance, transmission can occur even in well-maintained treated recreational water venues (e.g. pools) and a focal cryptosporidiosis outbreak can evolve into a community-wide outbreak associated with multiple recreational water venues and settings (e.g. childcare facilities).

In August 2004 in Auglaize County, Ohio, multiple cryptosporidiosis cases were identified and anecdotally linked to pool A. Within 5 days of the first case being reported, pool A was hyperchlorinated to achieve 99·9% Cryptosporidium inactivition. A case-control study was launched to epidemiologically ascertain the outbreak source 11 days later. A total of 150 confirmed and probable cases were identified; the temporal distribution of illness onset was peaked, indicating a point-source exposure. Cryptosporidiosis was significantly associated with swimming in pool A (matched odds ratio 121·7, 95% confidence interval 27·4–∞) but not with another venue or setting.

The findings of this investigation suggest that proactive implementation of control measures, when increased Cryptosporidium transmission is detected but before an outbreak source is epidemiologically ascertained, might prevent a focal cryptosporidiosis outbreak from evolving into a community-wide outbreak.

Preventing community-wide transmission of Cryptosporidium: a proactive public health response to a swimming pool-associated outbreak – Auglaize County, Ohio, USA

Epidemiology and Infection / Volume 143 / Issue 16 / December 2015, pp 3459-3467

http://journals.cambridge.org/action/displayAbstract?fromPage=online&aid=10012375&utm_source=Issue_Alert&utm_medium=RSS&utm_campaign=HYG

Crypto cases spike in Tenn.

Posted on September 2, 2015 by Douglas Powell

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

“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.

At least 3 sick with crypto from Kansas pool

Posted on August 21, 2015 by Douglas Powell

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.

“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.

Don’t poop in the pool: Cryptosporidiosis surveillance, US 2011–2012

Posted on May 3, 2015 by Douglas Powell

Problem/Condition: Cryptosporidiosis is a nationally notifiable gastrointestinal illness caused by extremely chlorine-tolerant protozoa of the genus Cryptosporidium.

Reporting Period: 2011–2012.

Description of System: Fifty state and two metropolitan public health agencies voluntarily report cases of cryptosporidiosis through CDC’s National Notifiable Diseases Surveillance System.

Results: For 2011, a total of 9,313 cryptosporidiosis cases (confirmed and nonconfirmed) were reported; for 2012, a total of 8,008 cases were reported; 5.8% and 5.3%, respectively, were associated with a detected outbreak. The rates of reported nonconfirmed cases were 1.0 and 0.9 per 100,000 population in 2011 and 2012, respectively, compared with an average of 0.0 during 1995–2004, and 0.3 during 2005–2010. The highest overall reporting rates were observed in the Midwest; 10 states reported >3.5 cases per 100,000 population in 2011 and in 2012. During 2011–2012, reported cases were highest among children aged 1–4 years (6.6 per 100,000 population), followed for the first time by elderly adults aged ≥80 years (3.4), and 75–79 years (3.3). Overall, cryptosporidiosis rates were higher among females than males during both years. For specific age groups, rates were higher among males than females aged <15 years and higher among females than males aged ≥15 years. Cryptosporidiosis symptom onset increased 4.4 fold during late summer.

Interpretation: Cryptosporidiosis incidence rates remain elevated nationally, and rates of nonconfirmed cases have increased. Rates remain highest in young children, although rates among elderly adults are increasing. Transmission of Cryptosporidium occurs throughout the United States, with increased reporting occurring in Midwestern states. Seasonal onset peaks coincide with the summer recreational water season and might reflect increased use of communal swimming venues.

Public Health Action: Future research is needed to address the evolving epidemiology of cryptosporidiosis cases, with a specific focus on the increase in nonconfirmed cases and increasing incidence rates among elderly adults. National systematic genotyping and subtyping of Cryptosporidium isolates could also help elucidate Cryptosporidium transmission and thus cryptosporidiosis epidemiology in the United States.

Focus on poop: NZ splash parks, AUS child cares, terrible people

Posted on March 24, 2015 by Douglas Powell

A mystery pool pooper – or poopers – has struck again at an Invercargill, NZ swimming pool.

It is the sixth Friday in a row someone has defecated in a swimming pool at the centre.

In the first instance a “smidgen” of faeces was discovered in the leisure pool at the Splash Palace Aquatic Centre about 4.30pm.

Aquatic Centre manager Pete Thompson said swimmers had been removed from the pool and extra chlorine had been added to the water but he believed this incident to be “an unfortunate coincidence”.

“The mode is dissimilar to anything else we have had. It was a very tiny 10 cent piece-size which suggests it probably came out of a baby’s togs,” he said.

He did not know if the poos were deliberate.

“How do you prove something is deliberate unless you catch them in the act?

“I hope whoever this person is, if it’s deliberate, ceases to behave in this manner. It’s disgusting.

In Australia, some childcare centres are sending kids home with their poo and undergarments in labelled plastic bags.

If a kid stocks the lake with brown trout (in their undies), it’s a health and safety issue. There is a chance of cross-contamination in sinks and fecal matter flicking up into a worker’s eyes. So instead of putting it in the teeny tiny toilets, the childcare workers just bag the undies up, log and all, name them and put them with the other packages of joy for the parents to deal with upon pick up.

We should also spare a thought for those who live in warmer climates. There would be some serious fermentation going on in those plastic bags.

And in Washington State an 8-year-old girl received a package of animal poop, perhaps an anonymous form of bullying.

Oddly enough, there are some companies that specialize in these sort of deliveries.

When Jamie Villanueva’s daughter opened the package, she thought someone sent her chocolate ice cream.

“And when I saw it, my heart just sunk,” Villanueva said.

Her worst suspicious however, turned out to be true.

“So I opened it and inside it has feces,” Villanueva said. “A container of feces.”

The container came with a calling card from a company called “I Poop You.” According to its website it specializes in packaging and delivering animal waste as a joke.

“I get it. I have a sense of humor. I think it’s very clever of the company,” Villanueva said. “But it’s really inappropriate with children.”

There are several websites that offer poop delivery and there doesn’t seem to be any specific law against it.

Person with diarrhea most likely source of Crypto at Georgia splash pad

Posted on August 21, 2014 by Douglas Powell

An infected person with diarrhea who used the East Athens Community Park splash pad earlier this month is the likely source for the recent spread of the parasite Cryptosporidium confirmed to have infected at least 16 children, the Athens-Clarke County Leisure Services Department and the Clarke County Health Department determined this week.

According to a statement, the CCHD was alerted Aug. 11 to several cases of children falling ill after attending a private party at the splash pad on Aug. 3. As part of its investigation, the health department contacted Leisure Services Aug. 12 for information and took water samples soon after. Water samples were submitted to the Centers for Disease Control and Prevention the next day, and while final CDC test results are not expected until later this week, the health department confirmed samples taken from infected children indicate Cryptosporidium, commonly known as Crypto.

One of the leading causes of recreational water illness, Crypto is spread when people swallow water recently contaminated by an infected person’s fecal matter.

Once the health department determined Crypto as a probable cause, staff at Leisure Services initiated a precautionary disinfectant treatment at the splash pad prior to reopening it to the public. The treatment used more than twice the amount of chlorine shown by CDC studies to eradicate Crypto and was used for a longer period of time than required by the health department, according to ACC Leisure Services Park Services Division Maintenance Supervisor Keith Kirkland.

Montana pool closed after intentional poop incident

Posted on July 19, 2014 by Douglas Powell

Who poops in a pool? On purpose?

Bogert Pool was closed Thursday after fecal matter was found in the pool that morning.

“To us it appears someone was in the facility overnight,” said Elizabeth Hill, the city’s interim aquatics manager. “It was something that would have been done sometime between us closing last night and opening this morning.”

Staff members discovered “a decent amount” of fecal matter intentionally placed in the pool when they removed covers from the surface, Hill said.

The pool was closed while it was cleaned and more chlorine was added. It is expected to reopen this morning.

“We just follow the standard procedure of letting chlorine do its work in filtering through the system for 24 hours,” Hill said. “Our first priority and concern is just getting the matter out of the water and letting the chlorine start to work.”

‘Wash your bum’ to avoid crypto at pools?

Posted on June 11, 2014 by Douglas Powell

Armchair microbiologist Rick Ledbetter with the Salt Lake County Health Department says that to avoid Cryptosporidium in pools, “Wash your bum! Use plenty of soap, scrub down thoroughly. If you’re a mom of little children, use diapers, wash their bum and make sure you wash your hands before you come back to the pool so again we’re not spreading germs.”

Salt Lake County battled an outbreak of cryptosporidium in 2007 and a spike in cases in 2012. Health officials say it can be easily prevented — if swimmers practice proper hygiene before diving into the pool.

At the Redwood Recreation Center, the pool is closed for five minutes every hour to encourage people to take a bathroom break, rather than going in the pool. Every other hour, the water is tested for bacteria.

The pool’s manager, Avonte King-Henry, said they’re vigilant about germs, knowing how fast crypto can spread.

“Super fast, especially with diarrhea,” he said. “That cloud that happens, it just spreads so fast. It’s so important to get them out and close the pool off.”

Why did UK pool stay open 11 days after diarrhea alert?

Posted on April 10, 2014 by Douglas Powell

The Aqua Vale Swimming Pool remained open for 11 days even though environmental health chiefs raised concerns about a dangerous contamination.

Its two pools were later shut down, on April 3, after tests revealed that cryptosporidium was present in the water.

Parents are demanding answers from Everyone Active, the firm that runs the facility.

One father, whose six-year-old daughter had to visit the hospital after swimming there, said: “My daughter has been really ill for more than a week now after going swimming and we’ve been back and forward to the doctors and even up to the hospital she has been so bad.

“None of her friends and family who don’t swim there are sick and to hear they knew about it is infuriating.

“I’m considering taking her out of her lessons there now.”

Crypto problems around the globe

Posted on September 16, 2013 by Douglas Powell

Both Amy and I are terrible swimmers so being in Australia, we take Sorenne to swimming lessons at a heated outdoor pool in Brisbane on Monday mornings and Friday afternoons.

Last week, they asked all the kids to go to the one end of the pool, while one of the instructors brought out a net-thingy to clean the water. Being interested in vomit protocol, I asked him what was going on. He said kids, including mine, tend to drink the pool, andsometimes they regurgitate if they take in too much water. It wasn’t vomit so much as water coming back up, and the chlorine would take care of it.

OK.

But what about those babies and their poop? He said we then shut down and take additional precautions.

OK.

This place is great, with the attention to the kids and dealing with obnoxious parents (as any coach has too). But lots of other pools still have problems with poop. And cryptosporidium.

In Iowa, there are now 703 cases of cryptosporidium, which is believed linked to pools, but proof has been lacking.

In New Zealand, a Canterbury swimming pool has been closed after a cryptosporidium outbreak that has sickened at least nine.

In Canada, at least nine are sick with crypto linked to a pool near Regina, Sask.

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