Poop, water and illness

A dozen people – mainly kids — got sick after exposure to raw sewage at a splash pad in Traverse City, Mich., an 8-year-old with cryptosporidium had a dump in a Philadelphia pool that forced its closure July 4, at least 90 people were sickened with Shigella after poop-in-poolswimming at Burrillville’s Spring Lake Beach in Rhode Island, and the municipality of Östersund in northern Sweden has been charged for environmental crimes following an outbreak of cryptosporidium which sickened some 30,000 people in the winter of 2010.

In Sweden, prosecutor Lars Magnusson said, “It concerns the fact that they failed to deliver drinking water free from parasites, and this is something that they are required to do under the drinking water regulations.”

The city established the source of the infection in late 2010, tracing the outbreak to a residential building in the Odensala area of the city. It was found that a sewage pipe had been erroneously connected to a rain water pipe.

Östersund has meanwhile disputed the charges, claiming that it had sufficient checks in place.

In Michigan, city workers discovered June 30 at mid-morning that sewage backed up when a pump station failed and pushed raw caddyshack.pool.poop-1sewage into an underground reservoir that feeds sprinklers for the splash pad, rain arc, and mister.

In Rhode Island, beach manager Cheri Hall rolled out the standard of risk communication bullshit, saying, “We’ve never had a problem. I’ve been manager for 22 years and all of our samples always come back good.”

Crypto outbreak in Victoria, Australia pools

Victorians could be in the poo, literally, if they sought relief at the local pool.

Victoria’s chief health officer Dr Rosemary Lester said there has been a three-fold increase in gastro cases after hot weather sparked people seeking to cool off at pool.pooppublic swimming pools.

She urged those who have had diarrhea not to go into a swimming pool for at least 14 days after symptoms had stopped for fear of passing on the bug.

There were 155 Victorian cases of gastro caused by the cryptosporidium parasite last month, three times the February average of 53.

2 sick; some Oregon pools closed after links with Cryptosporidium

The pools operated by the Sunset Empire Park and Recreation District were closed Thursday after the district received two reports from pool patrons that they suffered from a parasite that can cause diarrhea.

Following a treatment that will kill cryptosporidium, the pool will re-open Friday morning, said General Manager Justin Cutler.

One of the cases of cryptosporidium has been confirmed by a lab, but the other case has not yet been confirmed.

Cutler voluntarily closed the district’s two swimming pools and the therapy pool after he and Aquatic Supervisor Genesee Dennis spoke with the Clatsop County Public Health Department and the Oregon Health Authority.

To kill the parasite, the district will hyper-chlorinate the pool, which is the procedure recommended by the federal Centers for Disease Control and Prevention.

Don’t poop in the pool; 20 sickened; Welsh pool reopens after cryptosporidiosis cases

A swimming pool in Newport, Wales, where the Powell name is vaguely recognized, has reopened after 20 people were infected with cryptosporidium last month.

Newport Centre swimming pool was closed by the city council after the cases of cryptosporidium were confirmed.

The council said it was “100% satisfied everything is in order” after the pool was drained and re-grouted.

Public Health Wales (PHW) has urged swimmers to adopt better hygiene after seeing a rise in cases of the bug, which can survive chlorine in pools.

Meanwhile the BBC also reported a restaurant chain has apologized for accidentally serving whiskey to a two-year-old.

Frankie and Benny’s said on Thursday it was extremely sorry for Saturday’s incident and is looking into what systems need to be put in place to ensure that it does not happen again.

64 sickened; UK water park set to re-open after norovirus outbreak

Sickness-stricken Bretton Water Park will reopen to the public on Saturday – subject to getting a clean bill of health in final tests.

The £300,000 water park was abruptly closed four weeks ago after parents began reporting their children had been ill after playing at the complex.

Peterborough City Council closed the park to carry out tests and cleaning and revealed an outbreak of norovirus had caused 64 children to fall sick with diarrhoea and vomiting.

New facilities have now been installed at the park in a bid to prevent another outbreak, including setting up a drinking fountain, which had not been a feature of the park, plus improved baby changing and toilet facilities.

Signs have been put up urging people not to drink water in which children play and to wash their hands after changing their babies’ nappies.

Kathie Lee pees in the shower?

Following U.S. Olympic swimmer Ryan Locte’s admission that he pees in the pool, the train wreck that is Kathie Lee and Hoda on NBC decided to share their thoughts on the issue – 10 days later.

Lochte had originally said, "There’s something about getting into chlorine water that you just automatically go."

Wannabe microbiologist Kathie Lee chimed in this morning that, "chlorine doesn’t take care of ALL the germs.”

"Don’t you pee in the shower?" asked Hoda.

KLG admits that she does, but only because she’s concerned about the earth, and doing so saves a flush.

 
 
 

19 sick in apparent Crypto outbreak in Idaho

Within the past 10 days the Central District Health Department has seen 19 cases of cryptosporidiosis. During a normal year the health district might see 10 cases.

The Idaho Statesman reports the health department has advised area swimming pool operators of the situation and many responded by hyper-chlorinating the pools, a technique that kills the parasite. Still, those efforts can be rendered ineffective when people carrying the disease use recreational waters.

“We know the hot weather is driving people to seek relief in area pools, lakes and rivers,” Kimberly Link, Program Manager for Communicable Disease Control at CDHD, said in a press release. “If you’ve been ill with diarrhea we can’t emphasize enough how important it is to stay out of recreational waters for at least two weeks after your symptoms resolve.”

Pools with poop in them: outbreaks in New Zealand and UK linked to recreational water venues

Illnesses at pools and spray parks happen often because kids, like mine, seem to lose control of their bodily functions as they get excited by the water – and then poop comes out. Or maybe (also like my kids) excess poop from poor post-bathroom wiping hangs around in swim trunks and is washed away by the water.

Regardless of how it gets there, the poop might have pathogens in it and can overwhelm a facility’s sanitizing and filtrations systems. A few years ago a bunch of Utah recreational water venues (wading pools and spray parks) became the source of multiple outbreaks resulting in more than 5700 illnesses.

According to the BBC, a norovirus outbreak has closed Bretton Water Park in Peterborough (that’s in the UK, not Ontario).

A city council spokesman said its environmental health officers had confirmed the presence of the virus.

He said the park would remain closed until further tests were completed.

Initial checks revealed the council-owned park’s maintenance and cleaning procedures were up-to-date.

"It is highly probable that the virus originated with a child or children attending the park who were already infected," the spokesman added.

The Dominion Post reports that pool-visiting Kiwis are also dealing with their own increase of Cryptosporidia-linked illnesses, which has oocysts that isn’t easily inactivated with chlorine.

About half of the recent cases reported to public health have had contact with swimming pools throughout the region, but particularly Wellington Regional Aquatic Centre in Kilbirnie and the Arena Aquatic Centre in Porirua.

Regional Public Health is also working with pool managers to ensure systems are in place to reduce the risk.
The highest number of cases has been in the under-5 age group and it is important to ensure tight-fitting togs are worn by this group, Dr McKenzie said.

Porirua and Wellington city councils said there were signs reminding people not to swim after being sick and to shower before entering the pool.

Although modern treatment systems can remove the bug, people may come into contact with it before it’s removed by filters.

All pools in the region have been alerted to the increased number of cryptosporidium cases in the community.
 

Going public: Iowa law shields targets of norovirus probe

In March 2012, dozens of people were apparently sickened with norovirus after visiting an eastern Iowa swim facility.

The Quad-City Times has been trying to name the facility, but an Iowa law allows public health officials to keep secret the name of a business involved in a disease investigation; this, say some of those sickened, puts business interests before public safety.

Johnson County and state health officials won’t release the name of the facility despite dozens being sickened, citing state law that shields businesses that have cleaned up their act after an outbreak. They also believe there is no ongoing public health risk.

“I just wish the name would be out there, so others could know about this happening at a family attraction,” said Courtney Evans of Blue Grass, Iowa. Evans’ two young boys and her husband fell ill from norovirus after a visit to the swim facility.

The Quad-City Times and The Gazette of Cedar Rapids jointly filed a complaint with the Iowa Office of Citizens’ Aide about the health department’s refusal to release the name of the swim facility or provide key details about the investigation, such as dates of when people got sick. The Citizens’ Aide ruled public health officials followed the law.

“The problem is that I have to obey the law,” said State Epidemiologist Patricia Quinlisk. “If people feel that is incorrect, they have to talk with their legislators (about changing the law).”

Some Iowa legislators say the current law might go too far.

“We have a duty to inform the public that this has occurred and that it’s been remedied,” said Rep. Rick Olson, D-Des Moines. “I want to keep my kids healthy.”

Rep. Vicki Lensing, D-Iowa City, said the public needs accurate information from the health department, not speculation. “It would seem like after an investigation is concluded that information could be released,” she said.

Records obtained by the Quad-City Times and the Gazette through an Open Records request with the Johnson County Public Health Department indicate more than 30 people contracted norovirus after visiting the swim facility in March. Johnson County, which handled the facility investigation, inspects pools in Johnson, Iowa, Louisa and Muscatine counties.

“Early this morning, all family members began vomiting and have experienced diarrhea,” states a Johnson County record-of-contact form. The complainant “contacted the family members they traveled with, and all are experiencing the same symptoms.”

“…the complainant believes that illnesses derived from exposure to pool water. The two individuals that did not enter the pool water have not become sick,” the report shows.

According to the records, which include handwritten notes, reports and emails, chemical tests leading up to the outbreak showed the pools had little or no chlorine, which kills pathogens that can cause disease. Pool management told officials a chlorine feeder was plugged.

Iowa Code Section 139A.3 states “information contained in the report may be reported in public health records in a manner which prevents the identification of any person or business named in the report.” This means public health officials can tell the public about the outbreak only in a generic way that doesn’t identify the business.

Before Quinlisk decides to keep investigation details secret she asks herself one question: Would she take her own child to the facility?

In this case, the answer was yes, she said.

Not every state gives businesses the same protection as individuals when it comes to disease reports. Minnesota, for example, only keeps the health records of individuals private, not businesses.

“If we have an outbreak at Joe’s Diner, that’s public,” said Richard Danila, deputy Minnesota epidemiologist.

The Illinois Department of Public Health has a policy to keep confidential the name of a business involved in a disease investigation, but the information can be obtained through open records requests after the investigation is concluded, said Department spokeswoman Melaney Arnold.

An accompanying editorial says several Quad-City area families sickened by the virus contacted us and were referred by Scott County health officials to the Johnson County Health Department in late March. We followed up, pursuing public records to confirm the account.

We were not seeking the names of the victims. The victims came to us. They spoke on the record.

So, yes, we know what business was investigated.

But we need public officials verifying the investigation to be able to report this responsibly and without fear of liability from a possible lawsuit since the origin of the norovirus has not been proven, the business complied with orders to take corrective action, and there was no perceived ongoing public health risk.

If I wanted to take my child to the facility, I would want to know their track-record and whether they could adequately manage things like chlorine levels, or whether I should bring my own pH strips.

Just like I want to know the track record of a restaurant before I spend my money there.

It’s not OK to swim with diarrhea; safe swimming in Utah after cryptosporidiosis outbreak, 2008–2009, 5,700 sickened

It matters what’s done after people barf. Same if people have diarrhea – in a pool.

During the summer of 2007, almost 6,000 people in Utah started barfing from Cryptosporidium, transmitted via the barfblog fav, fecal-oral route

The U.S. Centers for Disease Control reports that of 1,506 interviewed patients with laboratory-confirmed cryptosporidiosis, 1,209 (80%) reported swimming in at least one of approximately 450 recreational water venues during their potential 14-day incubation period.

Cryptosporidium is extremely chlorine-tolerant, and secondary or supplemental disinfection with ultraviolet light or ozone can control but not prevent outbreaks. Because swimmers are the primary source of Cryptosporidium contamination, healthy swimming campaigns are needed to increase awareness and practice of healthy swimming behaviors, especially not swimming while ill with diarrhea (i.e., swimming while ill with diarrhea can lead to gross contamination of recreational water). Before the 2008 summer swimming season, Utah public health agencies launched a multimedia healthy swimming campaign. To assess knowledge of healthy swimming, a survey of Utah residents was conducted during July–September 2008. The results of that survey found that 96.1% of respondents correctly indicated that "it is not OK to swim if you have diarrhea."

In a separate national survey in 2009, 100% of Utah residents but only 78.4% of residents of other states correctly indicated that "not swimming while ill with diarrhea protects others from recreational water illnesses (RWIs)." No recreational water–associated outbreaks were detected in Utah during 2008–2011. The healthy swimming campaign, as part of a multipronged prevention effort, might have helped prevent recreational water–associated outbreaks of cryptosporidiosis in Utah.

Before the 2008 summer swimming season, Utah’s state and local public health agencies teamed with community partners to control recreational water–associated transmission of Cryptosporidium. For example, the Salt Lake Valley Health Department (SLVHD) collaborated with pool operators to establish fecal incident–response protocols and install secondary or supplement disinfection systems to inactivate Cryptosporidium at 75 treated recreational water venues.

SLVHD also collaborated with the Utah Department of Health and diagnostic laboratories to expedite reporting of cryptosporidiosis cases to public health authorities. To engage the public in prevention, SLVHD led efforts to disseminate healthy swimming messages via a website, two television advertisements, public service radio announcements, and posters at pools (e.g., "A Swimming Pool is Like a Community Bathtub"). In addition, targeted messages were disseminated to schools, competitive water sports teams, and licensed childcare facilities. SLVHD also conducted a press conference during Recreational Water Illness and Injury Prevention Week, which is held each year the week before the Memorial Day holiday.

The complete report is available at http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6119a5.htm?s_cid=mm6119a5_x.