Texas: Crypto suspect in child’s death

6-year-old Rosemary Stagaman of Richardson died last Tuesday morning in Dallas County.  Health officials believe that the death was due to a cryptosporidium infection, but the medical examiner is still waiting on toxicology tests to determine the exact cause of her death.  Her family says she tested positive for crypto after swimming in the Greenwood Hills Community Pool.

Tests will take 10 days to confirm
whether cryptosporidium played a part in the child’s death. If it is related, it would be the first death from the waterborne illness in recent memory.

Since June 2008, Dallas County has confirmed 41 cases of crypto. The crypto outbreak in the area began at Burger’s Lake in Fort Worth.  Tarrant County has reported 81 cases of crypto, with 67 of them coming from Burger’s Lake.

All 30 pools of the YMCA of Metro Dallas, along with the city pools, were temporarily closed and hyperchlorinated in an attempt to wipe out the nasty parasite.

Experts are unsure of why there’s been a spike in outbreaks of cryptosporidiosis in recent years.  It could be due to poor hygiene standards practiced by parents.

The crypto parasite has a thick outer shell, making it resistant to normal levels of chlorine.  Available treatments include hyperchlorination and UV filters.  Crypto enters the pool through fecal matter and the infection is especially dangerous to the young an the elderly, as well as the immunocompromised.  Swimmers should wash their hands with warm soap water and also take a shower before entering the pool and after using the bathroom.

Topeka, KS: Poop in Lake Shawnee

Lake Shawnee in Topeka, Kansas recently had a code brown: poop in the lake.  Lakes with swimming areas should have a safe policy in place, but two year lifeguard Gray Botswell was told to go into the water and retrieve the fecal matter with his bare hands.  When he refused, he was asked to go home and not to return. Girlfriend Kristen Whithorn who has been a lifeguard at the lake for four years also walked off the job after she was told that she couldn’t speak to media about her boyfriend’s incident.

It sounds like there was no proper policy in place, so the guys in charge decided that the lifeguards would just have to take care of the problem.  However, removing fecal matter with bare hands isn’t ideal. It’s much better to try to protect the hands somehow or to fish out the poop with a scoop.

The director of parks and recs for Shawnee County, John Knight, says that a new policy is in place for lifeguards at Lake Shawnee if poop is found in the lake again.  The lake water has been tested for E. coli but results have not been released.

Public beaches on the coast are often tested
for fecal coliforms and E. coli.  Both are indicator organisms of the presence of harmful bacteria in the water.  If the levels of bacteria are too high, the swimming area may be closed for a period of time.  But the same system does not exist for many lakes with swimming areas.

When swimming in lakes, oceans or rivers, children should not drink the water they are swimming in.  There is the possibility of human fecal matter and also wildlife fecal matter in the water.

Red, yellow, green inspection disclosure for Columbus pools

Toronto’s DineSafe program of restaurant inspection disclosure adopted the red, yellow, green display signs, along with a website, back in 2001.

Some people don’t like the colors and say a restaurant should either be open or closed – red and green.

In a June 2002 report for the City of Toronto, I wrote,

There are a variety of ways to communication the results of a municipal foodservice or restaurant inspection program including numerical scores, letter grades, colour schemes and a listing of critical and non-critical violations. Summaries and/or detailed inspection reports can be posted on premises, Internet-based web sites or available upon request by fax or mail. There is general agreement that no single approach or communication vehicle is superior to others, that a variety of approaches and systems are used, and that on-going evaluation and research are required to determine overall effectiveness. However, the limitations in various approaches should not preclude continued efforts to enhance restaurant inspection and disclosure systems to meet the overall objectives of a reduction in foodborne illness and enhanced consumer confidence.

How consumers interpret posted inspection results and web sites, along with the most effective delivery mechanism, is yet to be determined. But health officials in Columbus, Ohio, are jumping right in.

Columbus Public Health started placing signs at pools this summer. Green means the pool passed, red means the pool is closed, and yellow or white mean the pool is working on its problems.

The majority of pool closures are because of water chemistry. Columbus Public Health has closed pools 72 times since June, most of them in apartment complexes and hotels. Depending on further tests, some remain closed for as little as a few hours. Others remain closed for weeks.

When they fail, the red sign goes up.

Arizona: Phoenix pool closures due to Cryptosporidium

Phoenix city officials have announced that all city pools will be closed after reports of 35 people who swam at Starlight Pool, including 14 from the pool staff, developing symptoms of cryptosporidium.

The city of Phoenix says that while the water at all of its pools has been tested and "has continued to meet all water quality standards," it is taking extra precautions.  To treat the pools, parks staff is super-chlorinating all of the pools to a level of 40 parts per million of chlorine and maintaining that level of chlorine for 40 hours. The Centers for Disease Control recommends 20 parts per million, but the City of Phoenix is using 40 parts per million to be safe.

Last summer Utah suffered an outbreak of cryptosporidium.  Colorado has also suffered outbreaks.  Hopefully this summer’s outbreak will be quickly contained and taken care of to avoid large numbers of sickness.

And of course, when using the bathroom at the pool, always wash your hands.

Michele Samarya-Timm, guest barfblogger: Poop and pools do not mix

With Memorial Day on the horizon, people are gearing up for summer fun.  As the weather warms, people are anxious to start partaking of warm weather activities, including jumping into the nearest swimming pool. 

Before making that splash into swimming pool waters, we all need to be advocates for a splash of a different kind….the sudsing, scrub and splash of good handwashing…and we all need to make this an essential component of recreational water activities.

Outbreaks from recreational water are more common than we would like, and are especially more common than the average swimmer realizes.    Trace amounts of fecal bacteria can be carried into the pool by our hands as well as by our bottoms.  Chlorine kills germs, but it doesn’t work right away – it takes time.  In fact, without good hygiene practices, even the best-maintained pools can spread illness.  Poop and pools do not mix.

Standard signage at public pools often includes the rule:  “Shower before entering.”  Shouldn’t we also include the rule:  “Wash hands before entering pool?”    Good handwashing practices help prevent so many outbreaks, and we need to keep reinforcing the need to make handwashing as much a part of our daily lives as eating, sleeping, and –yes – having fun in our swimming pools.

Think healthy.  Be healthy.  Wash your hands!

May 19-25 is Recreational Water Illness Prevention Week 2008.  You can find additional information at www.healthyswimming.org

Michéle Samarya-Timm is a Health Educator for the Franklin Township Health Department in New Jersey.  

53 sick with Giardia in Ilkley, U.K.

Health officials urged people suffering symptoms of giardia lamblia to stay away from swimming pools as the number of infected people climbed to 53.

The Ilkley Gazette reports that the investigations continue to focus on Saffron restaurant, Station Plaza, currently closed for refurbishment, after local water supplies were ruled out.

The incubation period for the bug can be up to 25 days, and those who have contracted the illness may not show symptoms until then.

The PCT is still advising anyone with the symptoms of diarrhoea, gas or flatulence, indigestion, nausea, stomach cramps, bloatedness and lethargy, to see their GP. The trust also advises food handlers and health care workers who show the symptoms to seek advice about continuing to work.

Sounds like most people in the U.S. after Thanksgiving yesterday.

Pool poop

Colorado is the latest U.S. Midwest state to track an increase in cryptosporidium infections. The Colorado Department of Public Health and Environment said earlier this week about 50 cases were reported in August, more than four times the usual number.

Today, the U.S. Centers for Disease Control reported that cases of confirmed cryptosporidiosis increased from 3,505 for 2003 to 3,911 for 2004 and to 8,269 for 2005, a 111.4 per cent increase. The report makes excellent reading and contains solid advice.

Just keep your mouth shut and no one will get hurt

As cases of cryptosporidium continue to crop up across the U.S. Midwest, at least two separate outbreaks appear to be emerging in Kansas, with at lease seven sick in Sedgwick County and additional cases reported in Johnson County.

Kansas state epidemiologist Gail Hansen told The Witchita Eagle that people don’t have to quit swimming this weekend, adding,

"Basically, if you’re in a pool, keep your mouth shut. Because that’s really the only way you’ll get it."

Background information is available at the U.S. Centers for Disease Control Healthy Swimming website.

Don’t drink pool poop

There have been numerous outbreaks involving the parasite cryptosporidium linked to swimming pools across the U.S. this year.

Yesterday, Rich Lakin of the Utah Department of Health said that 70 cases have been reported this year in Utah, Salt Lake and Davis Counties, up from the annual average of 40. As well, 3 confirmed cases in Mason City, Iowa led to the closure of two pools.

Larkin was cited as saying the parasite enters pool water through diaper-wearing children, swimmers who do not wash their hands after going to the bathroom and swimmers who do not shower before swimming in public pools. The parasite survives in the water and splashes of water are then ingested by the victims. People who become sick with the parasite remain contagious as long as two weeks after their symptoms disappear, so they need to stay out of public pools even after they feel better.

ABC4 in Utah reported that a quick observation of the Seven Canyons Fountain; a popular water play area for children in Salt Lake City’s Liberty Park revealed a number of children playing in the water while wearing nothing but diapers. Their parents sat next to signs warning pool users not to allow children in diapers into the water. It is this kind of behavior that invites the spread of Cryptosporidium.

Lakin was further quoted as saying, "People need to step up and realize if they do have watery diarrhea they need to stay out of the pools and not spread this any further. Again, it is chlorine resistant and it’s a very difficult disease to kill."