Last year saw some of the worst recreational water
illness outbreaks on record. And that could be just a taste
of things to come especially when it comes to the
virulent bug, cryptosporidium.
In fact, crypto infections have increased
substantially, jumping 41 percent in 2005 and 24 percent in
2006, according to preliminary reports from the Centers for
Disease Control and Prevention.
The 2007 figures are still incomplete, but several
states saw unusually large crypto outbreaks,
including Utah, which reported more than 1,700 cases, vs. a
typical year of approximately 30. The outbreak was so
severe that officials took the extraordinary step of
banning children under age 5 from pools.
Idaho, which has averaged approximately 23 cases
annually since 1995 and last year, reported about 230. And
South Dakota recorded more than 100 compared with a
five-year average of 31 cases per year.
This increase in infections likely resulted in an
increase in detected outbreaks. CDC logged an average of
five crypto outbreaks per year, but already has
received 29 outbreak reports for 2007.
?We are, indeed, seeing an increase and there
are several factors for this trend,? said Michael
Beach epidemiologist, acting associate director for Healthy
Water at the National Center for Zoonotic, Vector-Borne and
Enteric Diseases at the CDC.
According to Beach and his colleagues at the CDC, the
increase in the number of reported cases of RWIs may be due
to a number of factors.
?There are a lot of variables as to why we might
be seeing more outbreaks,? agreed Diane Raccasi,
epidemiologist at the Utah Department of Health, Salt Lake
City. ?In 2007 we had a much hotter summer than
normal, so we had more swimmers in recreational water and
Another reason for the increase in reported cases may be
fact that Nitazoxanide (brand name Alinia), the first drug
approved to treat adults with crypto, became available in
2004. The availability of the treatment probably has caused
more health-care providers to test patients suffering with
severe diarrhea for the parasite.
Increased awareness also might be playing a part because
more health-care providers and public health departments
consider patients? last dip in the pool, rather
than their last meal. And when a crypto case in
confirmed, more public health agencies may be opening
But regardless of the causes, Beach and Raccasi agree
that operators will have to work with the public to prevent
?What we learned from our outbreak is that more
than anything, public responsibility has to be
key,? Raccasi said. ?I think operators are
going to have to become more vigilant in changing behavior
patterns, educating patrons and enforcing good practices
such as showering before entering. They may have to also
look at more mechanical solutions, such as additional
filtration in the pool and limiting the bather load
depending on the capabilities of the filtration