KDHE INVESTIGATES CRYPTOSPORIDIOSIS OUTBREAK IN
SOUTHWEST KANSAS

A cryptosporidiosis outbreak is being investigated in Ford, Gray and surrounding counties in southwest Kansas. The Kansas Department of Health and Environment (KDHE), both local health departments, and the Ford County Planning, Zoning and Environmental Health Department have identified a water slide in Ford County as the common location that all of the individuals visited prior to becoming ill late last week. Of 51 people who visited the Water Slide in Dodge City, 39 became ill. The water at the slide has been treated with high levels of chlorine to kill the parasite.

Cryptosporidiosis is a disease caused by microscopic parasites. It can be passed from person-to-person, through recreational waters and through food. Symptoms include diarrhea, dehydration, weigh loss, stomach cramps or pain, fever, nausea and vomiting. Some people have no symptoms. Symptoms generally begin two to 10 days after becoming infected and can last one to two weeks.

Cryptosporidiosis is very contagious and as swimmers travel throughout the state for competitions, and pool staff and lifeguards work at multiple recreational water facilities in different areas, it is important to take precautions against becoming infected, or if sick, against infecting others.

"If you have diarrhea, it's important that you avoid swimming for up to two weeks after the symptoms subside, to ensure you don't pass the illness on to others," said KDHE State Epidemiologist Gail Hansen. "This simple action can prevent the spread of cryptosporidiosis to many other people."

KDHE has contacted all health departments in Kansas about this outbreak and provided information regarding testing for cryptosporidiosis.

Once the parasite is established in the community, local transmission could occur through person-to-person contact, day care facilities, swimming and wading pools or recreational waters.

In 2003, a cryptosporidiosis outbreak in northeast Kansas resulted in new recommendations related to pools including increasing education of pool staff, swimmers and parents, maintaining the pool water quality, implementing safety programs for larger groups, evaluating hygiene practices, posting health information, and developing an outbreak/emergency response plan.

KDHE strongly recommends the following precautions to prevent further spread of the disease:

Hygiene:

• Wash hands thoroughly, especially after using the bathroom and before preparing food.
• Wash hands after changing diapers, or after caring for someone with diarrhea.

Day cares:

• It is recommended day cares enforce strict adherence to hygiene procedures and exclusion policies for children with diarrhea. Children with diarrhea should not be dropped off at day cares. Employees with diarrhea should be excluded from work.
• Wash hands after every diaper change, even if you are wearing gloves.
• Assist children with hand washing.

Swimming:

• Do not swim when ill with diarrhea or for two weeks after the end of diarrhea. Cryptosporidium bacteria are chlorine-resistant.
• Do not swallow pool/lake/river water.
• Practice good hygiene (i.e. shower before swimming).

Restaurants:

• Employees should carefully wash hands after using the bathroom, before preparing food.
• Employees with diarrhea should be excluded from food preparation activities.

Drinking Water:

• Avoid drinking untreated water from shallow wells, lakes, rivers, springs, ponds and streams

High Risk Individuals:

• People with weakened immune systems (such as those undergoing cancer treatment, HIV/AIDS, organ transplant recipients and/or receiving steroid treatment) should be vigilant in following prevention guidelines as Cryptosporidium can cause life threatening, chronic diarrhea in persons with weakened immune systems.
• Persons ill with cryptosporidiosis should avoid close personal contact with people who have weakened immune systems (see above). If people with weakened immune systems become infected, cryptosporidiosis can be a life-threatening disease.
• Children and pregnant women should drink plenty of fluids to avoid the dehydration from diarrhea caused by Cryptosporidium. They should consult a health care provider for information on preventing dehydration.

Summary:

Last year, 31 cases of confirmed cryptosporidiosis were reported in Kansas. In 2003 in Kansas, 174 cases of cryptosporidiosis were reported, an increase of more than 10 times that of previous years. In 2002, 16 cases were reported statewide in Kansas, according to the Reportable Diseases in Kansas 2003 Summary. The three-year media for 2000-2002 was four cases. The report can be viewed at

To learn more about healthy swimming, please visit www.cdc.gov/healthyswimming/.