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Outbreak of cryptosporidiosis at a California waterpark: employee and patron roles and the long road towards prevention

Published online by Cambridge University Press:  26 June 2006

C. WHEELER
Affiliation:
Epidemic Intelligence Service assigned to the California Department of Health Services, Centers for Disease Control and Prevention, Atlanta, GA, USA
D. J. VUGIA
Affiliation:
Infectious Diseases Branch, Division of Communicable Disease Control, California Department of Health Services, Richmond, CA, USA
G. THOMAS
Affiliation:
San Luis Obispo County Public Health Department, San Luis Obispo, CA, USA
M. J. BEACH
Affiliation:
Division of Parasitic Diseases, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
S. CARNES
Affiliation:
San Luis Obispo County Public Health Department, San Luis Obispo, CA, USA
T. MAIER
Affiliation:
San Luis Obispo County Public Health Department, San Luis Obispo, CA, USA
J. GORMAN
Affiliation:
San Luis Obispo County Public Health Department, San Luis Obispo, CA, USA
L. XIAO
Affiliation:
Division of Parasitic Diseases, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
M. J. ARROWOOD
Affiliation:
Division of Parasitic Diseases, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
D. GILLISS
Affiliation:
Infectious Diseases Branch, Division of Communicable Disease Control, California Department of Health Services, Richmond, CA, USA
S. B. WERNER
Affiliation:
Infectious Diseases Branch, Division of Communicable Disease Control, California Department of Health Services, Richmond, CA, USA
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Abstract

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In August–September 2004, a cryptosporidiosis outbreak affected >250 persons who visited a California waterpark. Employees and patrons of the waterpark were affected, and three employees and 16 patrons admitted to going into recreational water while ill with diarrhoea. The median illness onset date for waterpark employees was 8 days earlier than that for patrons. A case-control study determined that getting water in one's mouth on the waterpark's waterslides was associated with illness (adjusted odds ratio 7·4, 95% confidence interval 1·7–32·2). Laboratory studies identified Cryptosporidium oocysts in sand and backwash from the waterslides' filter, and environmental investigations uncovered inadequate water-quality record keeping and a design flaw in one of the filtration systems. Occurring more than a decade after the first reported outbreaks of cryptosporidiosis in swimming pools, this outbreak demonstrates that messages about healthy swimming practices have not been adopted by pool operators and the public.

Type
Research Article
Copyright
2006 Cambridge University Press