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A new Morbidity and Mortality Weekly Report (MMWR) on Outbreaks of Illness Associated with Recreational Water — United States, 2011–2012 brought a lot of attention to the issue of cryptosporidiosis, an infection by the protozoan parasite, Cryptosporidium, or how it is affectionately known–“Crypto”.

Florida map/National Atlas of the United States

Florida map/National Atlas of the United States

Cryptosporidium is a microscopic parasite that causes a diarrheal illness. Common symptoms include: diarrhea, stomach cramps or pain, dehydration (which is often most serious in the very young and the very old), nausea, vomiting, fever and weight loss.Symptoms usually begin 2 to 10 days after infection and normally last for one to two weeks. Once a person is infected, the parasites live in the intestines and are passed in the stool.

In the report, the authors looked at illness outbreaks linked to exposure to chemicals or infectious pathogens in recreational water venues that are treated (e.g., pools and hot tubs or spas) or untreated (e.g., lakes and oceans).

For the years 2011 and 2012, public health officials from 32 states and Puerto Rico reported 90 recreational water–associated outbreaks (http://www.cdc.gov/healthywater/surveillance/rec-water-tables-figures.html) (Figure 1), which resulted in at least 1,788 cases, 95 (5%) hospitalizations, and one death. Etiology was confirmed for 73 (81%) outbreaks: 69 (77%) outbreaks were caused by infectious pathogens, including two outbreaks with multiple etiologies, and four (4%) by chemicals (Table). Among the outbreaks caused by infectious pathogens, 37 (54%) were caused by Cryptosporidium. For more details on the study, see the report HERE

Being a Florida-based news site, I looked at the “Crypto” numbers for the state since 2011, although it is not specific as to how the individuals contracted the parasite.

In 2011, the Sunshine state reported 436 cases, while comparable numbers were seen in 2012 (470) and 2013 (411). However, things changed in 2014.

According to the health department, last year we saw a whopping 1,877 cryptosporidium cases. Of the 67 counties, 57 reported at least one case.

Four counties saw more than 100 cases: Hillsborough (350), Pinellas (239), Duval (149) and Pasco (141). Two zip codes reported more than 20 cases–33629 in Tampa (26) and 33218 in Jacksonville (21).

Cryptosporidium parvum oocysts

Cryptosporidium parvum oocysts/CDC/ DPDx

How is Florida doing so far in 2015? Since the beginning of the year, Florida has reported 269 cryptosporidium cases; however, that number is surely to rise with the onset of summer.

Related: Florida Vibrio: Hillsborough County reports 2nd death

Cryptosporidium is found in soil, food, water, or surfaces that have been contaminated with infected human or animal feces. Transmission occurs through animal-to-human or human-to-human contact. Consuming contaminated water or food, swimming in contaminated water and children visiting petting zoos are common ways people contract the parasite.

It is typically a self-limiting illness in otherwise healthy individuals. For more infectious disease news and information, visit and “like” the Infectious Disease News Facebook page

To help prevent Crypto, practice proper hand hygiene before preparing or eating food; after using the toilet; before and after tending to someone who is ill with diarrhea and after changing diapers. To keepswimming pools free from contamination, children and adults should not swim in a pool or enter a spa until at least two weeks after they have completely recovered from a diarrheal illness.

DOH recommends that parents and caregivers take these steps to avoid pool contamination:

  • Take children on frequent bathroom breaks and check diapers often.
  • Change diapers in a bathroom and not at the poolside as germs can spread to surfaces or objects in and around the pool and spread illness.
  • Shower before entering the water.
  • Wash their hands with soap and water after changing a child’s diaper.

Cryptosporidium life cycle

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