cryptosporidium

Cryptosporidiosis is a fairly common gastrointestinal disease that often goes unrecognized. Cryptosporidium is a single-celled parasite that is sometimes found in public pool or water parks. The organism is highly resistant to chlorine, so once the organism is in a public pool or water park, for instance, outbreaks can affect thousands of people. Summer and early fall are peak periods for this disease.

Cryptosporidium produces an illness characterized by vomiting, fever, diarrhea and fatigue, mimicking common viral gastrointestinal illnesses. Few patients have bloody stools. The illness lasts from four to seven days, but can exceed three weeks. The incubation period is about a week, so parents may not make the connection between swimming in a pool or lake and the subsequent illness.

The germ is usually not detected during routine stool examination for parasites. Special testing is required, and only 5% to 10% of clinical laboratories across the country routinely test for Cryptosporidium when a physician orders a test for parasites. One tipoff is the report of "A lot of yeast" in the stool.

"Crypto" is transmitted when fecal material is discharged into water in a pool, lake or river that is subsequently drunk by a human. An infected individual continues to shed infective spores (oocysts) for up to several weeks after his own diarrhea resolves. The cysts or spores remain very firmly stuck to the area around the anus, so just a cold water rinse will not remove them. Warm soapy water must be used to clean the diaper area.

The Centers for Disease Control says that the single most effective preventative measure is the use of kiddie pools - keep kids in diapers out of the general pool. Even diapers said to contain bowel movement material do not prevent the infective agent from getting into the water.

There is no known effective treatment for cryptosporidium infections; care is supportive and the disease is self-limiting, which is to say it runs its course and is gone - just like a viral gastroenteritis.

So the best treatment is prevention. Parents can take certain common sense measures to reduce the risk of infection.

Do not go swimming if you or your child has had diarrhea in the past 2 weeks.
Only swim in public pools that require a shower with warm water and soap before entering the pool.
If you swim with your infant or toddler in a kiddie pool, rinse thoroughly before entering the main pool.
Take your toddler to the potty often during pool excursions.
Always wash your hands and your toddler's hands well after a trip to the bathroom or a diaper change.
Change diapers in the bathroom, never at pool side. And notify the lifeguard if you see anyone changing diapers at pool side.
Never drink or swallow pool water, and teach your kids the same. Remind them often.
Do not rely on swim diapers or rubber pants to prevent stool from leaking into the pool water.
Notify the pool management if you or your child gets an unexplained gastrointestinal illness within a week of swimming there.

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