204689 Cryptosporidiosis outbreaks associated with interactive water fountains

Tuesday, November 10, 2009

Sharon I. Brummitt, BA , University of Texas School of Public Health, Dallas, TX
Wendy Chung, MD, MSPH , Dallas County Health and Human Services, Dallas, TX
Ann A. Ikonne, BS , University of Texas School of Public Health, Dallas, TX
Sonya Hughes, BS , Dallas County Health and Human Services, Dallas, TX
Juan Rodriguez, MPH , Dallas County Health and Human Services, Dallas, TX
Baumgart Kristy, MPH , Dallas County Health and Human Services, Dallas, TX
John Carlo, MD, MSE , Dallas County Health and Human Services, Dallas, TX
Background: Interactive water fountains have been known to be associated with transmission of enteric illnesses. During a community-wide outbreak of cryptosporidiosis occurring in Dallas in 2008, a subset of cases was epidemiologically linked to 2 neighborhood interactive water fountain parks and further analyzed. Methods: A case control study was conducted to examine risk factors associated with developing illness with cryptosporidiosis following visits to the fountain parks. Results: Interviews were completed for 44 fountain park attendees who met case definition and 54 community controls. The median age of cases was 6 years (range: 1 to 59 years) and 47.7% of the cases were males. Fountain park attendees who reported having been splashed in the face with water were 10 times more likely to become ill than controls (OR = 10.0, 95% CI = 2.8 35.1). Persons who reported having swallowed water from the interactive fountains were 34 times more likely to become ill than controls (OR = 34.3, 95%CI = 9.3 125.7). Conclusion: This investigation underscores the potential for cryptosporidiosis outbreaks to occur in interactive fountain parks, and the need for enhanced preventive measures in these settings. Prompt reporting of cases, identification of outbreak sources, and immediate implementation of remediation measures were critical in curtailing further transmission from these particular sites through the remainder of the season. Education of the public regarding avoidance of behaviors such as drinking water from interactive fountains is also an important component of public health prevention efforts.

Learning Objectives:
1.)Identify risk behaviors at an interactive water fountain associated with development of cryptosporidiosis illness. 2.) Describe the potential public health risks and impact of cryptosporidiosis associated with interactive water fountains.

Keywords: Infectious Diseases, Water

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I participated in the outbreak investigation and epidemiologic analysis.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.