Cryptosporidiosis outbreaks associated with interactive water fountains

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.