Perspective

Number of Crypto outbreaks increases 13% every year

Photo of Michele Hlavsa
Michele Hlavsa

The number of outbreaks caused by Cryptosporidium, or Crypto, increased approximately 13% each year between 2009 and 2017, researchers said.

In an MMWR, Radhika Gharpure, DVM, an Epidemic Intelligence Service Officer at the CDC, and colleagues wrote that Crypto is the No. 1 cause of outbreaks of diarrhea linked to water and the third leading cause of diarrhea related to animal contact in the U.S.

In the report, Crypto outbreaks were defined as two or more cases epidemiologically linked to a common source. During the study period, public health officials from 40 states and Puerto Rico reported a total of 7,465 cases stemming from 444 Crypto outbreaks. Exposure to pools, water playgrounds and other recreational water sources caused 35.1% of all outbreaks and 56.7% of all cases. Other outbreaks resulted from cattle exposure (14.6%) and contact with infected children in child care settings (12.8%).

To stem the increasing rate of outbreaks in the U.S., the CDC recommends against swimming or attending child care while sick, and the agency encourages hand-washing after exposure to animals.

“Young children can get seriously sick and easily spread Crypto,” Michele Hlavsa, RN, MPH, chief of the CDC’s Healthy Swimming Program, said in a press release. “They do not know how to use the toilet and wash their hands or are just learning how. We as parents can take steps to help keep our kids healthy in the water, around animals and in child care.” – by Katherine Bortz

Disclosures: The authors report no relevant financial disclosures.

Photo of Michele Hlavsa
Michele Hlavsa

The number of outbreaks caused by Cryptosporidium, or Crypto, increased approximately 13% each year between 2009 and 2017, researchers said.

In an MMWR, Radhika Gharpure, DVM, an Epidemic Intelligence Service Officer at the CDC, and colleagues wrote that Crypto is the No. 1 cause of outbreaks of diarrhea linked to water and the third leading cause of diarrhea related to animal contact in the U.S.

In the report, Crypto outbreaks were defined as two or more cases epidemiologically linked to a common source. During the study period, public health officials from 40 states and Puerto Rico reported a total of 7,465 cases stemming from 444 Crypto outbreaks. Exposure to pools, water playgrounds and other recreational water sources caused 35.1% of all outbreaks and 56.7% of all cases. Other outbreaks resulted from cattle exposure (14.6%) and contact with infected children in child care settings (12.8%).

To stem the increasing rate of outbreaks in the U.S., the CDC recommends against swimming or attending child care while sick, and the agency encourages hand-washing after exposure to animals.

“Young children can get seriously sick and easily spread Crypto,” Michele Hlavsa, RN, MPH, chief of the CDC’s Healthy Swimming Program, said in a press release. “They do not know how to use the toilet and wash their hands or are just learning how. We as parents can take steps to help keep our kids healthy in the water, around animals and in child care.” – by Katherine Bortz

Disclosures: The authors report no relevant financial disclosures.

    Perspective
    Joseph N. S. Eisenberg

    Joseph N. S. Eisenberg

    Crypto, first discovered as a human pathogen in 1976, has quickly become one of the most important pathogens in the U.S. and the world. In 1993, it caused the largest waterborne disease outbreak in U.S. history, contaminating Milwaukee’s drinking water system. A study conducted in the early 2000s found Crypto to be a leading global cause of moderate to severe diarrheal disease in children aged younger than 5 years. 

    The recent MMWR published by the CDC found that Crypto has been on the rise in the U.S. Outbreaks have increased an average of 13% annually over the past 10 years, largely in treated swimming pools. This report has both policy and personal implications. 

    Crypto is a small parasite that is resistant to chlorine. It often passes through filters designed to filter out larger parasites such as Giardia. Infrastructure investments are needed to address the spread of this parasite. 

    People should be aware of the risk factors for Crypto exposure. The MMWR suggests that high-risk venues include swimming pools, petting zoos and child care centers. Not swimming while sick, washing hands after high-risk activities, and being aware of early signs of diarrheal disease after participating in high-risk activities are a few ways individuals can both protect themselves and prevent the spread of this emerging pathogen.

    • Joseph N. S. Eisenberg, PhD, MPH
    • Chair, professor
      Department of epidemiology
      John G. Searle Professor of Public Health
      University of Michigan

    Disclosures: Eisenberg reports no relevant financial disclosures.