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Weldon B. Johnson/azcentral.com
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With Phoenix-area temperatures threatening to creep up to 120 degrees early next week, public health officials are encouraging people headed to the nearest pool to practice “healthy swimming” to prevent the spread of a diarrhea-causing parasite.
“When it’s hot out, the pool is one of the best places to stay cool, and we certainly want to encourage people to get out and enjoy the recreational water in the county, but we definitely want to make sure people know some important messages and how to practice healthy swimming behavior,” said Sally Ann Iverson, an epidemic intelligence service officer for the Centers for Disease Control and Prevention assigned to the Maricopa County Public Health Department.
Here’s what public health officials recommend
- Shower before swimming to ensure urine, fecal matter, sweat, blood and dirt is kept out of the water.
- Have children take frequent bathroom breaks to prevent accidents in the pool.
- Do not swallow pool or splash pad water.
- Don’t swim in public or private pools if you have diarrhea. Stay out of the water after it’s cleared up for at least two weeks.
Last summer, Arizona experienced the largest cryptosporidium outbreak in the state’s history, with 437 reported cases at 75 facilities in Maricopa County alone. In one instance, almost an entire Coconino County Little League team was infected with crypto after visiting a recreational water facility in the county in early August.
Officials estimate more people were likely infected than reported.
“We know that this was really only the tip of the iceberg,” Iverson said. “It’s estimated that for every case that is reported to public health, there are 50 or more that go unreported.”
So far this year, there have been 26 reported crypto cases in Maricopa County out of 39 reported cases in seven counties statewide, according to the Arizona Department of Health Services.
The number of reported cases are already more than double the historical average of 16 cases at this point of the summer. Last summer, there were only 19 reported cases as of the end of July.
“We’re not really sure if this is due to more disease in the community, or just better detection of the disease because people in the community are still more aware it because there’s been so much attention since last year’s outbreak,” Iverson said.
County health officials have not yet been able to identify any facilities that might be the source of the reported crypto cases. Iverson said if there was a facility they were concerned about, then the facility would be closed for treatment before it was opened back up to the public.
Cryptosporidium parvum, referred to as crypto, is a microscopic parasite found in water contaminated with fecal matter. It causes an infection resulting in weeks of frequent, watery diarrhea, known as cryptosporidiosis.
Other symptoms include stomach cramps or pain, nausea, vomiting and fever. They last two to three weeks on average.
The most common way to come in contact with the parasite is at public recreational water facilities such as swimming pools, water parks and splash pads — just where everyone wants to be on a scorching afternoon.
“People get sick with it when they either swallow or come into contact with something that’s been contaminated with poop from someone who is sick with crypto,” Iverson said. “All it takes is one person swimming with diarrhea, or even within two weeks of having diarrhea, to contaminate a recreational water facility.”
One diarrhea accident in the pool or at a splash pad can release more than a million parasites in the water at a time. All it takes to become infected is swallowing one mouthful of water with as few as 10 parasites in it.
It takes about a week for symptoms to manifest, so someone who is unknowingly infected can also spread the parasite from pool to pool if they don’t “don’t clean off as well” before getting into the water, said Dr. Cara Christ, the director of the Arizona Department of Health Services.
Children are particularly susceptible to infection because “a lot of kids aren’t as good about keeping pool water out of their mouths,” Christ said.
And once a child becomes infected with the parasite, it’s easy to spread from there.
“That’s why we want to make sure if you’ve got a little one who isn’t potty trained, you want to make sure they’re wearing swim diapers,” Christ said. “That you’re taking kiddos out to go to the bathroom frequently if you’re in the pool for long periods of time and that you’re showering before and after getting into the pool.”
The parasite is resistant to standard levels of pool chlorination. Once it’s introduced in the water, it can survive for up to 10 days. It can be killed off if the amount of chlorine in the pool is increased to 10 to 20 times higher than normal level.
As the temperature approaches 120 degrees, “the most important thing is encouraging yourself and kids not to swallow the pool water, because that’s how you’re going to become exposed. And strongly encouraging parents that if people in their family or they are sick with diarrhea, to avoid swimming,” Christ said.
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