Volume 5, Number 4—August 1999
Dispatch
Chlorine Disinfection of Recreational Water for Cryptosporidium parvum
Table 1
Outbreaks of cryptosporidiosis in recreational water facilities
Facility | Location | Disinfectant | No.of cases estimated/confirmed) | Date (year) | Ref. |
---|---|---|---|---|---|
Pool | Doncaster, UK | Chlorine | a/79 | 1988 | 2 |
Pool | Los Angeles County | Chlorine | 44/5 | 1988 | 3 |
Pool | British Columbia | Chlorine | 66/23 | 1990 | 4 |
Pool | Gloucestershire, UK | Ozone/chlorine | a/13 | 1992 | 5 |
Water slide | Idaho | Chlorine | 500/a | 1992 | 6 |
Pool (wave) | Oregon | Chlorine | a/52 | 1992 | 7 |
Pool (motel) | Wisconsin | Chlorine | 51/22 | 1993 | 8,9 |
Pool (motel) | Wisconsin | Chlorine | 64/b | 1993 | 9 |
Pool | Wisconsin | Chlorine | 5/b | 1993 | 9 |
Pool | Wisconsin | Chlorine | 54/b | 1993 | 9 |
Pool (motel) | Missouri | Chlorine | 101/26 | 1994 | 10 |
Lake | New Jersey | None | 2,070/46 | 1994 | 11 |
Pool | Sutherland, New South Wales | Chlorine | a/70 | 1994 | 12 |
Pool | Kansas | a | 101/26 | 1995 | 13 |
Water park | Georgia | Chlorine | 2,470/62 | 1995 | 13 |
Water park | Nebraska | a | a/14 | 1995 | 13 |
Pool | Florida | a | 22/16 | 1996 | 14c |
Water park | California | Chlorine | 3,000/29 | 1996 | 13,15c |
Pool | Andover, UK | Chlorine | 8/a | 1996 | 16 |
Lake | Indiana | None | 3/a | 1996 | 13 |
River | NW England & Wales | None | 27/7 | 1997 | 17c |
Pool | SW England & Wales | Ozone & chlorine | a/9 | 1997 | 17c |
Fountain | Minnesota | Sand filter | 369/73 | 1997 | 18 |
Three pools | Canberra, Australia | a | a/210 | 1998 | 19c,20c |
Pool | Oregon | a | 51/8 | 1998 | 21c |
Pools | Queensland | a | 129/a | 1997 | 21c |
Pools | New South Wales | a | 370/a | 1998 | 22c |
Pools | Hutt Valley, New Zealand | a | a/171 | 1998 | 23c |
aNo data available.
bReference did not identify cases as estimated or confirmed.
cReference is not peer reviewed and may not reflect a rigorous investigation of the outbreak.
References
- Fayer R, Speer CA, Dubey JP. The general biology of Cryptosporidium. In: Cryptosporidium and cryptosporidiosis. Fayer R, editor. Boca Raton (FL): CRC Press; 1997. p. 1-41.
- Joce RE, Bruce J, Kiely D, Noah ND, Dempster WB, Stalker R, An outbreak of cryptosporidiosis associated with a swimming pool. Epidemiol Infect. 1991;107:497–508. DOIPubMedGoogle Scholar
- Sorvillo FJ, Fujioka K, Nahlen B, Tormey MP, Kebabjian RS, Mascola L. Swimming-associated cryptosporidiosis. Am J Public Health. 1992;82:742–4. DOIPubMedGoogle Scholar
- Bell A, Guasparini R, Meeds D, Mathias RG, Farley JD. A swimming pool-associated outbreak of cryptosporidiosis in British Columbia. Can J Public Health. 1993;84:334–7.PubMedGoogle Scholar
- Hunt DA, Sebugwawo S, Edmondson SG, Casemore DP. Cryptosporidiosis associated with a swimming pool complex. Commun Dis Rep CDR Rev. 1994;4:R20–2.PubMedGoogle Scholar
- Moore AC, Herwaldt BL, Craun GF, Calderon RL, Highsmith AK, Juranek DD. Surveillance for waterborne disease outbreaksUnited States, 1991-1992. MMWR Morb Mortal Wkly Rep. 1993;42(SS-5):1–22.PubMedGoogle Scholar
- McAnulty JM, Fleming DW, Gonzalez AH. A community-wide outbreak of cryptosporidiosis associated with swimming at a wave pool. JAMA. 1994;272:1597–600. DOIPubMedGoogle Scholar
- MacKenzie WR, Kazmierczak JJ, Davis JP. An outbreak of cryptosporidiosis associated with a resort swimming pool. Epidemiol Infect. 1995;115:545–53. DOIPubMedGoogle Scholar
- Kramer MH, Herwaldt BL, Craun GF, Calderon RL, Juranek DD. Waterborne disease: 1993 and 1994. J Am Water Works Assoc. 1996;88:66–80.
- Wilberschied L. A swimming-pool-associated outbreak of cryptosporidiosis. Kans Med. 1995;96:67–8.PubMedGoogle Scholar
- Kramer M, Sorhage F, Goldstein S, Dalley E, Wahlquist S, Herwaldt B. First reported outbreak in the United States of cryptosporidiosis associated with a recreational lake. Clin Infect Dis. 1998;26:27–33. DOIPubMedGoogle Scholar
- Lemmon JM, McAnulty JM, Bawden-Smith J. Outbreak of cryptosporidiosis linked to an indoor swimming pool. Med J Aust. 1996;165:613–6.PubMedGoogle Scholar
- Levy DA, Bens MS, Craun GF, Calderon RL, Herwaldt BL. Surveillance for waterborne disease outbreaks-United States, 1995-1996. MMWR Morb Mortal Wkly Rep. 1998;47(SS-5):1–34.PubMedGoogle Scholar
- Past water-related outbreaks in Florida. Crypto Capsule. 1998;3:3.
- Effects of last summer's outbreak on Wild Water Adventure's theme park. Crypto Capsule. 1997;2:1–3.
- Sundkvist T, Dryden M, Gabb R, Soltanpor N, Casemore D, Stuart J, Outbreaks of cryptosporidiosis associated with a swimming pool in Andover. Commun Dis Rep. 1997;7:R190–2.
- Outbreaks in England and Wales. first half of 1997. Crypto Capsule. 1998;3:4.
- Outbreak of cryptosporidiosis associated with a water sprinkler fountain-Minnesota, 1997. MMWR Morb Mortal Wkly Rep. 1998;47:856–60.PubMedGoogle Scholar
- Swimming pools implicated in Australia's largest cryptosporidiosis outbreak ever reported. Crypto Capsule. 1998;3:1–2.
- Number of cryptosporidiosis cases increase in Australia. Crypto Capsule. 1998;3:1–2.
- Most cases in Australia linked to swimming pool exposure. Crypto Capsule. 1998;3:5–6.
- Recreational outbreak in Oregon. Crypto Capsule. 1998;4:1.
- New Zealand's pool related outbreak is over. Crypto Capsule. 1998;3:5–6.
- Fayer R. Effect of sodium hypochlorite exposure on infectivity of Cryptosporidium parvum oocysts for neonatal BALB/c mice. Appl Environ Microbiol. 1995;61:844–6.PubMedGoogle Scholar
- Finch GR, Black EK, Gyurek LL. Ozone and chlorine inactivation of Cryptosporidium. Proceedings of the AWWA Water Quality Technical Conference, San Francisco, CA 1994; 1303-8.
- Venczel LV, Arrowood M, Hurd M, Sobsey MD. Inactivation of Cryptosporidium parvum oocysts and Clostridium perfringens spores by a mixed-oxidant disinfectant and by free chlorine. Appl Environ Microbiol. 1997;63:1598–601.PubMedGoogle Scholar
- Gyurek LL, Finch GR, Belosevic M. Modeling chlorine inactivation requirements of Cryptosporidium parvum oocysts. J Environ Eng. 1997;123:865–75. DOIGoogle Scholar
- Korich DG, Mead JR, Madore MS, Sinclair NA, Sterling CA. Effects of ozone, chlorine dioxide, chlorine, and monochloramine on Cryprosporidium parvum oocyst viability. Appl Environ Microbiol. 1990;56:1423–7.PubMedGoogle Scholar
- Parker JFW, Smith HV. Destruction of oocysts of Cryptosporidium parvum by sand and chlorine. Water Res. 1993;27:729–31. DOIGoogle Scholar
- Pavlasek I. Effect of disinfectants in infectiousness of oocysts of Cryptosporidium sp. Cs Epidemiol 1984;33:97-101.1.
- Campbell I, Tzipori S, Hutchison G, Angus KW. Effect of disinfectants on survival of Cryptosporidium oocysts. Vet Rec. 1982;111:414–5.PubMedGoogle Scholar
- Kilani RT, Sekla L. Purification of Cryptosporidium oocysts and sporozoites by cesium chloride and percoll gradients. Am J Trop Med Hyg. 1987;36:505–8.PubMedGoogle Scholar
- ANSI/NSPI 1 Standards for public swimming pools. In: Pool and spa water chemistry. Taylor Technologies, Inc., Sparks, MD. 1994. p. 40.
- U.S. Bureau of the Census. Statistical Abstract of the United States: 1995. 115th ed. Washington: The Bureau; 1995. p. 260.
- Medema GJ, Schets FM, Yeunis PFM, Havelaar AH. Sedimentation of free and attached Cryptosporidium oocysts and Giardia cysts in water. Appl Environ Microbiol. 1998;64:4460–6.PubMedGoogle Scholar
- Kebabjian RS. Disinfection of public pools and management of fecal accidents. J Environ Health. 1995;58:8–12.