What You Need To Know About Crypto

Every year, Americans make an estimated 360 million visits to recreational water areas, according to the Centers for Disease Control (CDC). In fact, swimming is the second most popular exercise in the United States, with approximately 400 million pool visits annually.1 However, this summer, an increasing number of people have brought home more than a sunburn from their visit to a public pool, water park or lake.

Cryptosporidium, commonly referred to as “Crypto” (krip-TOE) for short, is a parasite that causes diarrhea. Crypto is found in infected people’s stool, and is highly contagious when contaminated water is accidentally swallowed in a pool, water park or lake. The germ is protected by an outer shell that allows it to survive for long periods of time and makes it resistant to chlorine disinfection found in swimming pools.2

Cryptosporidiosis outbreaks, the disease caused by the Crypto parasite, were relatively unheard of in the past. However, in recent years, the incidence of outbreaks has skyrocketed. For instance, during the summer of 2000, only five (5) cases of cryptosporidiosis linked to swimming pools were reported to the CDC.3 However, earlier this summer, city officials in Phoenix closed and disinfected the city’s 29 public swimming pools for a week after more than 100 people complained of illness after a pool tested positive for the parasite. A series of outbreaks last summer in Utah sickened nearly 2,000 people and an outbreak at a spray park in Seneca Lake State Park in New York in 2005 caused more than 4,000 people to seek medical treatment, and sparked a class action lawsuit involving more than 600 people.4

Last summer, the city council of Chico, California, temporarily shut down the city’s newly remodeled city plaza fountain, calling it a “lawsuit-in-waiting” due to fears of Crypto-infected water, which sprays jets of water over a hard paved surface designed to allow children to play and splash in the water feature.5 The city council cited a lawsuit filed against the city of San Jose, when children became sick after ingesting fountain water containing Crypto.

Texas, famous for doing everything bigger, has been the epicenter for a rash of Crypto outbreaks this summer. The outbreak started in Forth Worth’s Burger Lake, which local health officials shut down on July 16, 2008. Days later, the city of Forth Worth hyper-chlorinated their pools. Crypto was then discovered in Arlington on July 23, and in Dallas on July 25th. Days later, the city of Plano hyper-chlorinated one of their public swimming pools. So far this summer, over 100 cases have been reported in Texas, and is suspected in the death of a 6 year old girl. Dallas County Health and Human Services has advised individuals with weakened immune systems to stay away from recreational bodies of water, such as swimming pools, water parks and lakes. The number of reported cases in Texas has climbed from 79 in 2003 to 237 in 2007, and is expected to dramatically increase for 2008. So far this summer, 50 cases have been reported in Dallas-Fort Worth and 67 cases have been reported in Tarrant County.6

According to the CDC, Crypto is spread by:

    * Swallowing recreational water contaminated with Crypto, from swimming pools, hot tubs, jacuzzis, fountains, lakes, rivers, springs, ponds or streams that have been contaminated with sewage or feces from humans or animals;
    * By putting something in your mouth or accidentally swallowing something that has come into contact with the stool of a person or animal infected with Crypto;
    * By swallowing Crypto picked up from surfaces (such as lounge chairs, picnic tables, bathroom fixtures, changing tables, etc.) contaminated with stool from an  infected person.

Crypto lives in the intestine of infected humans or animals. An infected person or animal sheds Cryptosporidium parasites in the stool. Millions of Crypto parasites can be released in a single bowel movement from an infected human or animal. Shedding begins when the symptoms begin and can last for up to two weeks after diarrhea stops.

According to the CDC, people with greater exposure to contaminated materials are more at risk for infection, such as:

    * Children who attend day care centers, including diaper-aged children
    * Child care workers
    * Backpackers, hikes and campers who drink unfiltered, untreated water
    * Swimmers who swallow contaminated water

Symptoms of Cryptosporidiosis generally begin 2 to 10 days after becoming infected with the parasite. The most common symptom is watery diarrhea. Other symptoms include:

    * Stomach cramps or pain
    * Dehydration
    * Nausea
    * Vomiting
    * Fever
    * Weight Loss 10

Diagnosis of cryptosporidiosis is made by laboratory examination of stool samples. Because this type of testing is not typically done by health care providers, persons concerned that they may have become infected should specifically request laboratory testing by their doctor. Cryptosporidiosis is a nationally notifiable disease, which means that health care providers and laboratories that diagnose cases of laboratory-confirmed cryptosporidiosis are required by law to report those cases to the local or state health departments, which in turn must report the cases to the CDC. From a risk management standpoint, the difficulty in preventing an outbreak of Cryptosporidiosis versus E. coli is huge.

For instance, the germ inactivation time for chlorinated water is as follows:

     Germ                           Time
E. coli bacteria       Less than 1 minute 1
Hepatitis A virus     About 16 minutes
Giardia parasite     About 45 minutes
Crypto parasite      About 15,300 minutes, or 10.6 days

In order to hyper-chlorinate a swimming pool, the pool must be closed to all swimmers, the pool must be disinfected at chlorine levels unsafe to humans, the filtration system must be backwashed, and chlorine and pH levels must return to safe levels established by local health officials.

The legal exposure of an operator of swimming pools, jacuzzis, water parks and fountains open to the public can be enormous. Although no state or federal regulations currently exist requiring such operators to routinely test for Crypto, both the CDC and public health organizations have published protocols to minimize the risk of Crypto contamination in public swimming pools, spas and water parks. Failure to follow these published guidelines could be the basis to prove an operator was negligent in maintaining safe water conditions for their guests and patrons and liable for any resulting illness or death.

[About the author: Alexander Robertson, IV, Esq. is the senior partner of Robertson & Associates, LLP, based in Westlake Village, CA. Mr. Robertson has more than 20 years of experience as a trial lawyer and is a certified Emergency Medical Technician. Alex has handled litigation involving outbreaks of Legionnaire’s disease, toxic mold, methane gas, and sub-slab vapor intrusion of hazardous waste into homes by contaminated groundwater. Mr. Robertson is a frequent lecturer to both national and local bar and judicial conferences on the topics of construction defects and toxic torts.
1 U.S. Bureau of the Census, Statistical abstract of the United States: 1995 (11th Ed.) Washington, D.C., U.S. Bureau of the Census, 1995
2 Crypto Facts, CDC Healthy Swimming, Centers for Disease Control
3 Protracted Outbreaks of Cryptosporidiosis Associated with Swimming Pool Use - Ohio and Nebraska, 2000, Journal of the American Medical Association, Vol. 285, No. 23, June 20, 2001.
4 Battling the Parasite in your local pool, The Wall Street Journal, July 30, 2008.
5 City shuts down Plaza fountain, The Chico Beat, July 27, 2007.
6 Cryptosporidium parasite sickens Texas swimmers, Enews20.com, August 4, 2008.
7 Crypto Facts, CDC Healthy Swimming, Centers for Disease Control
8 Id.
9 Id.
10 Id.