A cryptosporidium outbreak has emerged in Cairns, Queensland (that’s in Australia) with 51 cases in a month when the usual number of yearly cases was below 20.

"If you’ve got 51 cases confirmed in a lab, chances are there are hundreds out there," Public Health medical officer Dr Steven Donohue said.

In the letter, Dr Donohue instructed day care centres to exclude children with diarrhea until they have not had symptoms for 48 hours.

He also recommended that swimming pools at day care centres be disinfected with adequate chlorination or refilled after each session.

Queensland Health is also in the process of notifying swimming pool operators about the health risk, Dr Donohue said.

"We’re not blaming the pools but they are a known factor in magnifying the outbreak," he said. "The pool operators should be very careful to make sure children with diarrhoea or dirty nappies are not in pools."

In other crypto news, Artieda et al report in Eurosurveillance that on 24 November 2011, some smart pediatrician in the Basque Countr of northern Spain notified the epidemiological surveillance service of Gipuzkoa of a child with diarrhea in whose stools oocysts of Cryptosporidium had been isolated, as well as of an unusually large number of children with diarrhea who attended the same day-care center as the first child. All were tested for Cryptosporidium.

Investigators concluded that from October to December 2011, an outbreak of 26 cases of cryptosporidiosis occurred in a day-care centre in Gipuzkoa, Spain. The infection spread from person to person and affected 24 children under two years of age (attack rate: 38%) and two caregivers. Cryptosporidium oocysts were observed in 10 of 15 samples. During 2010, only four cases of cryptosporidium were detected in Gipuzkoa, and 27 overall in Spain.

At the time of the study, 63 children between 0 and two years of age attended the day-care, as well as the staff that consisted of six caregivers. There were 39 1–2-year-olds in classroom 2 (ground floor) and classrooms 3 and 4 (first floor), 13 in each. In classroom 1 (ground floor) and classrooms 5 and 6 (second floor), there were 24 0–1-year-olds, eight in each. A total of 24 children fell ill (attack rate: 38.1%), and only three of them were in the group of 0–1-year-olds. Children shared some activities by age group. Two caregivers also fell ill. In the microscopic analysis, Cryptosporidiumspp. oocysts were isolated in 10 of 15 stool samples, and no other enteropathogen was found in any of the samples studied.

In addition, an environmental investigation was also undertaken by the local public health technicians. Information on hygiene practices and water usage was collected. The investigation detected deficiencies in hygiene procedures in the day-care centre. Single use paper towels were not available in any of the risk areas.

As soon as the outbreak was confirmed, strengthening of hygiene measures was recommended to the staff of the day-care center, and they were asked to advise taking children to their pediatrician in the event of more cases. The recommended measures involved correcting the above-mentioned deficiencies, improving compliance with universal hygiene rules and, given the characteristics of the microorganism (resistance to chlorine), cleaning surfaces with 3% hydrogen peroxide. All measures recommended were implemented within 24-48 hours.

A letter was sent to the parents informing them of the outbreak and advising good hygiene practices. In addition, they were told that those with diarrhea must not to use public swimming pools or other recreational water facilities for the duration of the outbreak.

The full report is available at http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=20070.

Queensland Health is warning against consuming a batch of salami made by smallgoods company Backa Australia, after samples were found with high levels of bacteria.

The company based in Beenleigh, in Queensland, has begun a voluntary recall of its chabi salami products sold at farmers markets in Brisbane and the Gold Coast last weekend (14-15 January 2012).

The salami product tested positive to staphylococcus bacteria which can cause a type of food poisoning.

Consumers who purchased the chabi products from farmers markets at Rocklea, Ascot, Chandler, Nerang, Palm Beach, and the Southport Sharks Club last weekend are advised not to consume them.

A statement released by Queensland Health said, “While there is no reason to suspect other products of Backa Australia are also contaminated, all retail sales have been suspended until further tests can be carried out.”

The Backa Australia chabi is unpackaged and not labelled.

Back when I thought going to conferences was important or at least a family diversion, my kids would rank the success of the trip based on the hotel water fountain.

A long-ago meeting of the International Food Protection Association in Orlando ranked particularly high.

A 2010 outbreak of Legionnaires' disease in Wisconsin has been linked to a decorative fountain in a hospital lobby, according to a study published in the February issue of Infection Control and Hospital Epidemiology, the journal of the Society for Healthcare Epidemiology of America.

When the outbreak of Legionnaires' disease was detected among eight people in southeast Wisconsin, state and local public health officials worked closely with hospital staff to launch an investigation to determine the source of the outbreak.

Through detailed interviews with patients, officials identified one hospital as the site of the contamination. Subsequent environmental testing within the hospital detected notable amounts of Legionella in samples collected from the "water wall" decorative fountain located in the hospital's main lobby.

The investigation revealed that all eight patients had spent time in the main lobby where the fountain is located. This, along with the proximity of each patient's onset of illness and the degree of Legionella contamination in the fountain strongly support the conclusion that the decorative fountain was the source of the outbreak. Hospital officials quickly shut down the fountain when it was first suspected as a source, and notified staff and approximately 4,000 potentially exposed patients and visitors. Prior to the investigation, the decorative fountain underwent routine cleaning and maintenance.

All eight patients in the Wisconsin outbreak recovered from the disease, and no cases occurred following the shutdown of the fountain.

The outbreak is notable since none of the patients with Legionnaires' disease was an inpatient at the hospital when exposed. And some patients reported only incidental exposure to the fountain, such as delivering a package or visiting the hospital pharmacy.

At the time of the outbreak there was no published information on the effectiveness of fountain disinfection and maintenance procedures to reduce the risks of Legionella contamination.

"Since our investigation, the Wisconsin Division of Public Health has developed interim guidelines advising healthcare facilities with decorative fountains to establish strict maintenance procedures and conduct periodic bacteriologic monitoring for Legionella," said Thomas E. Haupt, MS, an epidemiologist with the Wisconsin Division of Public Health and the study's lead author. "The guidelines stress that until additional data are available that demonstrate effective maintenance procedures for eliminating the risk of Legionella transmission from indoor decorative water fountains in healthcare settings, water fountains of any type should be considered at risk of becoming contaminated with Legionella bacteria."

Since this investigation, many healthcare facilities in Wisconsin shut down or removed decorative fountains in their facilities, while others enhanced their regular testing protocols to reduce the risk of Legionnaires' disease, the researchers report. Healthcare facility construction guidelines published after this outbreak stipulate that, "fountains and other open decorative water features may represent a reservoir for opportunistic human pathogens; thus they are not recommended for installation within any enclosed spaces in healthcare facilities."

EKO Australia Pty Ltd is recalling batches of their imported noodles sold in NSW in specialty Asian grocery stores.

The batches are being recalled because of the presence of Bacillus cereus, a harmful bacteria.
The recalled products are:

• Kamfen Buckwheat Noodles in 340g plastic bag with 'best before' date 2013.04.15
• Kamfen Beijing Noodles, Abalone Chicken Soup Flavour in 160g plastic bag, with 'best before' date 2013.01.15
• Kamfen Sichuan Noodles, Abalone Chicken Soup Flavour in 160g plastic bag, with 'best before' date 2013.01.15

The recall applies only to the above batches of the products and dates.

Consumers should not consume the products. Consumers can return the products to the place of purchase for a refund.