Blowing (food) chunks on vacation
Amy, Sorenne and I are hanging out in Venice, Florida, and I do most of the cooking. Lots of fresh fruits and veggies from the neighborly Publix supermarket, and I even bought a digital, tip-sensitive meat thermometer from Target because I just feel naked cooking without one.
Others aren’t so fortunate, I guess.
A group called HolidayTravelWatch, somewhere in the European Union, has just published its top-20 appalling holiday complaints and problems. Included in this year’s list:
1. Family holiday to Egypt where a child was struck down by severe food poisoning, hospitalization and subsequent scalding in the hotel restaurant.
2. Family holiday to Turkey found that most of their group were ill, they were diagnosed as suffering with Salmonella and Cryptosporidium.
12. One family reported that they had returned from Turkey and their daughter had been diagnosed with Salmonella - they report that many people were ill at the hotel.
15. Holidaymakers to one hotel in Egypt reported sewage smells on the complex, gardens irrigated by stagnant water, food lukewarm, drinks served through a hatch and not via sealed bottles - they suffered severe gastric illness which still continues.
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17. One family to Egypt suffered with food undercooked, poor chef hygiene practices (one chef was seen to handle bloody meat then touch other food), flies on the food in the pool bar, sewage smells in bathroom, cracks on the balcony and they are suspected as suffering with Cryptosporidium.
20, One couple’s trip to Egypt was marred by building work, diarrhoea on the public toilet walls, diarrhoea in the restaurant. They both suffered severe illness and weight loss - they are still ill.
Do you pee in the pool? Survey says, yes
That’s me and Sorenne in the pool in Phoenix last week. And I’m pretty sure one of us, at some point, peed in the pool.And I'm pretty sure all the drunk fashionistas at the afternoon pool parties emptied themselves in the pool.
A new study by the Water Quality and Health Council found that nearly one in five adults admits to urinating in a swimming pool instead of using the toilet.
Eight in 10 adults are convinced their fellow swimmers are guilty of such a crime, the study said.
Nevertheless, health officials insist that swimming in and even swallowing urine-contaminated water isn't harmful to someone's health.
Don Herrington from the Arizona Health Department, "Urine in itself has been purified through a whole variety of bodily processes so that it's removed a lot of the contaminants in it.”
Swimmers should be more concerned about swallowing parasites than swallowing urine, officials said, especially cryptosporidium.
Phoenix Parks and Recreation spokeswoman Amy Blakeney urged sick swimmers to stay out of the pool.
Sure kids can visit the farm, but should they be hugging the cows?
Yesterday I wrote about a bunch of schoolkids in Carlisle , U.K. that have been stricken with cryptosporidium, apparently related to so called-educational visits to nearby farms.
Teachers and school leaders said there were lots of precautions and lots of handwashing. So Shane Morris sent me a picture from the May 1, 2009 edition of the Cumberland News, (right) which documented the trip that apparently sickened the kids and included this charming picture, right, of cow-kid cuddling. Did she sanitize her cheek? And who knows what else went on.
Scott Weese of the Worms and Germs Blog wrote this morning that a recent study by Pritchard et al in the Veterinary Record reports that in samples collected from various animals on 31 different farms in U.K., verotoxigenic E. coli, like O157, was found on 61% of premises. Presence of young cattle and, surprisingly, adult pigs were identified as risk factors for finding verotoxigenic E. coli at a location. Verotoxigenic E. coli were most commonly identified in cattle (29%). It wasn’t surprising that cattle, especially young cattle, were the most common carriers based on what we know about the bacterium, but there were impressively high rates of carriage by other species, including sheep (24%), donkeys (15%), pigs (14%), horses (12%) and goats (10%).
On most farms where verotoxigenic E. coli was found, the same strain was identified in different animal species, indicating that this bacterium can spread widely on such premises. This may be because different animal species in petting zoos are mixed together, as opposed to the situation on conventional farms.
(Weese notes: the premises were evaluated following suspicion that they could have been the source of infection of people, so it’s possible that the numbers reported are higher than for the overall population of such farms.)
Weese writes,
“The risk of people acquiring an infection from animals depends more on the degree of contact and the precautions adopted than the prevalence of infection in a particular species.”
Where does cow hugging and possible face-licking rank on the risk scale?
UK schoolkids sickened after farm visit; 'an absolutely fantastic visit' says teacher
Cumbrian health chiefs have issued urgent advice about farm visits after confirming that four children were stricken by cryptosporidium, carried by cattle and lambs, and were investigating an unspecified number of other possible cases.
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The infections came after a number of recent farm visits, health officials say.
Pauline Little, an assistant head at the school, which sent 59 children on the visit, said,
“It was an absolutely fantastic visit. The farm was immaculate. Children were given the chance to milk a cow and stroke baby goats. They were given hand gel to clean their hands afterwards. And when we got back to school, we did more about washing hands than we would normally.”
The Health Protection Agency (HPA) North West yesterday advised parents and children how best to reduce the risk of infection during and following farm visits.
* Parents and teachers should check the hygiene facilities at the farm to ensure there are good hand-washing facilities with hot water, soap and paper towels.
* Children and their supervisors should always wash hands carefully after touching animals and other farm objects, especially before eating or drinking.
*Children must not eat or drink or put their fingers in their mouths whilst close to animals and before washing their hands.
Prof. Hugh Pennington of the U.K. has gone so far as to say that children under five (who are more vulnerable because of their still-developing immune systems) should be banned from visiting livestock farms because of the serious risk of acquiring E. coli O157:H7 infection from farm animals. Such a ban already exists in Sweden.
There is much to learn from interacting with animals, farms, and the world. The challenge is to do so in a microbiologically safe manner.
New study says keep poopy kids out of pools -- swim diapers not best solution
It was about 105 F when Amy and Sorenne and I touched down in Phoenix yesterday afternoon, to visit family and do some work. Pools – and air conditioning – become increasingly popular in Phoenix and elsewhere as the temperatures climb.
So that means the annual increase of cryptosporidium and other bugs related to exposure in swimming pools. Debate has raged over the past couple of years in various communities: what’s the best way to keep poop out of pools, especially with kids in diapers (I have one of those).
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The U.S. National Swimming Pool Foundation marked the emergence of summer by sending out a press release today about some research presented in March by researchers from University of North Carolina-Charlotte that found swim diapers help slow the release of disease-causing germs, but the benefits are short lived.
The researchers measured the amount of microspheres that released from swim diapers worn by children. The microspheres have a similar size (five microns) to that of Crypto. Normal swim trunks, common disposable diapers and reusable diapers with and without vinyl diaper covers were tested. Swimming trunks without a swim diaper of any kind had the poorest performance - almost 90% of the microspheres were released into the water within one minute.
Swim diapers released about 50% of the microspheres within one minute. A vinyl diaper cover placed over a disposable swim diaper slightly improved performance. Still, over 25% were released into the water within two minutes.
"When a fecal accident contains about a billion disease-causing Crypto oocysts, hundreds of millions of oocysts get into the water within minutes," explains Dr. James Amburgey, the lead scientist in the study. "Swimmers only need to ingest about ten Crypto oocysts to become infected."
"This study confirms that parental restraint is the key to preventing Crypto outbreaks - not swim diapers. Swimming with diarrhea is irresponsible because it places other people's health at risk," reinforces Thomas M. Lachocki, Ph.D., CEO of the National Swimming Pool Foundation(R) (NSPF(R)) who funded the research.
Texas: Crypto suspect in child's death
6-year-old Rosemary Stagaman of Richardson died last Tuesday morning in Dallas County. Health officials believe that the death was due to a cryptosporidium infection, but the medical examiner is still waiting on toxicology tests to determine the exact cause of her death. Her family says she tested positive for crypto after swimming in the Greenwood Hills Community Pool. Tests will take 10 days to confirm whether cryptosporidium played a part in the child’s death. If it is related, it would be the first death from the waterborne illness in recent memory.
Since June 2008, Dallas County has confirmed 41 cases of crypto. The crypto outbreak in the area began at Burger’s Lake in Fort Worth. Tarrant County has reported 81 cases of crypto, with 67 of them coming from Burger’s Lake.
All 30 pools of the YMCA of Metro Dallas, along with the city pools, were temporarily closed and hyperchlorinated in an attempt to wipe out the nasty parasite.
Experts are unsure of why there’s been a spike in outbreaks of cryptosporidiosis in recent years. It could be due to poor hygiene standards practiced by parents.
The crypto parasite has a thick outer shell, making it resistant to normal levels of chlorine. Available treatments include hyperchlorination and UV filters. Crypto enters the pool through fecal matter and the infection is especially dangerous to the young an the elderly, as well as the immunocompromised. Swimmers should wash their hands with warm soap water and also take a shower before entering the pool and after using the bathroom.
Arizona: Phoenix pool closures due to Cryptosporidium
Phoenix city officials have announced that all city pools will be closed after reports of 35 people who swam at Starlight Pool, including 14 from the pool staff, developing symptoms of cryptosporidium.The city of Phoenix says that while the water at all of its pools has been tested and "has continued to meet all water quality standards," it is taking extra precautions. To treat the pools, parks staff is super-chlorinating all of the pools to a level of 40 parts per million of chlorine and maintaining that level of chlorine for 40 hours. The Centers for Disease Control recommends 20 parts per million, but the City of Phoenix is using 40 parts per million to be safe.
Last summer Utah suffered an outbreak of cryptosporidium. Colorado has also suffered outbreaks. Hopefully this summer’s outbreak will be quickly contained and taken care of to avoid large numbers of sickness.
And of course, when using the bathroom at the pool, always wash your hands.
Bunny blamed for UK cryptosporidium alert
Just a harmless little bunny rabbit, like in Monty Python and the Holy Grail (right).A spokesman for Anglian Water said,
"Following extensive investigations, we can now confirm that the source of the cryptosporidium in the water has been linked to a small rabbit, which gained access to the treatment process via a remote ancillary tank shortly before cryptosporidia were detected. More scientific work will be undertaken to understand the unusual type of cryptosporidium found in this case."
Homewoners could be set for a cash rebate of up to £30 to compensate for the loss of water, with residents forced to endure days of having to boil water for drinking and cooking.
The Problem of Poop in the Pool
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Cryptosporidium and norovirus continue to be problems in public swimming pools, but many other kinds of illnesses can also be contracted from contaminated pool water. Including giardia, E. coli, and Shigella; collectively, all these diseases are known as recreational water illnesses (RWIs). The Centers for Disease Control and Prevention (CDC) defines RWIs as illnesses that are spread by swallowing, breathing, or having contact with contaminated water from swimming pools, spas, lakes, rivers, or oceans. The main culprit for RWIs is poop in the pool.Poop needs to be removed as soon as it’s spotted in the pool. If it’s formed stool, swimmers should exit the pool and the poop must be fished out of the pool without breaking it apart. Breaking the stool apart will release any harmful bacteria within it. Bacteria can still leech out of formed stool, but the sooner it’s removed the less likely that bacteria will escape. The pool must be properly treated before any swimmers can be allowed back into the pool. The CDC recommends raising the chlorine content of the water to 2.0 ppm (parts per million) for 30 minutes.
Diarrhea is a much more severe problem. Diarrheal accidents are much more likely than formed stool to contain germs. In this case, swimmers must exit the pool while the pool is treated. As much as possible of the fecal matter should be removed using a net or scoop. The chlorine will need to be raised to 20 ppm for 13 hours or 10 ppm for 26 hours. In most cases of diarrhea, the pool must be closed for an extended period of time.
Of course poop in the pool is a problem in private pools as well as commercial pools. Parents soon forget that their kiddie pool in the backyard must be treated in a similar manner when there is poop in the pool. In the case of small pools in the backyards, most do not have filters, so the entire pool must be emptied and scrubbed out with a strong bleach detergent.
Poop in the pool is a major health hazard. Luckily there are proven ways for pool managers to combat RWIs. Preventative measures include asking people suffering from diarrhea or infants with diapers to refrain from using the pool. Have a safe summer and help keep poop out of the pool.
Raw milk and crypto in pools -- policy choices and public health
And they often don't say much.
But there are examples of officials doing their jobs and being accountable to the public they serve. In the aftermath of the first case of homegrown bovine spongiform encephalopathy in Canada in May, 2003, Brian Evans, the chief veterinarian for the government of Canada, did an excellent job of explaining here's what we know, here's what we don't know, here's what we're doing to find out more, and whatever we find out, you'll hear it from me first.
Two public health officials have stepped out in the past two days and offered their analysis on a couple of persistent health risks: raw milk and parasites in swimming pools.
Yesterday, Dr. Stephen Ostroff, director, Bureau of Epidemiology, Pennsylvania Department of Health, wrote in the Lebanon Daily News that,
"In light of recent discussions pertaining to raw-milk health issues, the Pennsylvania Department of Health continues to advise consumers that raw milk is an inherently unsafe product regardless of how it is produced. While the permitting process unquestionably enhances the safety margin of raw milk, and we strongly endorse this program, it is not a substitute for milk pasteurization.…
Last year, an outbreak of salmonellosis due to consumption of raw milk sold in south-central Pennsylvania produced 29 illnesses. Sadly, many of the victims were children who had no choice in the kind of milk their parents purchased for them. Indeed, the department is currently investigating another raw-milk-associated outbreak of campylobacter infections. So far, more than 54 illnesses have been reported.
While standard hygiene and production practices can reduce the risk from consuming raw milk, they simply cannot eliminate it. In a 2006 survey of Pennsylvania dairy farms, pathogens were found in 13 percent of bulk tank raw-milk samples. Therefore, the department believes it is necessary to warn consumers about the risks associated with raw milk and to urge persons with immune disorders, pregnant women and young children to avoid consuming this product in the interest of protecting the public’s health."
Today, David N. Sundwall, executive director of the Utah Department of Health, wrote in The Salt Lake Tribune that,
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"The UDOH, along with our partners at Utah's local health departments, carefully considered whether to restrict young children from pools. Young children are more likely to become ill from crypto and more likely to leave poop in the pool. While it might seem like common sense to ban them, we cannot say that they caused the outbreak or that banning them would prevent another one.Children have been swimming in public pools in Utah in past years when outbreaks didn't occur. To our knowledge, no state bans children from public pools. Older children and adults, who have control of their bowels when healthy, are also susceptible to "leaking" if they swim with diarrhea.
We chose to continue to allow children to swim with swim diapers and waterproof swim pants. We believe this will help prevent contamination of the pool, but it isn't foolproof.
Parents of young children need to act responsibly and with common sense. They need to monitor their children and give them frequent potty breaks. Most important, they need to keep them out of the pools when they are ill with diarrhea and for two weeks afterward.
The UDOH takes seriously its responsibility to protect people from health threats like cryptosporidium. After last summer's outbreak, we considered multiple measures to help prevent a recurrence this summer. Preventing crypto transmission will require a combination of changes at pools and changes in behavior."
Both Ostroff and Sundwall are too be commended. You may not agree with what they say, but at least you know why they came to the positions they advocate. Public health types, please speak out.
Nothing will keep babies from pooping in pools -- so ban babies
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The editorial says,"Last year, after the outbreak, the state health department banned children under age 5 from public pools. It was a tough decision. But it was the right decision. …
"Swim diaper requirements will be difficult to enforce. And, unless the diapers
"waterproof" pants have elastic bands that are tighter than tourniquets, water-soluble fecal matter will still leak out.
"Public education won't work either. It might keep adults from spreading the parasite by showering thoroughly and abstaining from swimming after battling diarrhea, but nothing, short of a cork or maybe duct tape, will keep babies from pooping in pools."
The editorial concludes,
"If state regulators don't have the intestinal fortitude to ban babies from pools, local health departments should."
Babies won't be banned from public pools -- yet
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But, their parents may be required to buy special swim diapers that do a better job of containing diarrhea than widely available but ineffectual diapers like Huggies' Little Swimmers.And if there is another outbreak, tots in diapers will likely be banned.
Utah had one of 2007's largest crypto outbreaks in the nation, with 1,949 crypto cases reported. To try to stem the illness, spread through fecal-oral contact, pools in most of the state barred children under 5 from late August to late September. Children in diapers were banned through mid-November.
State epidemiologist Robert Rolfs was quoted as saying,
"Children should be able to go swimming. Most of the children aren't causing any trouble."
The suggested state rule would require waterproof pants and/or swim diapers that fit around the legs and waist for children 3 or younger, those who aren't potty-trained, and anyone without control of bodily functions.
Pooping in pools spreads to Australia
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This time it's New South Wales Health - it's nearly summertime in Sydney -- which has reported 129 reported cases of cryptosporidiosis in November, compared to 32 cases the previous month.NSW Health communicable diseases director Jeremy McAnulty said people who had suffered attacks of diarrhoea should wait two weeks before using swimming pools, adding,
"While there is no common link among most cases, in the past very large outbreaks in NSW have been caused by people swimming in contaminated pools. Pools can easily be contaminated by infectious swimmers and so it is vital that people take care not to contaminate pools."
Pool poop
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Colorado is the latest U.S. Midwest state to track an increase in cryptosporidium infections. The Colorado Department of Public Health and Environment said earlier this week about 50 cases were reported in August, more than four times the usual number.Today, the U.S. Centers for Disease Control reported that cases of confirmed cryptosporidiosis increased from 3,505 for 2003 to 3,911 for 2004 and to 8,269 for 2005, a 111.4 per cent increase. The report makes excellent reading and contains solid advice.
Just keep your mouth shut and no one will get hurt
As cases of cryptosporidium continue to crop up across the U.S. Midwest, at least two separate outbreaks appear to be emerging in Kansas, with at lease seven sick in Sedgwick County and additional cases reported in Johnson County.Kansas state epidemiologist Gail Hansen told The Witchita Eagle that people don't have to quit swimming this weekend, adding,
"Basically, if you're in a pool, keep your mouth shut. Because that's really the only way you'll get it."
Background information is available at the U.S. Centers for Disease Control Healthy Swimming website.
Stop pooping in the water
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Local health departments in Utah report that more than 150 cases of cryptosporidium have been, um, reported.The Utah Department of Health warns that the number of people reporting cases of severe diarrhea continues to rise, and exposure will likely not decline until people who are sick - or who have recently been sick - avoid pools and recreational waters
For more information about cryptosporidium, visit the Centers for Disease Control and Prevention or the Utah Department of Health's Web site.
Don't drink pool poop
There have been numerous outbreaks involving the parasite cryptosporidium linked to swimming pools across the U.S. this year.Yesterday, Rich Lakin of the Utah Department of Health said that 70 cases have been reported this year in Utah, Salt Lake and Davis Counties, up from the annual average of 40. As well, 3 confirmed cases in Mason City, Iowa led to the closure of two pools.
Larkin was cited as saying the parasite enters pool water through diaper-wearing children, swimmers who do not wash their hands after going to the bathroom and swimmers who do not shower before swimming in public pools. The parasite survives in the water and splashes of water are then ingested by the victims. People who become sick with the parasite remain contagious as long as two weeks after their symptoms disappear, so they need to stay out of public pools even after they feel better.
ABC4 in Utah reported that a quick observation of the Seven Canyons Fountain; a popular water play area for children in Salt Lake City's Liberty Park revealed a number of children playing in the water while wearing nothing but diapers. Their parents sat next to signs warning pool users not to allow children in diapers into the water. It is this kind of behavior that invites the spread of Cryptosporidium.
Lakin was further quoted as saying, "People need to step up and realize if they do have watery diarrhea they need to stay out of the pools and not spread this any further. Again, it is chlorine resistant and it's a very difficult disease to kill."
