Cryptosporidiosis Outbreaks On The Rise, CDC Warns

For example, because cryptosporidiosis has an incubation period of roughly a week or so, it can be easy to miss an outbreak at a given location, Hlavsa said.

"It's not like with the norovirus, where I  go swimming and a few hours later I become sick," she said.

Educating Patients on Healthy Swimming

According to Hlavsa, the biggest message to convey to patients about how to prevent recreational water illnesses is, "If you have diarrhea, stay out of the water."

It's also important to shower for at least one minute before entering a pool to remove dirt and any other bodily substance that chlorine will seek to break down instead of doing its job to kill germs.

In addition, the CDC recommends that people not swallow pool or similar aquatic facilities' water. "Chlorine kills germs, but doesn't do so instantly," she said. "So germs like E(scherichia) coli and Shigella can also cause outbreaks."

And finally, make sure to relay the simple message to parents and their children that it's important to not urinate or defecate in the pool.

The CDC offers additional tips>(www.cdc.gov) on protecting against recreational water illnesses, along with a free downloadable brochure>(www.cdc.gov) that can be printed and handed out to patients.

Diagnosing, Treating Cryptosporidiosis

A May 1 >MMWR Surveillance Summary(www.cdc.gov) on cryptosporidiosis and giardiasis recommended that health care professionals consider cryptosporidiosis in the differential diagnosis when a patient experiences diarrhea that lasts for more than three days.

And Hlavsa emphasized that because routine laboratory examination of stool for ova and parasites is unlikely to include testing for Cryptosporidium, health care professionals need to specifically request Cryptosporidium testing when exposure is suspected.

Furthermore, said the surveillance summary, because oocyst excretion can be intermittent, the parasite might not be detected in a given stool specimen. Therefore, three stool specimens should be collected on separate days for examination before considering test results to be negative.

Hlavsa said if a patient is diagnosed with cryptosporidiosis, he or she should be told to not only stay out of the pool when they have diarrhea, but also to stay out of the water for the following two weeks to avoid spreading the Cryptosporidium oocysts.

Nitazoxanide (Alinia) is FDA-approved for treatment of cryptosporidiosis>(www.cdc.gov) in immunocompetent patients ages 1 and older.

Related AAFP News Coverage

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AAFP Resource Offers Tips for Hydration, Sun Protection and Pool Safety

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Additional Resource

CDC Healthy Swimming/Recreational Water Information for Medical Professionals>(www.cdc.gov)

Source : http://www.aafp.org/news/health-of-the-public/20150701cryptooutbreaks.html

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