scholarly journals Swimming Pool-Related Outbreak of a Rare gp60 Subtype of Cryptosporidium hominis, England, October 2016

Water ◽  
2021 ◽  
Vol 13 (22) ◽  
pp. 3152
Author(s):  
Helen Bagnall ◽  
Rachel M. Chalmers ◽  
Michelle Henderson ◽  
Stewart Sorrell ◽  
Guy Robinson ◽  
...  
Keyword(s):  
Public Health ◽  
Water Treatment ◽  
Swimming Pool ◽  
Control Measures ◽  
Reference Laboratory ◽  
Swimming Pools ◽  
Cryptosporidium Hominis ◽  
Secondary Transmission ◽  
Transmission Pathways ◽  
Gp60 Subtypes

In October 2016, Public Health England was initially notified of four cases of cryptosporidiosis among users of two swimming pools. We investigated to identify further cases, the outbreak source, and ensure the implementation of appropriate control measures. Probable primary cases had diarrhoea and reported swimming in the pools 1–12 days prior to illness; confirmed cases were verified by the reference laboratory. Secondary cases had contact with primary cases 1–12 days prior to illness. We identified twenty-two cases: eleven were primary (eight confirmed) and eleven were secondary (five confirmed). Four cases were infected with C. parvum (different gp60 subtypes); all were primary and swam at two pools. Seven primary and secondary cases were infected with C. hominis gp60 subtype IdA16, and all were associated one pool. Failings in pool water treatment and management were identified that likely contributed to the load on the filters and their efficiency. Our investigation identified a complex outbreak, with secondary transmission, involving exposures to two swimming pools. C. hominis IdA16 is rare; it has been isolated from only three previous UK cases. We hypothesize that C. hominis cases arose from a common exposure, and the C. parvum cases were likely sporadic. This investigation highlights the value of integrating epidemiology and microbiology to investigate clusters of Cryptosporidium cases, defining the extent of the outbreak and the likely transmission pathways.

scholarly journals The effect of cyanuric acid on the disinfection rate of Cryptosporidium parvum in 20-ppm free chlorine

2008 ◽  
Vol 7 (1) ◽  
pp. 109-114 ◽  
Author(s):  
Joan M. Shields ◽  
Michael J. Arrowood ◽  
Vincent R. Hill ◽  
Michael J. Beach
Keyword(s):  
Public Health ◽  
Cryptosporidium Parvum ◽  
Cyanuric Acid ◽  
Free Chlorine ◽  
Swimming Pool ◽  
Swimming Pools ◽  
Log10 Reduction ◽  
Chlorine Residual ◽  
Cryptosporidium Oocysts ◽  
Reduction Current

Cyanuric acid is used to stabilize free chlorine to reduce photodegradation in outdoor swimming pools. While there have been numerous studies examining its effect on the disinfection rates of bacteria and viruses, it is not known whether cyanuric acid can significantly impact the effectiveness of hyperchlorination for inactivating Cryptosporidium oocysts present in fecally-contaminated swimming pools. This study examined the effect of cyanuric acid on the disinfection rate of Cryptosporidium parvum under swimming pool hyperchlorination conditions (20 mg/ml free chlorine). When 50 mg/L cyanuric acid was present there was a 0.70-log10 reduction in oocyst viability after 10 hours as compared to a 3.7-log10 reduction without cyanuric acid. Aids to remediation, such as decreasing the pH to enhance the germicidal efficiency of the free chlorine and doubling the amount of free chlorine residual, were still unable to achieve a 3-log10 reduction. Current public health recommendations for hyperchlorination and pool remediation are insufficient for pools using cyanurate-stabilized chlorine to achieve a three log inactivation of the parasite.

The Occurrence of Unfavorable Phenomena in Swimming Pool Water

2021 ◽  
Vol 9 (1) ◽  
pp. 38
Author(s):  
Anna Lempart-Rapacewicz ◽  
Edyta Kudlek ◽  
Mariusz Dudziak ◽  
Marta Dyrała
Keyword(s):  
Water Treatment ◽  
Experimental Studies ◽  
Swimming Pool ◽  
Swimming Pools ◽  
Organic Micropollutants ◽  
Water Turbidity ◽  
Pool Water ◽  
Treatment Processes ◽  
Swimming Pool Water ◽  
The Relationship

The study assessed unfavorable phenomena occurring in swimming pool water, including the occurrence of organic micropollutants in swimming pools and the transformation of these compounds during the swimming pool water treatment processes. The presence of three selected compounds was examined from the personal care products group (PCP) in pool water samples, collected in 2018 and 2019, from fifteen pools characterized using three different solutions of swimming pool water treatment systems. In addition, experimental studies on the effects of UV radiation and ozone on selected organic micropollutants, previously identified in swimming pools and the relationship between swimming pool water turbidity and the concentration of the selected PCP micropollutants, were carried out

scholarly journals An outbreak of Salmonella Saintpaul in a Scottish childcare facility: the influence of parental under-reporting

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Rachel M. Thomson ◽  
Hazel J. Henderson ◽  
Alison Smith-Palmer
Keyword(s):  
Public Health ◽  
Infection Control ◽  
Gastrointestinal Symptoms ◽  
Control Measures ◽  
Incident Management ◽  
Reference Laboratory ◽  
Public Health Department ◽  
Water Tank ◽  
Stool Samples ◽  
Childcare Facility

Abstract Background Salmonella outbreaks in childcare facilities are relatively rare, most often occurring secondary to contaminated food products or poor infection control practices. We report an outbreak of Salmonella Saintpaul at a pre-school facility in Ayrshire, Scotland with atypical clinical and epidemiological features. Methods Following notification of the initial two cases, the multi-disciplinary Incident Management Team initiated enhanced active case finding and two environmental inspections of the site, including food preparation areas. Parent and staff interviews were conducted by the Public Health department covering attendance, symptomatology and risk factors for all probable and confirmed cases. Microbiological testing of stool samples and the facility water tank was conducted. Whole Genome Sequencing (WGS) was performed for positive stool samples at the national reference laboratory. Infection control measures were introduced iteratively due to the atypical progression of the outbreak. Results There were 15 confirmed cases and 3 children admitted to hospital during the outbreak. However, 35.7% of cases reported extremely mild symptoms. The attack rate was 15.2%, and age of affected children ranged from 18 to 58 months (mean 35 months). All cases were the same Multilocus Sequence Type (MLST50). Epidemiological investigation strongly suggested person-to-person spread within the facility. Existing infection control practices were found to be of a high standard, but introduction of additional evidence-based control measures was inadequate in halting transmission. Facility staff reported concerns about lack of parental disclosure of gastrointestinal symptoms, particularly where these were mild, with 50.0% of cases having attended while symptomatic against public health advice. Voluntary two-week closure of the facility was implemented to halt transmission, following which there were no new cases. WGS results were unavailable until after the decision was taken to close the facility. Conclusions This is the first reported instance of a Salmonella Saintpaul outbreak at a childcare facility, or where person-to-person transmission is indicated. Clinicians should consider the influence of parental under-reporting on gastrointestinal outbreaks in childcare settings, particularly where perceived severity is low and financial or social pressures to attend work may reduce compliance. WGS cannot yet replace conventional microbiological techniques during short, localised outbreaks due to delays receiving results.

scholarly journals Translating genomics into practice for real-time surveillance and response to carbapenemase-producing Enterobacteriaceae: evidence from a complex multi-institutional KPC outbreak

PeerJ ◽  
2018 ◽  
Vol 6 ◽  
pp. e4210 ◽  
Author(s):  
Jason C. Kwong ◽  
Courtney R. Lane ◽  
Finn Romanes ◽  
Anders Gonçalves da Silva ◽  
Marion Easton ◽  
...  
Keyword(s):  
Public Health ◽  
Infection Control ◽  
Real Time ◽  
The State ◽  
Control Measures ◽  
Reference Laboratory ◽  
Epidemiological Investigation ◽  
Transmission Networks ◽  
Healthcare Facilities ◽  
Incident Cases

BackgroundUntil recently,Klebsiella pneumoniaecarbapenemase (KPC)-producing Enterobacteriaceae were rarely identified in Australia. Following an increase in the number of incident cases across the state of Victoria, we undertook a real-time combined genomic and epidemiological investigation. The scope of this study included identifying risk factors and routes of transmission, and investigating the utility of genomics to enhance traditional field epidemiology for informing management of established widespread outbreaks.MethodsAll KPC-producing Enterobacteriaceae isolates referred to the state reference laboratory from 2012 onwards were included. Whole-genome sequencing was performed in parallel with a detailed descriptive epidemiological investigation of each case, using Illumina sequencing on each isolate. This was complemented with PacBio long-read sequencing on selected isolates to establish high-quality reference sequences and interrogate characteristics of KPC-encoding plasmids.ResultsInitial investigations indicated that the outbreak was widespread, with 86 KPC-producing Enterobacteriaceae isolates (K. pneumoniae92%) identified from 35 different locations across metropolitan and rural Victoria between 2012 and 2015. Initial combined analyses of the epidemiological and genomic data resolved the outbreak into distinct nosocomial transmission networks, and identified healthcare facilities at the epicentre of KPC transmission. New cases were assigned to transmission networks in real-time, allowing focussed infection control efforts. PacBio sequencing confirmed a secondary transmission network arising from inter-species plasmid transmission. Insights from Bayesian transmission inference and analyses of within-host diversity informed the development of state-wide public health and infection control guidelines, including interventions such as an intensive approach to screening contacts following new case detection to minimise unrecognised colonisation.ConclusionA real-time combined epidemiological and genomic investigation proved critical to identifying and defining multiple transmission networks of KPC Enterobacteriaceae, while data from either investigation alone were inconclusive. The investigation was fundamental to informing infection control measures in real-time and the development of state-wide public health guidelines on carbapenemase-producing Enterobacteriaceae surveillance and management.

Swimming Pools – Brief Outline of Water Treatment and Management

1989 ◽  
Vol 21 (2) ◽  
pp. 151-160 ◽  
Author(s):  
D. E. J. Powick
Keyword(s):  
Water Treatment ◽  
Residual Effect ◽  
Swimming Pool ◽  
Swimming Pools ◽  
Pool Water ◽  
History Of ◽  
Swimming Pool Water

A brief history of the development of swimming pool water treatment and management has been discussed, applicable to both large and small pools. An outline of typical bathing loads and current methods of water treatment has been presented with particular emphasis being given to disinfection. Chlorine has been the traditional sole disinfectant used since the 1920's but alternatives are continually being sought. Chief amongst the alternatives to date has been ozone, used in conjunction with chlorine. Ozone acts as a powerful oxidiser and disinfectant but has little residual effect. Chlorine is therefore used to provide a residual in the pool. Current British trends in pool design and treatment have been noted.

scholarly journals Application of Water Quality Index in Assessment of Swimming Pools Water Quality in Hotels in Emerging Africa Littoral Metropolis of Warri, Delta State, Nigeria

2020 ◽  
Vol 13 (2) ◽  
pp. 91-107
Author(s):  
Obot Akpan IBANGA ◽  
◽  
Stephanie Emuobonuvie OHWO ◽  
Goodluck Mamuro OMONIGHO ◽  
◽  
...  
Keyword(s):  
Public Health ◽  
Water Quality ◽  
Water Quality Index ◽  
Quality Index ◽  
Heterotrophic Bacteria ◽  
Swimming Pool ◽  
Sub Saharan Africa ◽  
Public Health Issue ◽  
Residual Chlorine ◽  
Swimming Pools

Swimming pools in guest houses and hotels in many cities in sub-Saharan Africa have been labelled ‘beautiful irritation’ or hazard zones for public health issues due to the unwholesomeness of water. Pollution in swimming pools is therefore, not uncommon and it is a serious public health issue both at the global, regional, national and local levels. This study focused on application of water quality index in assessment of swimming pools water quality in hotels in emerging Africa littoral metropolis of Warri, Delta State, Nigeria. It used stratified random sampling technique to select five hotels with swimming pool in Warri for assessment. Temperature, pH, turbidity, free (residual) chlorine, total heterotrophic bacteria, total heterotrophic fungi, Escherichia coli and Staphylococcus aureus tested in the laboratory using scientific method of sampling. Water quality index (WQI) was computed using Weighted Arithmetic Water Quality Index (WAWQI) to evaluate in general, the quality of water in each of the five sampled swimming pools. A five-point scale (excellent, good, poor, very poor and unsuitable) was used to rank each swimming pool quality. Result showed that Wellington Hotel had the value of 2.52 and considered excellent in terms of water quality index value. Also, Brook View and Best Western Plus Hotels were classified as good water based on water quality index values of 36.9 and 39.9 respectively while BB swimming pool was ranked poor due to water quality index of 51.4. In contrast, Oasis Place Hotel swimming pool was declared unsuitable for recreational purpose due to a water quality index of 102.1. The study recommended routine and periodic surveillance of swimming pools and other recreational water sources to guarantee optimum health and wellbeing of users.

scholarly journals A Case of Lassa Fever Diagnosed at a Community Hospital—Minnesota 2014

2018 ◽  
Vol 5 (7) ◽  
Author(s):  
Mary J Choi ◽  
Shewangizaw Worku ◽  
Barbara Knust ◽  
Arnold Vang ◽  
Ruth Lynfield ◽  
...  
Keyword(s):  
Public Health ◽  
Health Care ◽  
Infection Control ◽  
Community Hospital ◽  
Lassa Fever ◽  
Control Measures ◽  
Health Care Personnel ◽  
Secondary Transmission ◽  
Infection Control Measures ◽  
Hospital Infection Control

Abstract Background In April 2014, a 46-year-old returning traveler from Liberia was transported by emergency medical services to a community hospital in Minnesota with fever and altered mental status. Twenty-four hours later, he developed gingival bleeding. Blood samples tested positive for Lassa fever RNA by reverse transcriptase polymerase chain reaction. Methods Blood and urine samples were obtained from the patient and tested for evidence of Lassa fever virus infection. Hospital infection control personnel and health department personnel reviewed infection control practices with health care personnel. In addition to standard precautions, infection control measures were upgraded to include contact, droplet, and airborne precautions. State and federal public health officials conducted contract tracing activities among family contacts, health care personnel, and fellow airline travelers. Results The patient was discharged from the hospital after 14 days. However, his recovery was complicated by the development of near complete bilateral sensorineural hearing loss. Lassa virus RNA continued to be detected in his urine for several weeks after hospital discharge. State and federal public health authorities identified and monitored individuals who had contact with the patient while he was ill. No secondary cases of Lassa fever were identified among 75 contacts. Conclusions Given the nonspecific presentation of viral hemorrhagic fevers, isolation of ill travelers and consistent implementation of basic infection control measures are key to preventing secondary transmission. When consistently applied, these measures can prevent secondary transmission even if travel history information is not obtained, not immediately available, or the diagnosis of a viral hemorrhagic fever is delayed.

The first UK report of a rare Cryptosporidium hominis genetic variant isolated during a complex Scottish swimming pool outbreak

2021 ◽  
Author(s):  
Padmaja Polubotho ◽  
Lucy Denvir ◽  
Lisa Connelly ◽  
Eleanor Anderson ◽  
Claire L. Alexander
Keyword(s):  
Genetic Variant ◽  
Swimming Pool ◽  
Control Measures ◽  
Gastrointestinal Infections ◽  
Cryptosporidium Hominis ◽  
Health Leadership ◽  
The Common ◽  
Multiple Species ◽  
The Uk ◽  
Public Health Leadership

Cryptosporidium species are responsible for causing the majority of parasite-related gastrointestinal infections in the UK. This report describes an outbreak of 12 laboratory-confirmed cryptosporidiosis cases identified as part of a Scottish swimming pool investigation, with 9 primary and 3 secondary cases occurring over an 8-week period. Molecular speciation was successful for 11/12 cases, which revealed 10 Cryptosporidium hominis cases and 1 Cryptosporidium parvum case. Of the 10 C. hominis cases, further typing identified 7 as being an unusual sub-type, IbA6G3, which is the first description in the UK of this rare variant. The remaining three C. hominis cases were identified as the common IbA10G2 subtype. Following implementation of control measures on two occasions, no further cases were reported. This report highlights the importance of molecular typing to identify and characterize outbreaks, and emphasizes the need to adhere to swimming pool guidance. It also raises awareness of the potential for outbreaks to involve multiple species/sub-types, and emphasizes the importance of strong public health leadership to ensure effective multi-agency investigations and management of outbreaks.

Review of swimming-associated cryptosporidiosis and Cryptosporidium oocysts removals from swimming pools

2013 ◽  
Vol 48 (1) ◽  
pp. 30-39 ◽  
Author(s):  
Ping Lu ◽  
Tao Yuan ◽  
Qiyan Feng ◽  
Aiqin Xu ◽  
Jiayuan Li
Keyword(s):  
Drinking Water ◽  
Water Treatment ◽  
Removal Rate ◽  
Drinking Water Treatment ◽  
Swimming Pool ◽  
Swimming Pools ◽  
Sand Filters ◽  
Pool Water ◽  
Cryptosporidium Oocysts ◽  
Swimming Pool Water

In this paper, outbreaks of cryptosporidiosis in swimming pools in the last 20 years are summarized. Cryptosporidium oocysts are very resistant to many disinfectants, including chlorine, one of the most widely-used disinfectants in swimming pools. Ozone or UV is shown to inactivate Cryptosporidium, while not effective to newly introduced Cryptosporidium and bacteria because of no residual ozone or UV in the treated swimming pool water. Additionally, swimming pool sand filters or cartridge filters are not able to effectively remove Cryptosporidium (removal rate <50%). Above 99% Cryptosporidium removals are achieved in drinking water treatment, but swimming pool water treatment is different from drinking water treatment: no coagulation is performed prior to filtration in most US swimming pools, filtration rate is four to five times higher for swimming pool water treatment compared with drinking water treatment, and the input compounds and microorganisms from bathers continuously recirculate in the swimming pool. Moreover, up-to-date Cryptosporidium or Cryptosporidium surrogate removals from swimming pools are discussed, and alternative swimming pool treatment techniques are reviewed.

scholarly journals Inactivation of SARS-CoV-2 in chlorinated swimming pool water

2021 ◽  
Author(s):  
Jonathan C Brown ◽  
Alex Blackwell ◽  
Maya Moshe ◽  
Wendy S Barclay
Keyword(s):  
Public Health ◽  
Mental Health ◽  
Direct Cost ◽  
Swimming Pool ◽  
Swimming Pools ◽  
Physical And Mental Health ◽  
Pool Water ◽  
Swimming Pool Water ◽  
Infectious Titre ◽  
The Uk

SARS-CoV-2 transmission remains a global problem which exerts a significant direct cost to public health. Additionally, other aspects of physical and mental health can be affected by limited access to social and exercise venues as a result of lockdowns in the community or personal reluctance due to safety concerns. Swimming pools have reopened in the UK as of April 12th, but the effect of swimming pool water on inactivation of SARS-CoV-2 has not yet been directly demonstrated. Here we demonstrate that water which adheres to UK swimming pool guidelines is sufficient to reduce SARS-CoV-2 infectious titre by at least 3 orders of magnitude.

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