Report on Cryptosporidiosis Outbreak at a North Carolina Summer Camp in 2009
An article in the CDC's Morbidity and Mortality Weekly Report (MMWR) discusses the final report on a 2009 outbreak of Cryptosporidium infections (cryptosporidiosis) linked to a summer camp in North Carolina.
In July 2009, local, regional, state, and federal public health officials investigated a cryptosporidiosis outbreak at a youth summer camp in North Carolina. The investigation identified 46 laboratory-confirmed and probable cryptosporidiosis cases at the camp. Analyses of data from a retrospective cohort study of staff members revealed that eating ham from a sandwich bar that included camp-grown raw produce and sharing a cabin with an ill person were significantly associated with illness.
Cryptosporidium isolates from stool specimens of livestock and humans at the camp were of the identical Cryptosporidium parvum subtype, IIaA17G2R1, indicating that zoonotic transmission had occurred, and suggesting a link not implicated by traditional epidemiologic methods. [C. parvum was detected in stool specimens from one (10%) of 10 Jersey calves, two (17%) of 12 Holstein calves, one goat kid (33%) of three goats, and one piglet (50%) of two pigs.] This investigation underscores the importance of reducing the risk for Cryptosporidium transmission in camp settings and the value of Cryptosporidium subtyping as a tool to elucidate cryptosporidiosis epidemiology.
On June 24 [2009] owners of a North Carolina youth summer camp and health-care providers began identifying cases of diarrhea in campers and staff members and notified local public health officials. By June 30, local, regional, and state public health officials had identified four laboratory-confirmed cases of cryptosporidiosis and >30 cases of diarrhea at the camp. CDC was asked to collaborate on the investigation because no common outbreak exposure was identified and multiple potential outbreak sources were present at the camp. The investigation focused on identifying risk factors associated with acute cryptosporidiosis and implementing control measures to stop Cryptosporidium transmission at the camp.
At the time of the outbreak, the camp did not have a hand-washing sink in the barn area. Instead, people were encouraged to spray a diluted bleach solution on their hands before and after interacting with the calves and other livestock. After the outbreak began, the camp installed a hand-washing sink in the barn area.
