Aquatics

Outbreak Survival Guide

By Elise Knox

y now most of you have probably heard about Cryptosporidium—a horrible parasite that makes your bathers very sick.

Cryptosporidium (commonly called Crypto) is a microscopic parasite, 2 to 6 microns in size that is chlorine-resistant. Symptoms of infection include many days of watery diarrhea, stomach cramps and fever followed by dehydration. Preschoolers and people with immune system conditions are particularly vulnerable. The parasite is waterborne, but it can also be transmitted through food or handling fecal matter. It's ugly.

As of Sept. 12, 2008, there were 419 confirmed cases of crypto for the summer in the Tarrant, Texas, county area. Of those, 114 alone were linked to an outbreak at Burger's Lake in Fort Worth. And these were only the "confirmed" cases. Basically, there was a lot of crypto in our area last summer. Every night, I watched local TV news broadcasts, as the confirmed case count rose, and the footage of public pool closures got closer and closer to my town.

Luckily for us, we anticipated this outbreak, and it gave us a big boost for our public relations. In 2007, our maintenance staffer Frank Armijo and I attended a presentation by the Centers for Disease Control at a state aquatics conference where they discussed the "potential nightmare" crypto could be to a community. We decided to take as aggressive an approach to prevention as we could manage.

Proactive Prevention Tips

Last year, we were the first pool in the region to use a new chemical to inhibit crypto. This product is designed to improve the filter's ability to trap particles (down to 0.5 microns). The crypto cysts are approximately 2 to 6 microns in size.

We keep the base level of chlorine at 2 or 3 parts per million, instead of the 1ppm that the state requires. That way, we don't ever drop below the state standard.

We hyperchlorinate, per the CDC recommendation.

Our staff actively works to enforce the "shower before swimming" rule.

Our policy response for formed-stool and diarrheal fecal accidents follows the CDC recommendations. We also do a gallon bleach drop in the immediate area (of a fecal release) to make sure that we have neutralized that target zone.

We display signs and posters from the CDC warning people not to drink, spit or spout pool water. Our guards enforce the "no spitting or spouting" rule.

We have given visiting day cares plenty of the CDC brochures to inform parents why kids need to be kept out of the pool if they have diarrhea.

We have installed diaper-changing stations in each restroom and stop adults from making changes on the deck and tables near the pools.

On weekdays (when children are most likely to come to the pool alone) we have a 3 p.m. and 5 p.m. restroom/hydration break. Every child, age 7 through 17, is required to exit the pool water for 30 minutes. They are encouraged to go to the restroom and to stop at the water fountain for a drink.

Chemical Prevention

We knew we couldn't budget for UV filters in all of our pools, but we needed to prepare because a Metroplex outbreak would be sure to include us. We decided to go "high tech" with a new kind of chemical treatment.

We were the first pool in the area to use a product designed to work on top of the filter surface, only allowing particles up to 0.5 microns to pass through. We have used this product now for two summers and we've had the side benefit of excellent water clarity.

The technology depends upon two complementary biopolymers that, used in the right proportions and molecular forms, lead quickly to the formation of stable flocculants and the effective entrapment of microorganisms such as algae, E. coli, Giardia and crypto in standard-depth filter media.

In addition, we did hyperchlorinate our water per CDC recommendations. However, chlorine is not an end-all. It's a clean-right-now solution only. I like to compare hyperchlorinating to washing a doorknob during flu season. The next person that comes along and sneezes on your doorknob, it's back to the same mess.

Staff & Lifeguard Training

We have always been heavy with the "low tech" methods, but this really showed our staff members why we actively work to enforce the "shower before swimming" and "no spitting or spouting" rules. We also displayed clever signs and funny posters that the CDC has on their Web site for our facilities, reinforcing those same rules.

Educating the Public

Before swim season, all of our visiting daycare centers received CDC brochures from us to inform parents why children need to be kept out of the pool if they have diarrhea. Diaper-changing stations were installed in each restroom in order to stop adults from making changes on the deck and tables near the pools.

On weekdays, when children are most likely to come to the pool alone, we have mandatory restroom/hydration breaks at 3 and 5 p.m. Every child age 7 through 17 years old is required to exit the pool water for 30 minutes. They are encouraged to stop at the water fountain for a drink and strongly pressured to go to the restroom (so they don't use the pool as their bathroom).

We established a Web site for the public to read about our prevention methods and offering links to CDC's site.

The End Result

Finally, people actually thanked us for enforcing rules! It was amazing how supportive our patrons became as we explained why we had breaks and required showers.

The month of August was very tough for us, as the Metroplex was having a reasonable panic over the "Crypto-Scare" in the Fort Worth area. With each nightly news show, we could see our attendance dropping. Even though we made the big news stations with our prevention program, we still took a big hit in our revenue.

I did get the horrifying call from the local health department that a woman infected with crypto while she was on vacation came home and visited her doctor for treatment. She must have been feeling better, because when the health department called to check on her, they found out she had just visited our facility. We did an emergency hyperchlorination and a lot of damage control in our publicity.

Although we did not have a major outbreak, we did have one confirmed case after being exposed by the diagnosed swimmer. We now have the confidence that we took the correct precautions to prevent this parasite from becoming a devastating infection of our facility. We are currently searching the industry and hoping for a better method of testing the water—or maybe someday there just might be a way to screen our guests for crypto before they enter our facility!

ABOUT THE AUTHOR

Elise Knox has been in the aquatics industry since 1976, when she started helping her mother with Red Cross training courses. Her current facility at The Colony has four pools ranging from 165,000 gallons down to 6,000 gallons, including a splash play area. She has been the aquatics director at The Colony since 1986. For more information on the chemical solution used at The Colony, visit www.seaklear.com.

For more information about The Colony Aquatic Park, visit www.ci.the-colony.tx.us/Depts/PARD/Aquatics/Aquatics.html.