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The mode of transmission was unknown for 63 Molecular characterization data were available for 67 Negative binomial regression analysis indicated that during —, the overall annual number of reported cryptosporidiosis outbreaks increased an average of The annual number of reported treated recreational water—associated outbreaks increased an average of During —, the annual number of reported outbreaks associated with contact with cattle increased an average of During —, the overall number of reported cryptosporidiosis outbreaks by month peaked during July—August, the number associated with treated recreational water peaked in June—August, the number associated with cattle contact peaked during March—May, and those associated with contact with infected persons in child care settings peaked during July—September Figure 2.

Top Discussion The outbreaks characterized in this report highlight the public health importance of Cryptosporidium, which is the leading etiology of waterborne outbreaks 1 and the third leading etiology of enteric infections attributable to animal contact 2 in the United States. These factors should be considered in the development of effective cryptosporidiosis prevention measures. The number of treated recreational water—associated outbreaks caused by Cryptosporidium drives the summer seasonal peak in both waterborne cryptosporidiosis outbreaks and cryptosporidiosis outbreaks overall.

The summer seasonal peak of cryptosporidiosis outbreaks associated with child care is similar to that of treated recreational water—associated outbreaks. Consequently, community-wide cryptosporidiosis outbreaks, in which an outbreak associated with a single treated recreational water venue evolves into one associated with multiple venues and settings e.

Thus, primary prevention of Cryptosporidium contamination is important. CDC recommends not swimming or attending child care if ill with diarrhea and not swimming for an additional 2 weeks after diarrhea has resolved. Cryptosporidium contamination can be unavoidable and widespread in environments where ruminants such as cattle, goats, and sheep live. Cryptosporidium transmission from preweaned calves to humans has been well documented, and the spring seasonal peak in outbreaks associated with contact with cattle coincides with the spring calving season 7.

Cryptosporidium caused 13 outbreaks associated with unpasteurized milk or apple cider during — Outbreak sources might include contaminated udders, apples, or processing equipment. CDC recommends consumption of pasteurized milk and apple cider because of the risk for infection from unpasteurized products in general and the risk for severe illness in young children, pregnant women, and immunocompromised persons.

First, the outbreaks described in this report likely underestimate the actual number of cryptosporidiosis outbreaks, and the reported number of cases likely underestimate the actual magnitude of individual outbreaks. Second, the advent of multipathogen molecular testing panels, which include Cryptosporidium, could have contributed to the increase in reported outbreaks in recent years.

Third, requirements and capacity to detect, investigate, and report outbreaks vary across jurisdictions. Thus, it is unclear if approximately half of the outbreaks actually occurred in the Great Lakes states; further investigation is warranted.

Fourth, only two outbreaks were determined to be the result of transmission by environmental contamination; this might be because of difficulties inherent to implicating fomites as an outbreak source. Finally, only 67 NORS outbreak reports included molecular characterization data, precluding analysis of mode of transmission by Cryptosporidium species and genotypes.

Reversing the increasing trends in annual numbers of reported cryptosporidiosis outbreaks overall and those associated with treated recreational water, contact with cattle, or contact with infected persons in child care settings will require implementing effective prevention measures.

The City of Shawnee has performed a shock treatment to the pool. This kills the protozoa and removes any potential danger. We encourage everyone to wash their hands frequently and ensure their children take frequent breaks from the pool to prevent accidents. It is spread by contact with feces of infected people or animals, consumption of food contaminated by feces, person-to-person, and animal-to-animal contact. Symptoms usually develop 2 to 10 days after exposure and last 1 to 2 weeks.

This illness can be spread for two weeks after the symptoms disappear. For this reason, anyone who has had diarrhea should not swim for 2 weeks after the symptoms end.