Prevention and Control of Crypto at Camps
Summer camps can provide the perfect environment for the spread of Crypto. To help prevent and control the spread of Crypto in camp settings, CDC has developed the following recommendations for camp owners and managers.
These recommendations were, in part, developed in collaboration with the New York State Department of Health. Wording for recommendations for preventing the spread of Cryptosporidium from animals to humans was taken or adapted from the Compendium of Measures to Prevent Disease Associated with Animals in Public Settings, 2011[PDF - 28 pages].
|Areas of focus||Logic supporting recommendations and resources|
Provide appropriate and accessible hand hygiene stations with running water, soap, and disposable towels or air dryers. Hands should be washed.
For steps on how to properly wash hands, visit www.cdc.gov/handwashing.
Many germs like Cryptosporidium (or "Crypto" for short) that cause diarrhea, vomiting, and other gastrointestinal symptoms can be spread by not washing hands with soap and clean, running water. Hand washing can help protect camper and staff health.
Note: Hand sanitizers are not effective when hands are visibly dirty. Alcohol-based hand sanitizers are not effective against Crypto.
Review and implement recommendations in the Compendium of Measures to Prevent Disease Associated with Animals in Public Settings, 2011 (or the Compendium for short), available at www.cdc.gov/mmwr/pdf/rr/rr6004.pdf[PDF - 28 pages].
Consult with veterinarians, state and local agencies, or cooperative extension programs on how to put these recommendations into practice.
Educate campers and staff, before animal contact, about the risk of animals spreading germs to humans and how they can reduce the risk of illness.
Provide accessible handwashing stations with soap and clean, running water and position the stations to encourage hand washing when exiting animal areas.
Supervise children during animal contact and discourage hand-to-mouth activities (for example, nail biting and thumb sucking) and contact with animal manure or soiled bedding.
Separate animal and non-animal areas. Do not permit any animals other than service animals in non-animal areas as much as possible.
Do not allow food and beverages in animal areas.
Remove manure and soiled animal bedding from animal areas promptly.
Monitor animals daily for signs of illness and ensure that animals receive appropriate veterinary care. Only staff responsible for animal care should have contact with ill animals, animals known to be carrying germs that cause diarrhea in humans, and animals from herds with a recent history of diarrhea.
Provide potable water for animals.
Consider limiting contact with calves to after calves are weaned.
Pre-weaned calves are often infected with Cryptosporidium parvum. Touching animals, their manure (feces), or anything in their environment can spread germs like Crypto from animals to humans. Objects such as clothing and shoes can become soiled and serve as a source of germs. Even animals that appear to be clean and healthy can spread germs to humans.
Note: Additional recommendations are included in the Compendium, such as designing animal areas to help prevent the spread of germs from animals to humans. Camp owners/managers might also find resources (for example, hand-washing posters) at the end of the Compendium helpful.
Maintain pools, lakes, and other recreational water venues at the camp to standards set by local or state laws. Maintaining proper chlorine (1–3 parts per million or ppm) and pH (7.2–7.8) levels is the first defense against the spread of most germs in pools.
Do not swim or enter recreational water when ill with diarrhea. This includes aquatics staff.
Exclude campers and staff diagnosed with cryptosporidiosis, the diarrheal disease caused by Crypto, from swimming or entering recreational water for two weeks after diarrhea stops. People infected with Crypto can continue to shed Crypto for two weeks after diarrhea stops.
Do not swallow pool, lake, or other recreational water.
Practice good swimmer hygiene — shower with soap and before swimming and wash hands (as described above) after using the toilet.
Swimmers share the water with everyone they swim with, and a person with diarrhea can easily contaminate the water with fecal matter and germs, like Crypto. Additionally, when these germs are on swimmer’s bodies they can wash off in the water and contaminate it. The germs can be spread when swimmers swallow the contaminated water.
Note: Chlorine kills germs in pools, but it doesn’t work instantly. Most germs are killed within minutes, but Crypto can survive even in well-maintained pools for more than 10 days.
Drinking water/Well water
Maintain wells at the camp to standards set by local or state laws.
Check camp well(s), at minimum, every spring before the camp opens to make sure there are no mechanical problems.
Test camp well(s), at minimum, every spring before the camp opens for total coliform bacteria, nitrates, total dissolved solids, and pH levels.
Water that seeps down through the soil and gets trapped in pores and spaces above the dense rock barrier is called ground water. Wells are drilled down deep to access this ground water. Ground water can become contaminated with germs like Crypto when septic tanks or systems fail or by runoff from farms. These germs can be spread when people drink contaminated well water.
Note: Failed septic tanks or systems are one of the most common causes of well water contamination. Septic tanks and septic leach fields should be at least 50 feet from wells. Manure stacks should be at least 250 feet from wells.
Maintain food services to the standards set by local or state laws.
Wash hands (as described above) before, during, and after handling food (for example, harvesting fruits and vegetables or shucking corn). If campers handle food, they should be treated like foodhandlers.
Wash hands (as described above) before eating food.
Exclude people ill with diarrhea or other gastrointestinal symptoms from food handling activities.
Exclude people ill with diarrhea or other gastrointestinal symptoms from preparing or handling beverages or handling ice for beverages.
It takes many steps to grow food and get it from the farm to the table. Food can be contaminated with germs like Crypto at many points in the process. For example, people, mainly those ill with diarrhea or other gastrointestinal symptoms, might have these germs on their hands and can contaminate food with their hands. These germs can be spread when people eat contaminated food.
People, mainly those ill with diarrhea or other gastrointestinal symptoms, might have these germs on their hands and can contaminate beverages and ice for beverages. These germs can be spread when people drink contaminated beverages or beverages with contaminated ice.
Cabins and Infection Control
Use personal protective equipment (for example, gloves) when cleaning feces (poop) or vomit. Use disposable cleaning products. Wash hands (as described above) immediately afterwards.
Use personal protective equipment (for example, gloves) when handling bed linens, clothing, sleeping bags, etc. soiled with feces or vomit. Wash hands (as described above) immediately afterwards.
Wash linens, clothing, sleeping bags, etc. soiled with feces or vomit with detergent in hot water at ≥113°F for at least 20 minutes or at ≥122°F for at least 5 minutes and then machine dry on the highest heat setting. If laundry facilities are not available on site or the recommended temperature cannot be reached, launder the items off site, or double bag them in plastic bags and instruct parents or caregivers on the proper washing and drying procedures, or discard the items.
Caring for people ill with diarrhea or other gastrointestinal symptoms, touching their feces (poop), or soiled items can spread germs like Crypto.
Screen campers and staff for diarrhea and other gastrointestinal symptoms as they arrive to camp. Monitor campers and staff for gastrointestinal symptoms while they are at the camp.
Separate campers and staff ill with diarrhea or other gastrointestinal symptoms from others.
Develop a list of ill campers and staff, including name, cabin, list of symptoms, and date symptoms start.
If multiple campers or staff develop gastrointestinal symptoms,
The local or state health department might require camps to report potential outbreaks as quickly as within 24 hours. Early notification and involvement of the local or state health department can help prevent and/or control outbreaks.
Note: Crypto is extremely tolerant to chlorine, and chlorine-based disinfectants (for example, bleach solutions) will not kill Crypto. If Crypto causes an outbreak, talk with the local or state health department about switching to disinfectants that kill Crypto. Disinfectants that kill Crypto might not kill other germs that cause gastrointestinal symptoms.
- Cryptosporidiosis Outbreak at a Summer Camp – North Carolina, 2009 MMWR (July 15, 2011 / 60(27);918-922)