Prevention & Control - Camps

Summer camps can provide the perfect environment for the spread of Cryptosporidium (or “Crypto” for short). To help prevent and control the spread of Crypto in camp settings, CDC has developed the following recommendations for camp owners and managers.

Handwashing

Crypto—like many other germs that cause diarrhea, vomiting, and other gastrointestinal symptoms—can be spread by not washing hands with soap and clean, running water. Handwashing with soap and water can help protect the health of campers and staff. Alcohol-based hand sanitizers do not effectively kill Cryptosporidium.  Camp staff can provide appropriate and accessible hand hygiene stations with running water, soap, and disposable towels or air dryers.

Campers and staff can stay healthy by washing your hands often, especially during these key times when you are likely to get and spread germs:

• Before, during, and after handling food
• Before eating food
• Before and after caring for someone who is sick

• Before and after treating a cut or wound

• After using the toilet

• After blowing your nose, coughing, or sneezing

• After touching an animal or anything in their environment
• After removing clothing or shoes worn in the animal environments
• After handling animal feed, pet food or pet treats
• After touching garbage

Animals

Touching animals, their poop, or anything in their environment can spread germs like Crypto between animals and humans. Objects such as clothing and shoes can become soiled and spread germs. Even animals that appear to be clean and healthy can spread germs to humans. Pre-weaned calves often carry Cryptosporidium parvum, which can make people sick.

• Review and implement recommendations in the Compendium of Measures to Prevent Disease Associated with Animals in Public Settings, 2017 CDC pdf icon[PDF – 25 pages]external icon.
  • Consult with veterinarians, state and local agencies, or cooperative extension programs on how to put these recommendations into practice.
• Educate campers and staff 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 handwashing when exiting animal areas.
• Supervise children during animal contact. Discourage hand-to-mouth activities (for example, nail biting and thumb sucking) and contact with animal poop or soiled bedding. Children younger than 5 years are more likely of getting sick from animals than most adults are.
• Separate animal and non-animal areas. Do not permit animals, other than service animals, in non-animal areas.
• Don’t allow food and beverages in animal areas.
• Remove poop 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.
• Limit contact with calves

Note: Additional recommendations are included in the Compendium pdf icon[PDF – 28 pages], 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.

Recreational Water

Swimmers share the water they swim in and a person who swims with diarrhea can easily contaminate the water with poop and germs, like Crypto. The germs can be spread when swimmers swallow the contaminated water.

Chlorine kills germs in pools, but Crypto is extremely tolerant to chlorine. Most germs are killed within minutes, but Crypto can survive even in well-maintained pools for more than 7 days. It is best to keep Crypto out of the water. Killing it in the water we swim in requires raising the chlorine to high levels for a long time.

• Maintain pools, lakes, and other recreational water venues at the camp to standards set by local or state laws. Maintaining proper chlorine level (at least 1 part per million or ppm) and pH (7.2–7.8) is the first defense against the spread of most germs in pools.
• Don’t swim or let kids swim if sick with diarrhea. This includes aquatics staff.
  • Keep campers and staff diagnosed with Crypto out of the water for an additional two weeks after diarrhea stops. People infected with Crypto can typically continue to shed Crypto for up to two weeks after diarrhea completely stops.
• Don’t swallow the water.
• Take kids on bathroom breaks every 60 minutes.

Drinking Water/Well Water

Owners of private wells are responsible for water safety. All private wells use ground water. Ground water can become contaminated with germs like Crypto when septic tanks or systems are located too closely to wells or runoff from urban areas and farms pollute ground water, particularly after flooding.

It is important that private ground water wells are tested at least once a year to ensure that the water is safe for drinking and other household uses. Maintain safe distances between private ground water wells and possible sources of contamination. One of the most common sources of well water contamination are septic tanks or septic systems.

• 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.

Food Safety

Campers and staff who are sick with diarrhea or other gastrointestinal symptoms might have germs like Crypto on their hands and can make others sick. Germs can be spread when people consume a contaminated food or drink.

• Maintain food services to the standards set by local or state laws.
• Wash hands before, during, and after handling food (for example, harvesting fruits and vegetables or shucking corn). If campers handle food, they should follow food preparation and food safety guidelines.
• Wash hands before eating food.
• Keep people sick with diarrhea or other gastrointestinal symptoms from food handling activities, preparing or handling beverages or ice for beverages.

Cabins and Infection Prevention

Caring for people sick with diarrhea or other gastrointestinal symptoms, touching their poop or vomit, or soiled items can spread germs like Crypto.

• Use personal protective equipment, like gloves, when cleaning poop or vomit. Use disposable cleaning products. Wash hands immediately afterwards.
• Use personal protective equipment, like gloves, when handling bed linens, clothing, sleeping bags, and any other items soiled with poop or vomit. Wash hands 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, then consider completing one of the following:
    • Launder the items off site
    • Double bag them in plastic bags and instruct parents or caregivers on the proper washing and drying procedures
    • Discard the items.

Disease Tracking

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 control outbreaks.

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.

• 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 sick with diarrhea or other gastrointestinal symptoms from others.
• Develop a list of sick campers and staff, including name, cabin, list of symptoms, and the date symptoms began.
• If multiple campers or staff develop gastrointestinal symptoms:
  • Notify your local or state health department immediately;
  • Increase cleaning of bathroom facilities and high-touch surfaces (for example, door handles), and
  • Discontinue salad and sandwich bars, “family-style” service, and buffets — use servers only.