Running head: CRYPTOSPORDIUM PARVUM OUTBREAK

There were people who were getting sick and I was asked to join a project where they are
trying to find what source is responsible for the outbreak. I was first asked to map out where
about of everyone and try to pinpoint where is a commonplace that everyone has been. The first
person that was sick had been to Thompson Park, Wateredge mall, and bowling alley. The second

Cryptosporidium Parvum Outbreak

person had been to the movie theater, Thompson park, and Recreation center. The third person
had been to a coffee shop and also Thompson park. The fourth person went to the zoo and
Thompson park. Lastly, the fifth infected patient went to the mall, Thompson park, and the zoo.
After mapping out where everyones where about for the last couple hours we were able to come
to an agreement that Thompson park might be our source of infection and should be a place we
should explore further. Then after I mapped out and found the source the epidemiologist Shoua
sent me to Thompson park to find out the possible place of contamination. There I met with Mai
who works for the Department of Health, who I will be working with in collecting data and
testing out the water source. I learned from here that many of the cases that had happened in the
past can be traced to the zoonotic disease that is caused by parasites that can transmit between
the animals and humans. As I was taking a look for a possible source of contamination about 25
people have been reported sick. I first went to examine the water fountain in front of the park, the
water fountain looks like could a source of contamination and I took notes for the
epidemiologist. Then I went to examine the refreshment section where drinks and food are being
sold, the refreshment place is closed but it looks like it could be a possible source of
contamination. Then I went to look at the water fountain near the lake and I found that the water
fountain looks a bit run down and is rusting. I also went to the beach to look for any other
possible contamination. Then I found a drain pipe where water flows into the lake and also there
is the goose that is around the area. I had also talked to a bystander and found out that nearly 100
people came to help out and clean the park. Which then explain the flyer about the beach cleans
up. After examining all those places I went back to the Department of Health to discuss with
Shoua about possible causes and maybe the sampling of all those possible sources.

Cryptosporidium Parvum Outbreak

After reviewing of all the pictures we wonder if the same well supply all the water
sources for the fountains and I would go back and sample all those water sources. Then we
discussed the lake, that there is a small amount of algae living in the lake and was wondering
could that be a possible source. So I would go back and sample the lake as well. We also talked
about how the water from the drain runoff from the surrounding area comes out of the drain and
was wondering if that would be a possible and source of the outbreak. So also I would go back
later and sample that drain. The goose in the area could possibly contaminate the beach with
ecoli from goose droppings. Then we found a flyer about Thompson park summer clean up
which took place the same day that everyone got sick, it is a potential source that we can explore
further into. At this moment there had been 31 people reported sick and I was sent back to
Thompson park to collect a sample from each water sources. Before I go back and collect the
samples I was asked to map out the activity of where everyones where about is.
The first person I had mapped out went the beach to swim and drink the water from the
water fountain near the beach as well as going getting a drink from the concession. The next
person drank water near the beach as well and fruit punch from the concession. The third person
drank water from the school cafeteria, movie theater and also the fountain near the baseball field
at Thompson park. This person also purchased a fruit punch from the concession. The fourth
person went into swim at the Thompson lake and also purchased a fruit punch from the
concession stand. The last person also went swimming at the lake, drank water from the fountain
at school and near the lake. After mapping out where everyones activity had been, we agreed
that the concession stand seems to be a common interest for all the patients who got sick. I would
start exploring at the concessions stand to see if I can find out anything there.

Cryptosporidium Parvum Outbreak

Then I went back to the park to sample all the water fountains while sampling the water I
had a chance to talk to the sale associate at the concession stand. He told me that there were a lot
of people at the clean up and that for some reason the water at the concession stand was turned
off because it was such a busy day all the fruit punches were sold out. He had to go over to the
fountain to the beach to get water to make more fruit punches. After collecting several water
source I was told to report back, and that is when I discovered the headline of the newspaper that
Heavy rains have officials concerned about runoff. Then I was asked to drop off the samples at
the lab for testing and report back to Shoua. The result of the water source had come back the
fountain that was found contaminated is the fountain by the beach. According to Shoua, that
fountain is the only tainted fountain in the park. Mai from Department of Health had confirmed
that the fountain filter was malfunctioned and was tested positive for Cryptosporidium.
Every year there is about 5-10% of patient with AIDS and also low CD4 count patient
infected with Cryptosporidium Parvum. Cryptosporidium Parvum is a parasite that causes
diarrhea in a person when infected with this parasite. It can also cause more severe problems if
the person is immunocompromised (Bruce et al., 2000). After getting infected with the parasite it
usually takes about 2 to 10 days for symptoms to occur. Symptoms associated with
Cryptosporidium Parvum are watery diarrhea, stomach cramps, dehydration, nausea, vomiting,
fever, and weight loss. People with healthy immune system usually will recover without any
treatment. But for people with weak immune system are at high risk for more life-threatening
conditions (CDC, 2015).
Then I met with Ted Hawthorne who was the public health information officer, whom I
worked closely with on a press release that will explain the cause and address what we are doing
to fix the problem. We discussed that the source of the water from the park has been obtaining

Cryptosporidium Parvum Outbreak

from the city water with one exception which is that the fountain water near the beach gets the
water from the old well. We also found out that the old pipes were never switched out on that
fountain when they did the update, which causes the parasites to isolate at that one particular spot
to cause the breakout.
From this case study, I learned that the heavy rain, water runoff from cattle, parasites in
the well, and malfunction fountain filter were all a contributing factor. People who drank the fruit
punch from the concession stand and also the fountain by the beach got sick because of the
tainted fountain. We found the source of our outbreak and they will change the fountain filter so
that the outbreak will stop. I learned the even though the healthcare team at the hospital treats the
patients when they arrive but it is also important for public health nurses to find out the sources
of the outbreak to prevent further injuries. Public health and epidemiology is an very important
aspect when it comes to community or local outbreaks. Without them the causative agent would
not be traced back and we would not find the sources of the infection.

References
Bruce, B. B., Blass, M. A., Blumberg, H. M., Lennox, J. L., del, R. C., & Horsburgh, C. R. J. ( 2000).
Risk of Cryptosporidium parvum transmission between hospital roommates. Clinical Infectious
Diseases : an Official Publication of the Infectious Diseases Society of America, 31, 4, 947-50.

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CDC. (2015). Parasite-Cryptospordium. Retrieved from
https://www.cdc.gov/parasites/crypto/treatment.html
Outbreak at Watersedge.(n.d). A Public Health Discovery Game. Retrieved from:
http://www.mclph.umn.edu/watersedge/