An outbreak of Cryptosporidium at a recreational water park in Niagara Region, Canada.

Cryptosporidium is a parasitic protozoan found in water sources and spread through the fecal-oral route. Cryptosporidiosis is characterized by gastroenteritis and is increasingly associated with recreational water sources. On December 3, 2010, Niagara Region Public Health was informed of a laboratory-confirmed case of Cryptosporidium. Over the subsequent two weeks, a total of three additional laboratory-confirmed cases were reported. All cases had visited the same water park in Niagara Region, Canada, over November 14-16, 2010. A total of 12 cases associated with the outbreak ranged in age from 1 to 66 years. This article describes the outbreak, environmental investigation, and control measures. The environmental investigation revealed that the ultraviolet disinfection system was offline on November 14, 2010, which may have allowed for the transmission of Cryptosporidium to bathers. Further research into the detection of Cryptosporidium outbreaks and regulations and guidelines for water park operators may help to decrease future outbreaks.

Intestinal toxemia botulism in 3 adults, Ontario, Canada, 2006-2008.

Five cases of intestinal toxemia botulism in adults were identified within an 18-month period in or near Toronto, Ontario, Canada. We describe findings for 3 of the 5 case-patients. Clinical samples contained Clostridium botulinum spores and botulinum neurotoxins (types A and B) for extended periods (range 41-61 days), indicative of intestinal toxemia botulism. Patients' clinical signs improved with supportive care and administration of botulinum antitoxin. Peanut butter from the residence of 1 case-patient yielded C. botulinum type A, which corresponded with type A spores found in the patient's feces. The food and clinical isolates from this case-patient could not be distinguished by pulsed-field gel electrophoresis. Two of the case-patients had Crohn disease and had undergone previous bowel surgery, which may have contributed to infection with C. botulinum. These cases reinforce the view that an underlying gastrointestinal condition is a risk factor for adult intestinal toxemia botulism.