E.coli, Giardia and crypto: Beware the duck pond at NZ Botanical Gardens

Gisborne’s chief medical officer has warned parents that children do not have to be in contact with water to pick up bugs from dirty water at the Botanical Gardens.

botanical-garden-japaneseGisborne District Council this week confirmed the duck pond at the gardens contained E.coli, Giardia and Cryptosporidium.

Although a statement from GDC said someone would have to drink “a good amount” of water to get sick, medical officer of health Dr Margot McLean pointed out that was not the case.

“You don’t have to enter the pond or drink the pond water to pick up the bugs that can make you sick. You could also pick up the bugs by putting hands in the water or touching areas where there is duck poo.

“This shouldn’t put people off visiting the ducks, as long as extra care is taken with hand hygiene.

“Antibacterial wipes could be used immediately after leaving the area, however parents should supervise children washing their hands and use the 20/20 rule; 20 seconds to wash/20 seconds to dry on the return home.

“Any duck poo should be removed from shoes so that the poo doesn’t contaminate surfaces like floors, or hands.”

20 firefighters sickened with cryptosporidium after rescuing calves in barn fire

We have a hockey friend near Guelph who is forever creating News-of-the-World type drama to keep his mates entertained. Like the girlfriend who held his cat hostage in a bar; missing hockey because he fell off a roof, and having his tractor spontaneously combust and burn his father’s Lincoln SUV also parked in the barn.

This summary from the Centers for Disease Control’s Morbidity and Mortality Weekly Report didn’t involve our hockey friend, but could have.

On June 6, 2011, a fire occurred in a barn housing approximately 240 week-old calves. A total of 34 firefighters responded from three Michigan fire stations and one Indiana fire station. Local hydrant water and onsite swimming pond water were used to extinguish the fire.

On June 20, 2011, the Indiana Department of Homeland Security notified the Indiana State Department of Health (ISDH) of an Indiana fire station that reported gastrointestinal illness among a substantial percentage of their workers, causing missed workdays and one hospitalization as a result of cryptosporidiosis.

All ill firefighters had responded to a barn fire in Michigan, 15 miles from the Michigan-Indiana border on June 6; responding firefighters from Michigan also had become ill. ISDH immediately contacted the Michigan Department of Community Health (MDCH) concerning this outbreak. The investigation was led by MDCH in partnership with ISDH and the Michigan local health department (LHD). Among 34 firefighters who responded to the fire, 33 were interviewed, and 20 (61%) reported gastrointestinal illness ≤12 days after the fire.

Cryptosporidium parvum was identified in human stool specimens, calf fecal samples, and a swimming pond. Based on these findings, the following public health recommendations were issued: 1) discontinue swimming in the pond, 2) practice thorough hygiene to reduce fecal contamination and fecal-oral exposures, and 3) decontaminate firefighting equipment properly. No additional primary or secondary cases associated with this exposure have been reported. The findings highlight a novel work-related disease exposure for firefighters and the need for public education regarding cryptosporidiosis prevention.

The complete report is available at:

E. coli outbreak at Durham, NC nursing home

Raleigh ABC 11 reports the possibility of a pathogenic E. coli outbreak at the  Emerald Pond retirement home in Durham, NC. It’s early on, when information sometimes get’s messed up, but the report says:

A spokesperson from the Durham County Health Department told Eyewitness News the department learned of at least four patients and staff members at Emerald Pond who have the bacterial illness.
Some strands (sic) of the bacteria can cause diarrhea, while others cause urinary tract infections, respiratory illness, pneumonia and other illnesses.
The initial report of E. coli cases was made over the weekend, but the Health Department is just beginning its investigation.
Emerald Pond has closed its dining room as a precaution.
The retirement home said it’s cleaning the facility and "precautions are in place."

If the outbreak does happen to be pathogenic E. coli it could get messy for elderly individuals, and is often misdiagnosed.  In a 2006 article published in the Journal of the American Geriatrics Society, Reiss and colleagues write:

A growing pool of epidemiological surveys reveals that geriatric populations are at risk of severe manifestations of EHEC O157:H7 infections. A 5-year review of cases in Alberta, Canada, and in Scotland found that morbidity rates, defined as need for hospitalization, in those aged 60 and older were similar to or worse than those in young children. Of 703 patients requiring inpatient medical treatment in Alberta, Canada, during the study period, rates of hospitalization in persons aged 60 and older were nearly twice as high (68.9% of reported cases) as those of children younger than age 5.

Given the absence of fever, and often only the complaint of ‘‘bleeding per rectum,’’ it is not surprising that cases will be initially misdiagnosed as hemorrhoids, diverticulosis, or another source of painless lower gastrointestinal bleeding.

A review of nursing home outbreaks and epidemiological data indicate that nursing home patients are indeed at high risk for EHEC O157:H7 infection and related complications, although common perception may still place EHEC and associated HUS/TTP in the category of a pediatric infectious disease.

The mention of infected staff member(s) puts an interesting twist on things — raising the possibility that an infected food handler is involved.