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Cryptosporidiosis Outbreak Associated With a Single Hotel


We investigated a gastrointestinal illness cluster among persons who attended a baseball tournament (>200 teams) during July 2015. We interviewed representatives of 19 teams; illness was reported among only the 9 (47%) teams that stayed at Hotel A (p < .01). We identified 55 primary cases. A case-control study demonstrated that pool exposure at Hotel A was significantly associated with illness (odds ratio: 7.3; 95% confidence interval: 3.6, 15.2). Eight out of nine (89%) stool specimens tested were positive for Cryptosporidium, with C. hominis IfA12G1 subtype identified in two specimens. The environmental health assessment detected a low free available chlorine level, and pool water tested positive for E. coli and total coliforms. A possible diarrheal contamination event, substantial hotel pool use, and use of cyanuric acid might have contributed to this outbreak and magnitude. Aquatic facilities practicing proper operation and maintenance (e.g., following the Centers for Disease Control and Prevention's Model Aquatic Health Code) can protect the public's health.


  • Mary-Margaret A. Fill, MD, Centers for Disease Control and Prevention, Tennessee Department of Health
  • Jennifer Lloyd, MSPH, Shelby County Health Department
  • Tamal Chakraverty, MPH, MD, CPH, Shelby County Health Department
  • David Sweat, MPH, Shelby County Health Department
  • Judy Manners, MSc, Tennessee Department of Health
  • Katie Garman, MPH, Tennessee Department of Health
  • Michele C. Hlavsa, RN, MPH and Dawn M. Roellig, MS, PhD, Centers for Disease Control and Prevention
  • John R. Dunn, DVM, PhD, Tennessee Department of Health
  • William Schaffner, MD, Vanderbilt University School of Medicine
  • Timothy F. Jones, MD, Tennessee Department of Health
Volume#: 79.9
Page #: 16-22
Publication Month: May 2017

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