Wednesday, February 12, 2025

US Splash Pad Waterborne Disease Outbreaks, 1997–2022

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Between 1997 and 2022, public health authorities across 23 U.S. states and Puerto Rico reported 60 outbreaks linked to splash pads (Figure 1). These outbreaks occurred in places exclusively featuring splash pads (n=39) and in venues combining splash pads with other recreational water facilities, such as swimming pools and hot tubs (n=21), resulting in 10,611 cases, 152 hospitalizations, 99 ER visits, and no deaths (Table 1).

Laboratory evidence identified the cause in 52 (87%) of the outbreaks (Table 2). Cryptosporidium was the culprit in 40 (67%) outbreaks, accounting for 9,622 infections and the majority of hospitalizations and ER visits. Notably, Cryptosporidium hominis led to the three most severe outbreaks. Other pathogens included Shigella, E. coli O157:H7, Campylobacter jejuni, Giardia, norovirus, Salmonella Newport, and Legionella pneumophila. The vast majority of cases were acute gastrointestinal infections.

A striking 95% of these outbreaks occurred between May and August (Figure 2), often in community or municipality-run parks (Figure 3).

Outbreaks Solely Tied to Splash Pads

The focus on splash pad-only outbreaks revealed 39 incidents, with 5,384 cases and considerable medical intervention required. Cryptosporidium was noteworthy for causing the lion’s share of these outbreaks. Other agents like Shigella, E. coli O157:H7, and norovirus also featured prominently. A lone outbreak was attributed to chlorine issues.

Data unveiled key contributing factors: splash pads often cater to children in diapers, who might be prone to spreading pathogens. Facility designs lacking adequate disinfection measures and management pitfalls like poor water monitoring were frequently noted. These insights underpin the need for stringent operational protocols to safeguard public health in such recreational settings.


Vocabulary List:

  1. Outbreaks /ˈaʊtˌbreɪks/ (noun): Instances of widespread occurrence of an infectious disease.
  2. Cryptosporidium /ˌkrɪp.tə.spəˈrɪd.i.əm/ (noun): A genus of protozoan parasites known to cause gastrointestinal illness.
  3. Hospitalizations /ˌhɒs.pɪ.təl.aɪˈzeɪ.ʃənz/ (noun): The process of admitting a patient to a hospital for treatment.
  4. Transmission /trænzˈmɪʃ.ən/ (noun): The act or process of passing something from one person place or thing to another.
  5. Intervention /ˌɪn.təˈven.ʃən/ (noun): The action of becoming involved in a difficult situation to improve it.
  6. Pathogens /ˈpæθəˌdʒɛn/ (noun): Microorganisms that can cause disease.

How much do you know?


What percentage of the outbreaks linked to splash pads occurred in venues combining splash pads with other recreational water facilities?
34%
46%
57%
65%


Which pathogen was responsible for the majority of outbreaks linked to splash pads?
Shigella
Giardia
Cryptosporidium
E. coli O157:H7


During which months did a striking 95% of the outbreaks occur?
December to February
March to May
May to August
September to November


What type of recreational facilities were often associated with splash pad-only outbreaks?
Amusement parks
Shopping malls
Community or municipality-run parks
Private residences


Which pathogen is not mentioned as a cause of outbreaks linked to splash pads?
Norovirus
Legionella pneumophila
Salmonella Newport
Streptococcus pyogenes


What was the primary factor attributed to a lone outbreak related to splash pads?
Poor water monitoring
Chlorine issues
Lack of lifeguards
Inadequate signages


Cryptosporidium was the cause of 67% of the outbreaks linked to splash pads.


All outbreaks linked to splash pads resulted in deaths.


Splash pads cater mainly to adults.


Poor water monitoring was frequently noted as a management pitfall in splash pad outbreaks.


Children in diapers were identified as potential carriers of pathogens in splash pad environments.


Norovirus caused the three most severe outbreaks linked to splash pads.


The outbreaks linked to splash pads resulted in a total of cases.


The vast majority of cases linked to splash pads were due to infections.


95% of the splash pad-related outbreaks occurred between May and .


was responsible for causing the lion's share of splash pad-only outbreaks.


Insights from the data underpinned the need for stringent operational protocols to safeguard public health in splash pad settings.

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