Outbreak of Giardiasis and Cryptosporidiosis Associated with a Neighborhood Interactive Water FountainFlorida, 2006
An outbreak of giardiasis and cryptosporidiosis was identified in central Florida in September 2006. Environmental and epidemiological investigations indicated the likely source was a neighborhood interactive water fountain in a large upscale urban neighborhood. Forty-nine cases meeting the case definition were identified, of which 38 were giardiasis, nine were cryptosporidiosis, and two were co-infections. The median age of those affected was four years old, and 32 (65.3%) cases were male. This outbreak and other similar occurrences highlight the need to design and implement more stringent disinfection practices and filtration requirements for treated interactive water venues. Giardia cysts and Cryptosporidium oocysts are small and chlorine-resistant, and they may require supplemental disinfection methods, such as ultraviolet light irradiation, ozonation, or chlorine dioxide. Individuals who use these types of venues also need to change their behavior to prevent disease transmission. This is the first documentation of a giardiasis outbreak associated with exposure to an interactive water fountain in the United States.