Control Measures for Oubreaks
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If an outbreak of cryptosporidiosis occurs in the child-care setting:
Educate staff and parents
- Inform all staff about the ongoing outbreak, the symptoms of cryptosporidiosis, how it is transmitted, and control measures to be followed.
- Inform parents about the ongoing outbreak, the symptoms of cryptosporidiosis, how it is transmitted, outbreak control policies, and needed changes in hygiene and cleanliness.
- Notify parents of children who have been in direct contact with a child or an adult caregiver with diarrhea. Parents should contact the child's healthcare provider if their child develops diarrhea.
- Inform parents of children and staff about Cryptosporidium’s potential to cause severe disease in immunocompromised persons. Immunocompromised persons should consult their healthcare provider for further guidance.
Exclude any child with diarrhea from the child care setting until the diarrhea has stopped.
- Children who are infected with Cryptosporidium but who do not have diarrhea may be allowed to return.
- Recently returning children can be grouped together in one classroom to minimize exposure to uninfected children.
- Move adults with diarrhea to jobs that minimize opportunities for spreading disease (administrative work instead of food preparation).
Terminate all water play or swimming activities (e.g., water tables, inflatable or rigid temporary swimming pools, public pool visits). This water can become contaminated and facilitate the spread of infections.
Practice good hygiene. Note: The measures outlined should be routine but are especially important during outbreaks.
- Enforce frequent hand washing and good hand washing technique for all children and adults.
- Note: Cryptosporidium is not killed by alcohol gels and hand sanitizers so these materials are of little use in controlling an outbreak.
- Use disposable towels.
- Good hand washing means:
- Wet your hands with clean running water and apply soap.
- Rub hands together to a lather and scrub all surfaces.
- Continue rubbing hands for 20 seconds (imagine singing “Happy Birthday” twice).
- Rinse hands well with water.
- Dry hands with paper towels or an air dryer. If possible, use a paper towel to turn off the faucet.
- For children:
- Observe hand washing or assist when needed. Wash children’s hands when they arrive at the child care facility, after they use the toilet, after having their diapers changed, and before eating snacks or meals.
- For adults:
- Wash hands after using the toilet, after helping a child use the toilet, after diapering a child, and before preparing or serving food. (Note: Where staffing permits, people who change diapers should not prepare or serve food).
- Improve diaper changing practice.
- Separate diaper changing areas from children’s play and food preparation areas.
- Use disposable gloves and change them after each diaper change.
- Use disposable paper over the diaper changing surfaces and change it after each diaper change.
- Ensure children wear clothing over their diapers to reduce the opportunity for leakage.
- Wash hands: both yours and the child’s.
Disinfect surfaces and objects
- No disinfectant is guaranteed to be completely effective against Cryptosporidium. However, hydrogen peroxide is usually effective.
- Instead of a bleach solution, use a 3% (99% kill rate) or, if available, 6% (99.9% kill rate) concentration of hydrogen peroxide to soak contaminated surfaces for 20 minutes.
- Ammonia can also be used (5% solution for 18 hours) but it has a strong odor and, if accidentally mixed with bleach or other chlorine-containing solutions, produces hazardous chlorine gas.
- Disinfect bathrooms, diaper areas, and food preparation surfaces daily.
- Disinfect toys, tabletops, and high chairs more frequently than usual (at least twice daily).
- Dishwasher-safe toys can be disinfected in a commercial dishwasher that has a dry cycle or a final rinse that exceeds 113°F for 20 minutes or 122°F for 5 minutes or 162°F for 1 minute. Cloth toys may be washed and heat-dried on the highest clothes dryer heat setting for 30 minutes.
- These are not routine measures, but may be necessary if an outbreak occurs; usually 2 or more cases in the same child care group.
Notify the state or local health department about an excessive level of diarrhea or any Cryptosporidium infections in a daycare. Cryptosporidium is a reportable disease.
Related Day Care Facilities - Outbreak Links
Cryptosporidiosis Outbreak in a Day Care Center – Sample Letter to Day Care Center Parents 
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Page last reviewed: April 16, 2008
Content Source: Division of Parasitic Diseases (DPD)
National Center for Zoonotic, Vector-Borne, and Enteric Diseases (ZVED)