Prevention Measures
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Good hygiene practices can help prevent cryptosporidiosis outbreaks. Effective measures include:
- Frequent hand washing and good hand washing technique for all children and adults.
- 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).
- Note: Cryptosporidium is not killed by alcohol gels and hand sanitizers. Soap and clean running water are specifically recommended for preventing cryptosporidiosis.
- Clear separation of diapering and food-handling areas and responsibilities.
- Clear separation of diaper-changing areas and children’s play areas.
- Clothes worn over diapers to reduce the opportunity for leakage.
- Use of disposable gloves when changing diapers. Gloves should be changed after each diaper change.
- Use of disposable paper over the diaper changing surfaces. The paper should be changed after each diaper change.
- Daily disinfection of surfaces and objects, including but not limited to bathrooms, diaper-changing areas, food-preparation areas, tabletops, high chairs, and toys.
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, a 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. Dishwasher-safe toys may be disinfected using dishwashing machines that have 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 in a clothes dryer for 30 minutes.
If there is an increase of diarrhea, parents and staff should be informed of the symptoms of cryptosporidiosis, how it is transmitted, the risk of severe illness in immunocompromised persons, and necessary control measures. The state or local health department also should be notified about an excessive level of diarrhea or any Cryptosporidium infections in a day care. Cryptosporidium is a reportable disease.
In the event of an outbreak of Cryptosporidium, clean and disinfect surfaces, toys, table tops, and high chairs more frequently than usual (at least twice daily).
Children with diarrhea should be excluded 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.
Adults with diarrhea should be moved to jobs that minimize opportunities for spreading disease (e.g., administrative work instead of food preparation).
All water play or swimming activities should be terminated (e.g., water tables, inflatable or rigid temporary swimming pools, public pool visits). This water can become contaminated and facilitate the spread of infections.
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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)