ABSTRACT
This chapter summarizes the factors facilitating transmission of Cryptosporidium via recreational water use, data from case surveillance and epidemiologic studies, data from outbreak reports, and changes in operation and use of recreational water that are needed to reduce the risk of future transmission. Recreational water—which includes natural water found in oceans, lakes, rivers, and hot springs, as well as artificial, disinfected venues such as swimming pools, water parks, hot tubs, and interactive fountains—has been well documented through outbreaks and epidemiologic studies as a transmission vehicle for pathogens. Since its identification as a human pathogen in 1976, Cryptosporidium has emerged as the major cause of outbreaks of acute gastrointestinal illness associated with use of recreational water, particularly those outbreaks associated with artificial, disinfected venues. There are multiple parasite, environmental, and populational factors that make Cryptosporidium ideally suited for transmission through recreational water.
