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It causes diarrhea that often lasts for weeks and is readily missed by the lab. Cryptosporidium red in a stool specimen, seen under a microscope. Cryptosporidium is now the leading cause of water-borne outbreaks in the U.

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This parasite made a grand debut in , sickening more than , people in Milwaukee , Wisconsin--a quarter of the city's population--and killing as many as , mostly immunocompromised hosts. As a result, many places now filter their water to remove the organism prior to chemical treatment. More recently, Cryptosporidium has been associated mostly with water parks and swimming pools.

This is because even chlorine may not kill the parasite for days. On the other hand, the general public is not advised to try that on their own, as improperly handled pool chemicals are dangerous. The CDC also reported a number of cases of chlorine toxicity , resulting in vomiting, coughing, and eye irritation. In , they noted there were an estimated 4, visits to emergency departments after pool chemical—associated health events. Further, between , more than 27, people became ill and eight people died from infections from such freshwater pools and hot tubs. A third were acquired at hotels. Other diarrheal diseases may be caused by another parasite, Giardia , often from water contaminated by stool from wild animals.

Hot tubs have long been a source of infections from a bacterium called Pseudomonas aeruginosa. This water-loving bacteria can cause an infection of the hair follicles, which results in a diffuse rash of small zit-like bumps.

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  7. Occasionally, people become more generally ill with fever, sore throat, headache or diffuse symptoms. Because pool codes and, therefore, inspection items differed across jurisdictions, reported denominators varied. Of , inspections, 13, Of , inspections, 12, Although these results likely are not representative of all pools in the United States, they suggest the need for increased public health scrutiny and improved pool operation. The results also demonstrate that pool inspection data can be used as a potential source for surveillance to guide resource allocation and regulatory decision-making.

    Collecting pool inspection data in a standardized, electronic format can facilitate routine analysis to support efforts to reduce health and safety risks for swimmers. Prevention of RWIs at treated venues requires pool operators to 1 maintain appropriate disinfectant and pH levels to maximize disinfectant effectiveness and 2 ensure optimal water circulation and filtration. Pool codes, promulgated by individual state or local public health agencies, govern pool operation.

    Each agency's pool inspection data were standardized for analysis and included information on water chemistry, circulation and filtration system, policy and management, and pool setting and type. A violation was defined as an inspection item that did not meet standards set by the jurisdiction's pool code.

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    CDC developed an algorithm based on facility name to classify pool setting e. Facility-identifying data then were deleted, and data from individual agencies were aggregated. Denominators in this report vary because pool codes, and therefore inspection items, differed across jurisdictions. During , inspectors in the 15 jurisdictions conducted a total of , routine pool inspections.

    Among the , inspections, the number of code violations identified ranged from 0 to 28 median: 1 , and 73, A total of 13, The following violations also were identified: improperly maintained pool log 12, [ Of the , inspection records, 59, Among venues with known pool settings, child-care pool inspections had the highest percentage of immediate closures Of the , inspection records, , Interactive fountain inspections had the highest percentage of immediate closures Therapy pool inspections had the lowest percentage of disinfectant and pH level violations but the highest percentage of other water chemistry violations Interactive fountain inspections identified the lowest percentage of circulation and filtration violations N Doxford, Florida Dept of Health.

    This report is the second to examine pool code compliance in multiple U. The first report analyzed aggregated pool inspection data collected during May September 1, , from six jurisdictions 3. This report examined data from more jurisdictions and for an entire year, resulting in a sample more than five times larger than reported previously. The conclusions from the two reports are similar: pool operation violations and immediate closures appear to be common in the United States.

    Although the sampled jurisdictions are not necessarily representative of the United States, the results underscore the public health importance of pool inspections.


    The results also underscore the potential for inspection data to better inform and direct public health decision-making regarding swimmer health and safety, particularly if these data are standardized. Pool inspections are a key part of ensuring pool code compliance 4. This report indicates that routine pool inspections resulted in a high percentage Moreover, disinfectant and pH level violations were identified during Such violations are particularly important because improper disinfectant and pH levels can result in transmission of chlorine- and bromine-susceptible pathogens.

    Reduced chlorine levels and lower inspection scores have been associated with positive microbiologic water testing results 5. In this report, Pool operator training has been associated with decreased water quality violations 6. This analysis suggests that efforts to prevent RWIs should focus on certain pool settings i.

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    In pool settings where swimming is not the primary activity, the person responsible for pool operation likely has other competing responsibilities e. Requiring operator training for staff responsible for pool operation might improve water quality, and should be considered for these and other pool settings. Disinfectant and pH levels should be measured and adjusted more frequently at these pool types, particularly when bather load is high. The findings in this report are subject to at least three limitations.

    First, the results of these inspections might not be representative of inspections conducted by agencies nationwide. Second, some jurisdictions combined multiple inspection items into a single variable to increase efficiency of data entry , which could lead to an underestimate of the actual total number of violations. Even Goosebumps , R. Stine's spooky-funny horror series from the early '90s, still sells about 2 million books a year.

    With its TV spinoff and broad array of licensed merchandise, Goosebumps pioneered the idea that a kids series could be a multimedia hit.

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    What makes Wimpy Kid unique is that it's the first series aimed squarely at middle-grade readers kids to dominate the list since Goosebumps, and it succeeds not by selling a particular product so much as Kinney's knack for turning the mundane and trivial into comic gold. That's a description Kinney would like because he describes Greg Heffley, the titular wimpy kid, as a middle-school version of Larry David: well-intentioned but always getting in trouble for saying out loud what other people are thinking.

    Wimpy Kid is big business. Kinney's take?

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    The franchise looks to continue to grow. Kinney just returned from his first international book tour "It's getting ready to explode over there," he says , and the script for a third movie is on his desk awaiting an official green light from Fox. He also has his eye on television.

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    Says screenwriter Terri Tatchell, who is adapting Amanda Hocking's self-published YA sensation the Trylle Trilogy for the big screen and is a big YA fan, "You don't know how many grown-up women have told me they haven't left their bed all day" because they were curled up with a good YA novel.