Outbreak of Cryptosporidiosis Among Responders to a Rollover of a Truck Carrying Calves — Kansas, April 2013
Weekly
December 19, 2014 / 63(50);1185-1188
Lindsey Martin Webb, MPH1, Sheri A. Tubach, MS, MPH1, D. Charles Hunt, MPH1 (Author affiliations at end of text)
In April 2013, the Thomas County Health Department notified the Kansas Department of Health and Environment's Infectious Disease Epidemiology and Response section (KDHE) of two cases of cryptosporidiosis among emergency responders to a tractor-trailer rollover. The truck was carrying approximately 350 preweaned
Holstein calves. An outbreak investigation was led by KDHE with assistance from the county health department; six cases of cryptosporidiosis were identified among the 15 emergency responders. No additional primary cases with this exposure or secondary cases were identified. Disease was associated with carrying calves (relative risk [RR] = 3.0) and contact with fecal matter (RR = 4.5). The calves were aged <10 days and reportedly suffered from scours (diarrheal disease), which is often caused by Cryptosporidium spp. (1), a chlorine-tolerant protozoan parasite. Because of the age of the calves and the conditions at the rollover scene, a high potential existed for fecal contamination and subsequent transmission of Cryptosporidium. This outbreak is the first report of both law enforcement and volunteer emergency responders contracting cryptosporidiosis, with transmission of Cryptosporidium attributed solely to direct contact with animals and their feces. Human illness resulting from contact with animals during an emergency response might be minimized if 1) all responders are aware of the potential for zoonotic transmission, 2) education is provided on proper animal handling including the use of appropriate personal protective equipment, and 3) responders practice thorough hand hygiene and decontaminate clothing and equipment following contact with feces.
In the early morning of March 10, 2013, a truck carrying approximately 350
Holstein steer calves overturned in a snowstorm near Colby, Kansas. Many of the calves died as a result; many others were scattered outside of the truck. City police officers and county sheriff's deputies responded to the incident, controlled traffic, and secured the scene. The officers then contacted a towing company and community volunteers with horses and cattle trailers to assist with righting the truck and securing the calves. Because of the very young age of the calves and the injuries and stress resulting from the rollover, most calves that survived the initial impact were unable to walk and had to be carried by responders onto cattle trailers. Responders noted that most of the calves had scours. Deceased calves were loaded into the wrecked truck and towed to the local sale barn. The next day, towing company employees returned to the sale barn and loaded the carcasses onto another truck for shipment to a rendering plant.
Following the report of two cases of cryptosporidiosis in persons who responded to a tractor-trailer rollover involving calves, investigators from KDHE hypothesized that illness might be associated with exposure to calves, fecal contamination at the scene, and returning to a location without electrical power and therefore no hot water to thoroughly wash hands or decontaminate equipment and clothing. A retrospective cohort study was conducted among emergency responders to identify additional ill persons and determine risk factors associated with illness. For this investigation, a probable case was defined as diarrhea (three or more loose or watery stools in 24 hours) and either abdominal cramping, vomiting, or anorexia in an emergency responder within 10 days after the response to the rollover. A confirmed case was defined as an illness that met the definition for a probable case with laboratory evidence of Cryptosporidium infection.
http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6350a1.htm?s_cid=mm6350a1_e