CRYPTOSPORIDIUM NOW BEING TRACKED BY DOCTORS IN STATE

Everyone knows cryptosporidium -- a microscopic parasite that can cause sickness in people -- is out there, but there are no mandatory guidelines in place on how to test for its presence in water supplies.

Neither the Missouri Department of Natural Resources nor the U.S. Environmental Protection Agency has issued testing procedures for the parasite.

In Cape Girardeau County, 36 cases of cryptosporidiosis -- the disease caused by the parasite -- have been reported since January, said Charlotte Craig, director of the county health department. Statewide, 64 cases have been reported this year.

But Craig and other health experts point out that it has been only this year that doctors have been required to track the disease, so it is difficult to gauge whether that number represents a high or low number of cases.

"We have a feeling that this has been present with us forever, but now that it's become a reportable disease, we know to look for it," Craig said.

The cases have been reported all over the county, and no common thread -- drinking water, recreational visits, or anything else -- has been found linking the cases, she said.

Cryptosporidiosis was blamed for the deaths of 100 people in Milwaukee in 1993, when the microbe contaminated drinking water supplies.

Since that contamination, people automatically link the disease with tainted water supplies.

There is no evidence that is the case in Cape Girardeau County, Craig said.

"It's not Cape's water. It's not Jackson's water," Craig said.

The parasite can be contracted in a number of ways, not just through water, said Howard Courtney, a sanitarian with the county health department.

The parasite exists in the stool of infected animals or people. Courtney said cattle are "really good reservoirs" for the parasite. People who work with cattle and don't wash their hands well and follow good hygiene are at risk for the parasite.

The parasite also exists in rivers, lakes and streams, so people could be infected while swimming, he said. It can also be spread from person to person through contaminated fecal matter or poor hygiene.

"It's easy to get it in the outside world if you're not careful in your sanitary practices," Courtney said.

Symptoms of the disease include nausea, vomiting, stomach cramps, diarrhea and fever. In some cases people may have to be hospitalized, he said, but people with healthy immune symptoms may show limited symptoms or no symptoms at all.

Tom Taggart, the manager of Cape Girardeau's water system, said the city uses a "multi-barrier" approach to prevent cryptosporidium contamination, including watershed control, sedimentation, disinfection and filtration.

The parasite is resistant to chlorine, he said, but sedimentation and filtration seem to work well.

"It's a fairly large organism," Taggart said. "It's like two microns, which is big."

Surface water supplies are more at risk for the parasite because they are more exposed, he said.

Jackson's water supply comes from wells, said Ralph Schreiner, foreman of the city's water and sewer treatment plant. The source is less exposed, and natural rock formations help filter out many contaminants.