Outbreak of cryptosporidiosis among responders to a rollover of a truck carrying calves - Kansas, April 2013.

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., 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.