MADRID – Health services from the UK and Ireland are sounding the alarm after discovering hundreds of cases of an intestinal parasite in returning holidaymakers from Spain.
This concerns the parasite Cryptosporidium, which causes the intestinal infection cryptosporidiosis, characterised by abdominal pain and diarrhea. The parasite enters the human intestine through the consumption of water or contaminated food. It then multiplies and releases thousands of oocysts into the environment. These oocysts are often resistant to the chlorine levels used in closed-water treatment systems, such as in swimming pools and water parks, which is believed to be the cause of recent outbreaks.
Increase in parasite throughout Europe
The European Centre for Disease Prevention and Control (ECDC) has long warned about the increase in cryptosporidiosis throughout Europe. Specifically, the British and Irish health services point to holiday destinations in Spain as the source of these infections. These institutions have identified the parasite in hundreds of patients who spent their holidays in Spain, many of them in Salou. An Irish statement suggests that water in Spain – particularly in swimming pools – is playing a role in the spread of the disease.
Advice to tourists: be careful with water
British authorities are advising tourists not to drink iced drinks and to check whether tap water is treated when travelling to Spain. They also warn that after becoming infected with the parasite, people should wait two days before swimming from when their symptoms have disappeared. However, according to Spanish experts quoted in El País, this should be 14 days.
Not just through international travel
A study published in the United Kingdom suggests that many of the cases may be related to international travel. It points to a strong link to Spain and other Mediterranean countries. They want to emphasise the importance for holidaymakers to be alert to their health. Furthermore, they must take the advice of health authorities seriously.
Spanish newspaper El País reports that it is actually important to note that the risk of contracting the disease is not only related to travel but also to bathing in contaminated swimming pools. In Britain, half of people who contracted the virus did not travel abroad.
Increasing number of cases of Cryptosporidium
So far this year, Spain has recorded 2,940 confirmed cases of Cryptosporidium. This is an increase of 805 on the previous year, with 121 people requiring hospitalisation. Similar trends have been observed in the UK, Ireland, the Netherlands, and Luxembourg, according to recent publications from the European Centre for Disease Prevention and Control.
How do infections occur?
Infections in humans usually occur in two ways. The first is due to environmental contamination of drinking water networks or facilities such as swimming pools. A process that can be promoted by periods such as heavy rainfall. Water purification systems and installations can then become overwhelmed. There may also be a carryover effect from oocysts spread in the environment or on livestock farms.
The second major form of contamination occurs between people and usually occurs in closed water supplies. Swimming pools and water parks are a recurring focus of outbreaks. However, the fact that they occur has more to do with the hygiene of some users than the cleanliness of these spaces. Usually, these are subject to strict maintenance, and governed by regulations.
Proper cleaning after using the toilet is therefore crucial. The same applies to not using a swimming pool during the recommended fourteen days after having diarrhea. Ignoring this can result in releasing thousands of oocysts into the water. If this is done by one or two people, the water cleaning system will usually handle it without issues. But if multiple people fail to adhere to these guidelines, the pool will become contaminated.
A full and detailed study is needed to understand the health situation and genotypes. This study must take place before and after travel. Without this, the source of the outbreaks cannot be pinpointed. Consequently, it remains unclear whether Spain is the origin. It’s also possible that the parasite may have come with tourists from their home countries. These insights come from a researcher, as mentioned in El País.