United States
Environmental Protection Office of Water EPA 811-F-96-007
Agency 4603 May 1996
wEPA ICR OPTIONAL PUBLIC NOTICE
LANGUAGE FOR CRYPTOSPORIDIUM
INTRODUCTION
Cryptosporidium has been found in nearly ail surface waters that have been tested nationwide, As
water systems monitor for Cryptosporidium, the likelihood exists that it will be detected
occasionally at low levels in finished water derived from surface water sources. Cryptosporidium
oocysts are very resistant to disinfection, and even a well-operated water system cannot ensure
that drinking water will be completely free of this parasite. Because all monitoring data required by
the U.S. Environmental Protection Agency's (EPA) Information Collection Rule will be available to
the public, systems may wish to notify the public that Cryptosporidium may be (or has been)
detected in the finished water. Systems are encouraged to work with health department officials in
developing a public health response plan for releasing information to the public and the media
before testing begins. Systems in which a specific plan has not been developed before detecting
oocysts in the finished water are encouraged to consult with their local public health officials and
prepare, a joint statement. EPA does not require a public notice for Cryptosporidium occurrence.
The optional public notice may be circulated in monthly bills, newspapers, radio or a number of
other ways. Elements of the message may include items in the list below. Other information about
Cryptosporidium and cryptosporidiosis is available from EPA, the Centers for Disease Control and
Prevention (CDC), the American Water Works Association, and State and local public health
agencies. One example of such information is a joint EPA/CDC statement entitled, "Guidance for
People with Severely Weakened Immune Systems," available from the Safe Drinking Water Hotline
(1-800-426-4791). An example of optional public notice/education language is attached.
If a system wishes to prepare a public health advisory different from the example attached, it might
consider incorporating some or all of the informational elements below.
LIST OF INFORMATIONAL ELEMENTS
• Cryptosporidium definition - a microscopic parasite that can cause disease, mainly diarrhea,
if swallowed.
• System has been (or will be) testing for Cryptosporidium in water leaving the treatment
plant.
• Test results (or notice that customers will be receiving quarterly reports on test results, if
applicable).
• Cryptosporidium is common in the environment, including surface waters, and the finding of
an occasional oocyst in finished water is not unusual.
• A number of waterborne disease outbreaks caused by Cryptosporidium have recently
occurred in the U.S. and other countries.
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• Symptoms may include diarrhea, nausea, and/or stomach cramps. (Note that diarrhea
be caused by pathogens and conditions other than Cryptosporidium).
• Cryptosporidium can be spread in a number of ways, including contaminated drinking water
and recreational water, unwashed hands, surfaces or food contaminated with feces, and
sexual behavior involving contact with feces.
• Interpretation of Cryptosporidium-positlve test results is difficult. (According to a CDC
workshop report, detecting this parasite at low levels in finished water should not be used
as the sole criterion for issuing a boil-water advisory. Other criteria should include data such
as turbidity levels, number of large particles, conditions at the treatment plant, or evidence
of disease in the community that suggests water quality is unacceptable. [D. Juranek et al.,
Cryptosporidiosis and public health: Workshop Report, J. Amer. Water Works Assoc.
87:69-80,1995.].)
- Cryptosporidium may be dead.
- Cryptosporidium may not be infective to humans, if alive. [A number of species of
Cryptosporidium exist, and only one is known to infect humans]
- Cryptosporidium recoveries are low using the current method
- A rapid analysis is not possible with current method; analysis may take up to two
weeks.
- Thus, health significance is unknown.
• Local public health department officials are aware of the test results (if public notice is not a
joint statement, health department officials should be notified in advance about release of
statement).
* Control
- System is taking steps to improve Cryptosporidium control.
- If system has joined EPA/State/water system Partnership for Safe Water, tell the
customers about this and what this partnership involves.
- System has been and will be in consultation with local health department during
entire monitoring period (If applicable).
- Local health department has a surveillance system in place for cryptosporidiosis
and/or for an unusually high incidence of diarrhea in the community (if applicable).
- Local health department believes that no precautions are currently necessary (if true).
Individuals with a severely weakened immune system should consult with their health
care providers.
• EPA/CDC guidance/pronouncements.
• System is in full compliance with all EPA/State standards and requirements (if true).
• System will continue to keep you informed.
For More Information Contact the Safe Drinking Water Hotline at 1-800-426-4791
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OPTIONAL PUBLIC NOTICE LANGUAGE
The water system name, along with the U.S. Environmental Protection Agency (EPA) and hundreds of other water
systems in the U.S., is taking part in a major drinking water testing program. This program, known as the
Information Collection Rule (ICR), will gather information on drinking water contaminants. Along with ongoing
research on health effects, water treatment, and other areas, this information will be used to revise drinking water
safety standards.
One of the contaminants we are testing for as part of the ICR is Cryptosporidium. This parasite has caused a
number of recent outbreaks of waterborne disease in the U.S. and other countries. The testing we are doing is vital
to future control of Cryptosporidium. The following information from EPA, the Centers for Disease Control and
Prevention (CDC), and others, tells more about our current knowledge of this parasite.
Cryptosporidium is a protozoan parasite, a one-celled animal too small to be seen without a microscope. It is
common in surface waters (e.g., lakes and rivers), especially when these waters contain a high amount of sewage
contamination or animal waste. Cryptosporidium is very hard to kill with disinfection, and even a well-run water
treatment system cannot ensure that drinking water will contain no live parasites. Current EPA drinking water
safety standards were not explicitly designed to assure the removal or killing of Cryptosporidium. EPA is now
working to resolve a number of scientific questions that will assist it in setting specific safety standards for
Cryptosporidium in the future.
Cryptosporidium can cause symptoms that include diarrhea, nausea, and/or stomach cramps. Because many other
organisms and conditions can produce these same symptoms, a special laboratory test is needed to find out
whether Cryptosporidium is the cause. The parasite is found in the feces of infected humans or animals. To cause
illness, the parasite must first be swallowed. Cryptosporidium can be spread by a very small amount of feces
found in a number of places, including unwashed hands, contaminated surfaces inside and outside the home, and
contaminated food, drinking water, and recreational water, as well as sexual behavior involving contact with feces.
No precaution about our drinking water is currently needed for the general public. People with severely weakened
immune systems are likely to have more severe and longer lasting symptoms than healthy individuals, and should
speak with their health care providers about how to protect themselves against Cryptosporidium from all sources.
According to EPA and CDC, there are problems with-the current water testing method for Cryptosporidium. The
method now in use cannot determine with certainty whether Cryptosporidium found in drinking waters is alive or
dead. Also, the method cannot distinguish among several different types of Cryptosporidium, only one of which is
known to cause disease in humans. Also, the current method may capture only a small portion of the
Cryptosporidium in the water sample, and the time needed between taking a sample and getting back test results
from the laboratory may be as long as one or two weeks.
Thus the health significance of any Cryptosporidium that we detect in the water system is hard to know, especially
if only very low levels of Cryptosporidium are found. Throughout the entire testing period, we will consult with
name of State or local public health agency. If Cryptosporidium is found in system's name's drinking water, we
will examine a number of measures of water quality and system operation and, if appropriate, let the public know
of any precautions they might need to take.
[If Applicable] In addition to the required testing, the system is also taking part in the new voluntary
EPA/State/water industry Partnership for Safe Water. This program is part of our continuing effort to improve
water treatment for the control of Cryptosporidium and other disease-causing organisms.
We will make all of our data available to the public. To learn more about Cryptosporidium and system name's
water, please contact identify contact.
For More Information Contact-the Safe Drinking Water Hotline 1-800-426-4791
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