Two Lawrence day-care centers have been visited by health officials as part of the investigation into an outbreak of a diarrhea-inducing parasite, officials said Tuesday.

Lawrence-Douglas County Health Director Kay Kent said Raintree Montessori and Children’s Learning Center had been visited, and that the Learning Center had at least one confirmed case of cryptosporidium.

Health officials visited the centers “to evaluate their sanitation and diapering practices and to stress hand-washing and disinfection of toys,” Kent said.

Lleanna McReynolds, director of Raintree Montessori, said she had been told by the parents of one child that their child had the parasite.

Other parents were notified, she said, and the school’s swimming pool was hyperchlorinated twice to ensure the safety of students. Only one student at Raintree has the parasite, she said.

“We feel like it’s a very narrow case, though we’ve encouraged any child who has symptoms to get a (stool-testing) kit and get tested,” McReynolds said.

Officials with Children’s Learning Center did not return a call for comment. Kent said parents of the children at the center had been contacted.

Kent briefly mentioned the day-care centers at a Tuesday afternoon news conference designed to repeat two messages to the public: that officials believe the city water supply is safe and that residents should wash their hands often, among other measures, to prevent the parasite’s spread.

But officials still don’t know how the outbreak got started.

¢ 6News video: Search for outbreak’s cause continues¢ Cryptosporidium cases on hold at 22 in county (8-31-03)¢ 6News video: City plans to test water supply (8-30-03)¢ Audio clips from city and county officials¢ Parasite outbreak strikes more victims (8-29-03)¢ 6News video: Outbreak spurs search for parasite’s source (8-29-03)¢ Letter to parents (pdf)¢ Questionnaire for parents (pdf)¢ Swimmers flock to pools opened after bacteria scare (8-25-03)¢ Outbreak closes city pools (8-23-03)¢ 6News video: Parasite discovered in city pools¢Centers for Disease Control information

‘Long and complex’

“This is a fairly long and complex investigation,” said Dr. Gianfranco Pezzino, state epidemiologist with the Kansas Department of Health and Environment. “We are working as hard as we can, and we hope to have some results (on how far the parasite has spread) in the next few days.”

Cryptosporidium is a microscopic parasite that causes diarrhea, loose or watery stool, stomach cramps, upset stomach and a slight fever. It can be fatal to patients with weakened immune systems, such as the young, elderly or people with HIV. More than two-thirds of those who contract cryptosporidiosis are children.

The parasite is easily passed in swimming pools because it is able to survive outside the body for long periods of time and is resistant to levels of chlorine typically found in pools.

Kent said Tuesday that 23 cases of cryptosporidium had been diagnosed in Lawrence, though she didn’t know how many were associated with Lawrence pools.

Authorities received more than 600 survey responses during the weekend from the families of students at four randomly selected elementary schools. The Health Department is then contacting potential carriers of cryptosporidium to pick up a stool-testing kit to aid diagnoses.

Kent said those responses likely would lead to a rise in the number of diagnosed cases — but she wouldn’t say how many of the responders confirmed they had diarrhea. Nor would she say how many stool-sample collection kits were being distributed.

She did say that potential carriers of the parasite were not cooperating with testing as well as she would like.

“It’s important, in terms of the investigation, that people come in and give a sample and return the kit to us,” Kent said. “We would hope they would be coming back in.”

No suspects

Pezzino said authorities had “no suspicion” that Lawrence drinking water — which is being tested for cryptosporidium — was the culprit.

“We are asking questions about the consumption of drinking water, just because we want to ask the entire gamut of questions,” he said. “But we don’t have that suspicion — it’s not supported by any evidence we have available at this time.”

Kent said the Health Department had heard “inaccurate” public concerns about how the parasite is transmitted.

“I don’t personally think that it’s real helpful to repeat the myths,” she said.

The only way to contract the parasite, she said, was through oral ingestion of even microscopic amounts of contaminated fecal matter.

Pezzino suggested that authorities were focusing on local pools as a source of the outbreak. He also said it was unlikely the parasite was being transmitted through food.

“It can be transmitted through food, but it’s not really a very common source of transmission unless it’s a very localized outbreak where you have the sick person handle food and then serves the food to other people,” he said.

Kent said she wasn’t worried about that possibility.

“I’ve been working every evening since it started and haven’t had time to fix dinner,” she said. “I’ve been eating out every night.”