Health authorities have said a late-July letter about cryptosporidium to parents of members of a Lawrence youth swim club was for investigative purposes, not to sound the alarm about the pending outbreak.
But the letter -- obtained by the Journal-World under the Kansas Open Records Act -- shows parents were given explicit instructions on symptoms of the parasite and how to avoid its spread. And they were given that information a month before the rest of the community.
"The symptoms can include diarrhea, loss of appetite, vomiting and abdominal cramping," said the letter from Kim Ens, disease control program coordinator for the Lawrence-Douglas County Health Department. "The infection is spread through oral-fecal contact, including person-to-person, waterborne and foodborne transmission."
The letter went to parents of the 200-member Lawrence Aquahawks swim team July 25, after one case had been diagnosed. By the time the health department alerted the public Aug. 22, the illness had spread to 11 people. As of Monday, the number of people diagnosed with the illness was 82, up from 78 on Friday.
The mailing also included a fact sheet, which warned parents that outbreaks "have also been associated with contaminated swimming pools and lakes and drinking unpasteurized apple cider contaminated with cow manure. Hands can become contaminated with parasites when a person changes the diaper of an infant with cryptosporidiosis. Pets, farm animals, drinking water and unpasteurized milk can also contain the parasite."
The correspondence released to the newspaper also shows Douglas County physicians were first alerted about the parasite July 28.
Officials have said that Douglas County day care centers have been "disproportionately" affected by the parasite. But the health department declined to furnish a list -- also requested by the Journal-World under the open records law -- of day care centers visited in connection with the outbreak, citing state law that says information about day care centers cannot be released "in a manner that would identify individuals."
Health officials have said they were correct not to alert the broader public about the cryptosporidium cases.
"There was an attempt to disseminate information to the parts of the public that were considered at risk for the disease, and to all the physicians in the community," Dr. Gianfranco Pezzino, the state epidemiologist, said Friday.
The next update on the outbreak will be at 3 p.m. today.