Since late 2005, the AFA Air Safety, Health
and Security Department has learned that several flight attendants across the country
are suffering from gastro-intestinal diarrheal diseases possibly caused by
microscopic parasites of the genus Cryptosporidium.
A fact sheet from the Centers for Disease Control and Prevention (CDC),
which can be posted in crew rooms, states that the most common symptom of Cryptosporidiosis,
or crypto, is watery diarrhea. Other symptoms include dehydration, weight loss,
stomach cramps or pain, fever, nausea or vomiting. Also, some people with
crypto will have no symptoms at all. Symptoms generally begin 2 to 10 days
(average 7 days) after becoming infected with the parasite. In persons with
healthy immune systems, symptoms usually last about 1 to 2 weeks. The symptoms
may go in cycles in which you may seem to get better for a few days, then feel
worse again before the illness ends.
People most likely to become infected with
Cryptosporidium include parents of infected children, international travelers,
swimmers who swallow water while swimming in swimming pools, lakes, rivers,
ponds, and streams, people who drink from shallow, unprotected wells, and
people who swallow water from contaminated sources. Contaminated water includes
water that has not been boiled or filtered.
Although Crypto can infect all people, some
groups are more likely to develop more serious illness, including:
Those with severely weakened immune
systems should talk to their health care provider for additional guidance,
and/or call the CDC AIDS HOTLINE toll-free at 1-800-342-2437, and/or go to the
CDC fact sheet Preventing Cryptosporidiosis: A Guide for People with
Compromised Immune Systems.
Young children and pregnant women may be
more susceptible to the dehydration resulting from diarrhea and should drink
plenty of fluids while ill.
Treatment for cryptosporidiosis includes a
new drug, nitazoxanide, which has been approved for treatment of diarrhea
caused by Cryptosporidium in people with healthy immune systems. Consult with a
health care provider for more information. For diarrhea, drink plenty of fluids
to prevent dehydration. People who are in poor health or who have a weakened
immune system are at higher risk for more severe and more prolonged illness,
and should see their health care provider for treatment strategies.
How to Avoid Cryptosporidiosis
To avoid becoming infected with
Cryptosporidium, flight attendants should wash hands thoroughly with soap and
water, after using the toilet and before handling or eating food. They should
also avoid water that might be contaminated, should not swallow recreational
water, should not drink untreated water from shallow wells, lakes, rivers,
springs, ponds, and streams, and should not use untreated ice or drinking water
when traveling in countries where the water supply might be unsafe. Also, do
not rely on chemicals to disinfect water and kill Cryptosporidium. Because it
has a thick outer shell, this particular parasite is highly resistant to
disinfectants such as chlorine and iodine.
Also, avoid food that might be contaminated:
and/or peel all raw vegetables and fruits before eating.
Use safe, uncontaminated water to wash
all food that is to be eaten raw.
Avoid eating uncooked foods when
traveling in countries with minimal water treatment and sanitation systems.
How to Avoid Spreading
Cryptosporidium can be very contagious -
flight attendants diagnosed with Crypto should follow these guidelines to avoid
spreading the disease to others:
hands with soap and water after using the toilet, changing diapers, and before
eating or preparing food.
Do not swim in recreational water (pools,
hot tubs, lakes or rivers, the ocean, etc.) for at least 2 weeks after diarrhea
stops. Cryptosporidium can be passed in stool and contaminate water for several
weeks after symptoms have ended.
Avoid fecal exposure during sexual
AFA activity and hot topics
To determine possible causes and the extent
of this disease outbreak, we are encouraging symptomatic flight attendants to
complete and return a short, two-page complaint form (MSWord
from questions included in a survey developed by the U.S. Environmental Protection Agency
Airline Water Supplies program. Flight
attendants who have been diagnosed with crypto, or who have had watery diarrhea
and suspect the cause may be work-related (i.e., contracted while working,
traveling for work, or staying at hotels because of work), should print out and
complete these forms, then return them to the Air Safety, Health and Security
Department by fax, 202-434-1105, or by mail to AFA-CWA Air Safety, Health and
Security Dept., 501 Third Street NW 2nd Floor, Washington, DC 20001.
The information you provide will be used by
AFA to support studies of gastrointestinal disease outbreaks linked to water
quality or sanitation on board aircraft. They are also crucial in helping the
AFA International Office make a case for stricter federal regulation of
sanitation and water quality on board aircraft.