Top 5 Takeaways

1. Two Distinct Outbreaks Identified: Investigations revealed two outbreaks at a Kansas wildlife park’s splash pad: one shigellosis outbreak with 21 cases and a norovirus outbreak with six cases, both linked to getting splash pad water in the mouth.
2. Contributing Factors: Inadequate disinfection, equipment, and training were identified as factors contributing to the outbreaks. The splash pad lacked an automated controller for maintaining free chlorine concentration and did not have staff with documented operator training.
3. Public Health Response: Following the outbreaks, the splash pad was closed, and the CDC provided operation and management guidance for reopening. The operator voluntarily implemented best practices, including continuous recirculation, filtering, and disinfecting of water.
4. Prevention Messages: To prevent similar outbreaks, the report emphasizes prevention messages for caregivers of splash pad users, such as not getting in the water if sick with diarrhea, not standing or sitting above the jets, and not swallowing the water.
5. Importance of Regulation and Education: The outbreaks highlight the need for splash pads to be regulated and inspected and for environmental health expertise in managing such recreational water venues. Adopting CDC’s Model Aquatic Health Code (MAHC) recommendations can help reduce outbreak incidence.

Original Article Author and Citation

Corresponding Author

Michele Hlavsa, acz3@cdc.gov.

Suggested Citation

Aluko SK, Ishrati SS, Walker DC, et al. Outbreaks of Acute Gastrointestinal Illness Associated with a Splash Pad in a Wildlife Park — Kansas, June 2021. MMWR Morb Mortal Wkly Rep 2022;71:981–987. DOI: http://dx.doi.org/10.15585/mmwr.mm7131a1.

Summary

The CDC reported on two outbreaks of acute gastrointestinal illness at a Kansas wildlife park splash pad in June 2021, one due to Shigella and the other due to norovirus. The outbreaks were linked to inadequate disinfection, equipment, and training. The public health response included closing the splash pad, consulting with CDC for guidance, and implementing best practices for reopening.

Methods

A case-control study identified the outbreaks, with investigations including stool cultures, whole genome sequencing, and environmental microbiology. The public health response involved drafting and implementing operation and management guidance based on the MAHC.

Discussion

The report emphasizes the importance of maintaining adequate water disinfection and environmental health expertise. It suggests targeting prevention efforts towards caregivers of children using splash pads and adopting CDC’s MAHC recommendations to prevent future outbreaks.

Conclusion

Splash pad–associated outbreaks of gastrointestinal illness can be prevented through adequate water disinfection, proper equipment, staff training, and public education on healthy swimming practices. Regulatory oversight and adherence to CDC guidelines are crucial for preventing such incidents.

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