Rise in Cryptosporidium Infections

Cryptosporidium infection (cryptosporidiosis) is a gastrointestinal disease whose primary symptoms are diarrhea and painful sores. The illness begins when the tiny cryptosporidium parasites enter your body and travel to your small intestine. Cryptosporidium then begins its life cycle inside your body — burrowing into the walls of your intestines and then later being spreading to other parts of your body.

In most healthy people, a cryptosporidium infection produces a bout of watery diarrhea and the infection usually goes away within a week or two. If you have a compromised immune system, a cryptosporidium infection can become life-threatening without proper treatment. You can help prevent cryptosporidium by practicing good hygiene and by avoiding drinking water that hasn’t been boiled and/or filtered. The parasite also thrives in waters with high levels of TOC (Total Organic Carbon).
The first signs and symptoms usually appear two to seven days after infection with cryptosporidium and may include:

Watery diarrhea
Noticeable increase in skin acne
Sores
Dehydration
Weight loss
Stomach cramps or pain
Fever
Nausea
Vomiting

Symptoms may last for up to two weeks, though they may come and go sporadically for up to a month, even in people with healthy immune systems. Some people with cryptosporidium infection may have no symptoms. Seek medical attention if you develop watery diarrhea that does not get better within several days. You’re likely to start by seeing your primary physician. However, in some cases, he or she may refer you to a doctor who specializes in infectious diseases or a doctor who specializes in disorders of the gastrointestinal tract (gastroenterologist).

Here’s some information to help you get ready for your appointment, and what to expect from your doctor. Write down any symptoms you’re experiencing, including any that may seem unrelated to the reason for which you scheduled the appointment.
Write down key personal information, including any recent travel, especially to other countries. Make a list of all medications, vitamins and supplements you’re taking. Write down questions to ask your doctor.

Your time with your doctor is limited, so preparing a list of questions can help you make the most of your time together. For cryptosporidiosis, some basic questions to ask your doctor include:

What’s the most likely cause of my symptoms?
Are there other possible causes?
What kinds of tests do I need, if any?
What treatments are available and which do you recommend?
Are there any dietary restrictions that I need to follow?
Are there any brochures or other printed material that I can take home with me? What websites do you recommend visiting?

In addition to the questions that you’ve prepared to ask your doctor, don’t hesitate to ask questions during your appointment at any time that you don’t understand something.
 
Your doctor is likely to ask you a number of questions. Being ready to answer them may reserve time to go over any points you want to spend more time on. Your doctor may ask:

When did you first begin experiencing symptoms?
Have you developed any painful sores/blisters?
How severe are your symptoms?
Does anything seem to improve your symptoms?
Does anything make your symptoms worse?
Have you been swimming recently?
Have you traveled out of the country recently?

Cryptosporidium infection begins when you ingest the cells of one of nearly a dozen species of the one-celled cryptosporidium parasite. The Cryptosporidium parvum (C. parvum) species is responsible for the majority of infections in humans.
These parasites then travel to your intestinal tract, where they settle into the walls of your intestines. Eventually, more cells are produced and shed in massive quantities into your feces, where they are highly contagious. You can become infected with cryptosporidium by touching anything that has come in contact with contaminated material, especially feces. Methods of infection include:

Swallowing or putting something contaminated with cryptosporidium into your mouth
Drinking water contaminated with cryptosporidium
Swimming in water contaminated with cryptosporidium and accidentally swallowing some of it
Eating uncooked food contaminated with cryptosporidium
Touching your hand to your mouth if your hand has been in contact with a contaminated surface or object
Having close contact with other infected people or animals
Living in an area where the water source is contaminated with high amounts of TOC (Total Organic Carbon)

If you have a compromised immune system from HIV/AIDS, you’re more susceptible to illness from cryptosporidium than is a person with a healthy immune system. People with HIV/AIDS can develop severe symptoms and a chronic, persistent form of disease that may be difficult to treat.

Cryptosporidium is one of the most common causes of diarrhea in humans. This parasite is difficult to eradicate because it’s resistant to many chlorine-based disinfectants and can’t be effectively removed by many filters. Cryptosporidium can also survive in the environment for many months at varying temperatures, though the parasite can be destroyed by freezing or boiling.

People who are at increased risk of developing cryptosporidiosis include:

Those who are exposed to contaminated water
Children, particularly those wearing diapers, who attend child care centers
Parents of infected children
Child care workers
Animal handlers
International travelers, especially those traveling to developing countries
Backpackers, hikers and campers who drink untreated, unfiltered water
Swimmers who swallow water in pools, lakes and rivers
People who drink water from shallow, unprotected wells

Complications of cryptosporidium infection include malnutrition resulting from poor absorption of nutrients from your intestinal tract (malabsorption), development of painful sores or blisters on all parts of the body, severe dehydration, weight loss (wasting), inflammation of a bile duct — the passage between your liver, gallbladder and small intestine, and inflammation of your gallbladder, liver or pancreas. Cryptosporidium infection itself isn’t life-threatening. However, if you’ve had a transplant or if you have a weakened immune system, developing complications can be dangerous.
You may undergo the following tests to diagnose cryptosporidium infection:

Acid-staining test. The simplest way to diagnose cryptosporidium infection is a method called an acid-staining test, which identifies cryptosporidium under a microscope. To obtain cells for the analysis, your doctor might ask for a stool sample, or in more extreme cases, take a tissue sample (biopsy) from your intestine for the test.

Stool culture. Your doctor might also order a standard stool culture. Although this test cannot detect the presence of cryptosporidium, it may help rule out other bacterial pathogens.

Other tests. Once it’s clear that your infection is cryptosporidium, you may need further testing to check for development of serious complications. For example, checking liver and gallbladder function may determine whether the infection has spread.

If you have both AIDS and cryptosporidiosis, a T cell count — which measures the level of a certain white blood cell that’s part of your immune system — can help predict the duration of the cryptosporidiosis. A high T cell count means you’re more likely to recover quickly, while a low count means you may need to be monitored for further complications.

There’s no commonly advised specific treatment for cryptosporidiosis, and recovery usually depends on the health of your immune system. Most healthy people recover within two weeks without medical attention.

If you have a compromised immune system, the illness can last and lead to significant malnutrition and wasting. The goal of treatment is to alleviate symptoms and improve your immune response. Cryptosporidium treatment options include:
Anti-parasitic drugs. Medications such as nitazoxanide (Alinia) can help alleviate diarrhea by attacking the metabolic processes of the cryptosporidium organisms. Azithromycin (Zithromax) may be given along with one of these medications in people with compromised immune systems.

Anti-motility agents. These medications slow down the movements of your intestines and increase fluid absorption to relieve diarrhea and restore normal stools. Anti-motility drugs include loperamide and its derivatives (Imodium A-D, others). Talk with your doctor before taking any of these medications.

Fluid replacement. You’ll need oral or intravenous replacement of fluids and electrolytes — minerals such as sodium, potassium and calcium that maintain the balance of fluids in your body — lost to persistent diarrhea. These precautions will help keep your body hydrated and functioning properly.

Anti-retroviral therapies. If you have HIV/AIDS, highly active anti-retroviral therapy (HAART) can reduce the viral load in your body and boost your immune response. Restoring your immune system to a certain level may completely resolve symptoms of cryptosporidiosis.

Currently there is an outbreak of cryptosporidiosis in four US states (Alabama, Florida, Oklahoma and Arizona). If you live in one of these key states and you notice any of these symptoms, visit your physician immediately.

100Feed: Oklahoma Ranks 36th in the Nation on ACT Test Scores

Oklahoma’s graduating class of 2012 scored below the national average on the ACT college entrance exam, but student performance on the exam varies greatly by school, according to data released Monday by the Education Department. Seniors at the Oklahoma School for Math and Science had the highest average ACT score in the state with a 31.4, while at the bottom of the list is a small alternative high school in Oklahoma City for at-risk students with an average score of 13.7. The four-hour long multiple-choice exam is scored on a scale from 0-36. It has become synonymous with college acceptance for Oklahoma seniors. A high score can mean entrance into the university of their choice and more scholarship money, while a low score can tip the admission’s scale toward a rejection letter. The average score among all Oklahoma high school seniors on the ACT is 20.7. That is close to the national average on the exam 21.1 but well below admissions standards for the state’s two largest universities.

Top scores largely come from the suburbs of Tulsa and Oklahoma City, but a few inner city specialty schools with admissions requirements are in the top ten performers. At the Oklahoma School for Science and Mathematics, students must take the ACT as an entrance exam for the school, said Suzanne Donnolo, the school’s director of admissions and registrar. Sophomores from across the state can apply to attend the free public boarding school for their final two years of high school. Donnolo said the average score for incoming juniors on the exam is a 26, and then the students are required to take the exam three more times before they graduate. “Many of them take it a lot more than that,” Donnolo said. Her students are motivated by the lucrative Academic Scholars Program, which offers substantial scholarships to students who score in the very top echelons on the ACT or SAT. “They are required to read so much more here and do so much more between the reading and the math. That usually helps,” Donnolo said. “Some of our students who have taken it multiple times even tell us that they will see the same reading passage on a different test. If you know what to expect, then that test anxiety goes down.”

In Oklahoma about 76 percent of high school seniors have taken the ACT, which is much higher than the national average. Only 27 states in the U.S. have more than 50 percent of their students take the ACT. The fee for the full exam is $50, but waivers are available to students who qualify for free and reduced price lunch. All three of the regular Edmond Public High Schools are in the top ten list for the highest composite ACT scores in the state, and the district’s overall average score of 23.7 was the highest ever. According to the district 80 percent of their graduating seniors took the exam. The second highest composite score in the state, at 25, is from Classen School of Advanced Studies, an Oklahoma City specialty school that has admissions standards. The school has a college preparatory track for students as well as a fine arts school.

“They have a wide range of students in terms of academic achievement with those two groups, so they’ve been working with both groups to improve the overall ACT,” said Sheli McAdoo, executive director of secondary schools and reform for Oklahoma City Public Schools. The district also has a high school with one of the lowest average scores in the state on the ACT. Oklahoma Centennial High School seniors scored an average of 14.8 on the ACT in 2011. McAdoo said the district is undergoing a number of reforms at all grade levels to improve college readiness. including the professional development program America’s Choice. “A lot of our work with America’s Choice has been to work with our students to increase the level and rigor in the class,” McAdoo said.

100Feed: Drought Side Effects May Include Toxic Crops In The Midwest

By Michael Hirtzer and Meredith Davis

CHICAGO, Aug 15 – The worst U.S. drought in five decades has parched the land and decimated crops. It now threatens to deal a second blow to farmers, who may have to throw out tonnes of toxic feed.

Growers are rushing to check the nitrate levels of that silage, the stalks and leaves that corn farmers often harvest to feed to locally raised cattle or hogs.

Agriculture groups are warning farmers that drought-hit plants may have failed to process nitrogen fertilizer due to stunted growth, making them poisonous to livestock.

Exceptionally early spring planting has caused a crush of early summer requests for the tests. Farmers are also expected to chop down a near-record swathe of their fields for silage to make up for this year’s poor yields.

“We’ve had a lot of walk-in business and normally we are not a walk-in business,” said Lola Manning, a 30-year employee of Agri-King, a laboratory that tests for nitrates and other toxins. “At this point it’s the busiest I’ve seen it.”

Manning said the facility, approved by the National Forage Testing Association, checked about 400 samples — roughly double the norm — in July.

So far, few samples have shown elevated levels of toxins, she said. But late-season rains — far too tardy to help salvage the corn crop — could prompt mostly mature plants to draw even more nitrogen out of the soil and into the stalks.

“The tests are coming out OK but as soon as they have rain, the situation will change,” Manning said.

SO FAR, SO GOOD

Two months of dry weather and high heat that stunted plants and shriveled ears likely caused the absorption of excessive amounts of nitrogen, experts say. Instead of being distributed safely through the plant, the chemical built up in the lower portions of the stalk at potentially toxic levels.

Kenny Wagler, a dairy farmer in Nashville, Indiana who also farms 2,500 acres (1,000 hectares) of corn and pasture, is testing his corn for the first time since the last major drought in 1988.

“It’s almost never a factor,” said Wagler, who raises about 1,500 dairy cows and cattle, adding that he is testing this year on recommendation from his farm nutritionist.

Nearly half of what he typically harvests to sell as a cash corn crop will be cut for silage this year because most of the plants had no ears of grain.

In the worst-case scenario, silage with high levels of nitrate can be absorbed into an animal’s bloodstream, causing poisoning leading to death.

The absorption causes hemoglobin to be converted to methemoglobin, which is incapable of transporting oxygen and so can be fatal to the animal, according to the U.S. Department of Agriculture. Symptoms of nitrate poisoning include labored breathing, rapid heartbeat, weakness, lack of coordination and blue-gray discolored skin.

Extensive losses of livestock are an unlikely, extreme scenario, beef and dairy experts say.

“Certainly there are instances of dead cattle from nitrate,” said Chris Hurt, agriculture economist at Purdue University. “Widespread education has helped reduce the problem.”

But nitrate-laced silage would force those farmers to buy extra feed grains in order to sustain their animals.

LOW GRAIN YIELDS, MORE SILAGE?

Silage is usually harvested while plants are still green and contain a high level of moisture. It is then fermented, often in silos. Many dairy farmers raise corn specifically for silage, in part to avoid having to buy feed elsewhere.

The rest of the crop is allowed to mature and is harvested as grain to be sold to elevators for export or feed use, or to ethanol makers.

Farmers are expected to harvest more of their corn crop for silage than usual this season due to poor yields, which are forecast by the USDA to be the lowest in 17 years.

As many as 9 million acres — or 9 percent of the corn crop — may not be harvested for grain this year, according to USDA data released last week. That would be the most abandoned acres in a decade. Much of that will be used instead as silage.

At Agri-King in western Illinois, tests cost $8 per sample for nitrate. Farmers are advised to take six stalks, chop them up and put them into a bag for testing.

Nitrate levels under 4,400 parts per million are considered safe while those over 15,000 ppm are considered potentially toxic and should not be fed to livestock, said Randy Shaver, extension dairy nutritionist at the University of Wisconsin.

At between 8,800 and 15,000 ppm, silage should be limited to less than half of the total feed ration and well fortified with minerals, data from that university showed. However, acceptable nitrate levels vary slightly from state to state.

“We’ve had quite a few tests that have come in at 14,000 parts per million or higher, and that seems to come up after a rain,” said Travis Meteer, a beef extension specialist at the University of Illinois, one of several universities to issue bulletins about nitrates in silage in recent weeks.

LIVESTOCK PAIN, CORN’S GAIN

If the silage proves to be toxic, farmers like Wagler could be forced to cull their herds, as many ranchers are doing. Or they could buy additional grains from the cash market to feed their livestock — incurring extra expenses in a year when some of their income will depend on crop insurance claims.

Extra demand could add fuel to corn prices, which have already rallied more than 60 percent in two months to a record as drought deepened across two-thirds of the country.

“It will mean higher feed costs for livestock producers,” said Roger Elmore, a professor of agronomy and a corn specialist at Iowa State University. “In addition to the drought, forage quality and the quantity will be less.

“We’ll have less forage out there, so that price will also increase. All of that increases the cost of production for livestock producers,” he added.

100Feed: Latest news on Oklahoma wildfires

Flames leap into the air as area firefighters fight a wildfire on Cemetery Road east of 120th on Friday, Aug. 3, 2012, east of Norman, Okla. Photo by Steve Sisney.

Due to ongoing fires, the State Emergency Operations Center remains activated. The Oklahoma Department of Emergency Management (OEM) is in contact with emergency managers in the affected areas. Additionally, OEM is working with the Oklahoma National Guard, Oklahoma Highway Patrol, Oklahoma Forestry Division, Oklahoma Office of Homeland Security, Oklahoma State Department of Health, American Red Cross and the Salvation Army.

A statewide Burn Ban is in effect. This ban, issued by Gov. Mary Fallin on Friday, supersedes all county burn bans currently in place and remains in place until conditions improve and it is removed by the Governor. For a copy of the current burn ban resolution or for the most up-to-date information go to: http://www.forestry.ok.gov/burn-ban-information

A State of Emergency remains in place for all 77 Oklahoma counties as declared Monday by Gov. Mary Fallin due to extreme or exceptional drought conditions. The Executive Order allows state agencies to make emergency purchases related to disaster relief and preparedness. It is also a first step toward seeking federal assistance should it be necessary. Under the executive order, the state of emergency lasts for 30 days.

Creek County Emergency Management reports the fire is ongoing. Two National Guard helicopters are assisting on the fire. Delaware, Mayes and Washington county task forces are responding. Evacuations are underway west, southwest of Mannford.

Kiowa County Emergency Management reports a fire near the Tom Steel Reservoir. The fire has cut off water to Altus and other communities in the area.

Lincoln County Emergency Management reports a fire between County Road 750 and County Road 3520 near Drumright. Evacuations are underway in this area.

Noble Emergency Management reports the Noble/Slaughterville fire in Cleveland County is ongoing. A National Guard helicopter is on scene assisting. Johnston and McClain county task forces are responding.

Oklahoma County Emergency Management reports the fire at Luther is ongoing. Early reports indicate approximately 56 structures have been destroyed since yesterday.

Pittsburg County Emergency Management reports a fire 10 miles west, southwest of Quinton at Lick Creek Road near Lake Eufaula. Homes have been evacuated. A National Guard helicopter is on scene to assist.

Pittsburg County Emergency Management reports an additional fire near 31 Landing off Highway 31. Seven fire departments are responding.

Pottawatomie County Emergency Management reports a fire on I-40 at mile marker 181 through 183.

Stillwater Emergency Management reports a fire between Stillwater and Glencoe. A National Guard helicopter is en route to assist and a second one is en route. Glencoe and Ingles fire departments are on the scene as well as OSU Fire Service Training. Evacuations in

Glencoe and the surrounding area are underway.
Woods County Emergency Management reports a fire at Highway 14 and Avard Road. Four fire departments are responding.

More than 52,000 acres have burned in fires across the state since yesterday.

Oklahoma Forestry Services reports:
Noble/Slaughterville Fire – 7,900 acres
Creek County Fire – 32,000 acres
Luther Fire – 2,600 acres
Grady County Emergency Management reports 9,600 acres have burned in the Ninnekah fire.

OEM has been working in conjunction with State Forestry officials to deploy Oklahoma National Guard helicopters for aerial fire support. Oklahoma Forestry Division is providing ground firefighting support. Water drops are being provided today on fires in Cleveland, Creek, Oklahoma, Payne and Pittsburg counties.

The following American Red Cross Shelters remain open:

Harmony Christian Church – 7100 S. Choctaw Road in Choctaw, OK

Noble City Hall – 304 S. Main Street in Noble, OK

Sand Springs United Methodist Church – 101 W. 38th Street, Sand Springs, OK

American Red Cross Reports 38 people stayed overnight at the Mannford shelter that is now closed, 48 people stayed at the Noble Shelter and 8 people stayed at the Choctaw Shelter. Additionally, American Red Cross and The Salvation Army are providing canteens and volunteers to support firefighters in the affected areas.

Hot and dry weather over the past few months has lead to drought conditions statewide. Strong winds, extremely high temperatures and low relative humidity has created critical fire weather conditions across much of the state. An area along and 100 miles either side of I-44 is under a Red Flag Fire Warning. A cold front is moving into northern Oklahoma this afternoon which will help lower temperatures across the state by Sunday. Even with this cold front, temperatures will remain in the upper 90s to 104 degrees. The cold front is expected to create further challenges for firefighters as wind shifts occur.

The Oklahoma Insurance Department recommends taking the following steps after your property has been damaged by a fire:

· When the fire has moved on or been extinguished, call your insurance agent or company claim line as soon as possible.
· Make a list of your damaged property and make necessary repairs to protect your home and property from further damage.
· Read your homeowner’s insurance policy carefully to fully understand your coverage and your rights. If you don’t have the policy in hand, ask the agent for a copy.
· Know if you have replacement cost or actual cash value coverage.
· Ask your agent about additional living expenses (ALE) or loss of use.
· Refer to your policy to know what deductible you’ll be required to pay.

For questions about insurance claims or to report insurance fraud, please call the Oklahoma Insurance Department consumer assistance number at 1-800-522-0071 or online at http://oid.ok.gov

For Oklahoma residents seeking non-emergency disaster or health and human service information, please contact your local 2-1-1. Services are available 24 hours a day by dialing 2-1-1 from your home or cellular telephone. Please only call 911 for emergencies.

100Feed: Oklahoma road closings

Dead cedar trees went up in flames on Squire Hill Ranch on HWY 281 In between Hinton and Geary. Photo by Taylor Meriwether.

BRISTOW – A major thoroughfare that connects Oklahoma City with Tulsa is closed for a second time in two days do to wildfire. Westbound traffic on the Turner Turnpike between Bristow and Tulsa was diverted beginning around 2:45 p.m. Saturday due to billowing smoke across the roadway, according to Oklahoma Highway Patrol.
Alternative routes of travel from Tulsa to Oklahoma City include:

-U.S. 412 (Cimmaron Turnpike) west to I-35 and south to Oklahoma City; or
-U.S. 75 south to I-40 west to Oklahoma City.

The turnpike was closed in its entirety for more than six hours Friday due to a major fire in the Luther area northeast of Oklahoma City. In addition to the Turner Turnpike, all other state highways in Creek County west of Tulsa were closed on Saturday.

Additional road closings in Payne and Lincoln counties:

Lincoln County: State Highway 99 South from State Highway 33 to Stroud.

Payne County: State Highway 33 East from Cushing East to Drumright.

The following roads are remained closed in Creek County due to wildfires:

State Highway 33 from State Highway 48 to State Highway 99.

State Highway 51 from State Highway 48 to State Highway 99.

State Highway 99 from State Highway 51 to State Highway 33.

State Highway 48 from State Highway 51 to State Highway 33.

100Feed: Wildfire evacuation orders lifted in Oklahoma

Many Oklahomans forced to leave their homes because of raging wildfires were being allowed to return Sunday, despite some fires continuing to burn. A “monster” fire had devoured almost 91 square miles and continued to burn between Mannford and Kellyville in northeastern Oklahoma’s Creek County as light rain and cooler temperatures gave firefighters a brief respite Sunday, said Oklahoma Forestry Services spokeswoman Michelle Finch-Walker. She described the blaze as hopscotching as it burns some areas and leaves others untouched. “It’s not like an inferno moving across the landscape,” Finch-Walker said. “You can drive for miles down the highway and see nothing but black, but then you can see pockets of green, pockets unburned. “Maybe there was a creek (that stopped the fire),” she said. “Maybe the wind blew it in a different direction.” Finch-Walker said residents of the town of Mannford, which was evacuated Saturday, had been allowed to return and that she was not aware of any other evacuation orders.

Officials with the Oklahoma Department of Emergency Management did not immediately return phone calls Sunday seeking comment. Nigel Holderby, a spokeswoman for the American Red Cross, said shelters remained open Sunday in Payne County, about 35 miles to the west. Finch-Walker said three firefighters were treated and released Friday after suffering burns, but that there had been no reports of serious injuries as a result of wildfires statewide. Since late last week, as many as 18 fires have been reported.

The National Weather Service said .15 to .16 inches of rain fell early Sunday in the area, but no more was expected until at least midweek. “They really ran out of steam the further south that they moved,” meteorologist Bart Haake said about the rainfall. Haake said temperatures for the next two to three days are expected to be somewhat milder, in the 90s rather than above 110 degrees. Finch-Walker said firefighters welcome that bit of news, but with the knowledge that it’s only about a two-day window. “It’s not fabulous,” she said. “We’re not out of the woods by any stretch.” She said the fire season was just getting under way, and whether it will be as severe as 2011 cannot be projected. Forestry services firefighters battled about 1,800 blazes in 2011, including an estimated 93 square-mile fire in the Wichita Mountains of southwestern Oklahoma. The causes of the various fires had not been determined Sunday, although one that began Friday near Luther was being investigated as a possible arson. Witnesses told Oklahoma County sheriff’s deputies they saw a man throwing a lighted newspaper from a black Ford pickup. Sheriff’s spokesman Mark Myers said Sunday that no arrests had been made and no suspects identified. “We’re getting leads and following up on them,” Myers said. Gov. Mary Fallin toured Luther on Saturday, calling the sight “heartbreaking” after visiting with families milling around the still-smoking debris of what remained of their homes. “I gave them a hug, told them I was sorry,” Fallin said.