Preventing and Controlling Crypto at Childcare Facilities

At a glance

Crypto outbreaks, caused by the parasite Cryptosporidium, can happen any time of the year. Crypto causes watery diarrhea and is easily spread among young children and their caregivers. Childcare facilities can follow these steps to help prevent Crypto from spreading and control any outbreaks that occur.

Young children playing with blocks at a childcare facility.

Background

Millions of Crypto germs can be found in the poop of an infected person or animal. When other people (or animals) swallow Crypto germs, they can become infected. Crypto can be found in water, food, soil and on surfaces that have been contaminated with poop containing Crypto germs.

Prevent the spread of Crypto

Educate staff and parents

  • Inform all staff about the symptoms of Crypto, how infection is spread, and prevention steps to be followed.
  • Require that children with diarrhea be kept at home until their diarrhea has stopped.
  • Move adults with diarrhea to jobs that minimize opportunities for spreading infection (for example, administrative work instead of food preparation).

Establish water-play policies that prevent the spread of germs

  • Discourage children from getting the water in their mouths and swallowing it.
  • Have children and staff wash their hands before using water tables.
  • Have children and staff rinse with soap before swimming or playing in the water.
  • Take frequent bathroom breaks and check diapers often.
    • Change children’s diapers in a diaper-changing area or bathroom and not by the water.
  • Do not use plastic kiddie pools and slides because they can easily spread germs when they are being used by many kids at once.

Follow good handwashing practices

  • Wash hands regularly with soap and running water for at least 20 seconds.
    • For children: Adults should observe handwashing or assist when needed. Wash children's hands when they first arrive at the childcare facility, after they use the toilet, after having their diapers changed, and before eating snacks or meals.
    • For adults: Wash hands after using the toilet, after helping a child use the toilet, after diapering a child, and before handling or eating food.

Implement good diapering practices

  • Separate diaper-changing areas from children's play and food preparation areas.
  • Use disposable gloves and change them after each diaper change.
  • Use disposable paper over diaper-changing surfaces and change it after each diaper change.
  • Ensure children wear clothing over their diapers to reduce the opportunity for leakage.
  • Wash hands -- both yours and the child’s -- after each diaper change.
  • Where staffing permits, people who change diapers should not prepare or serve food.

Clean and disinfect thoroughly

  • Clean and disinfect surfaces and objects, including (but not limited to): bathrooms, diaper-changing areas, food-preparation areas, tabletops, highchairs, and toys.
    • Staff should clean surfaces regularly and follow recommended procedures for cleaning, sanitizing, and disinfecting after activities such as diapering, feeding, and contact with body fluids.
    • More information on this can be found on the How to Clean and Disinfect Early Care and Education Settings page.

Notifying your public health department‎

Notify the state or local health department about an excessive level of diarrhea or any Crypto cases in the childcare facility. Crypto is a nationally reportable disease.

Respond to a Crypto outbreak

The steps below will help control an outbreak that occurs in the childcare setting. Please note that any guidance provided by your health department should be followed in place of these steps.

Educate staff and parents

  • Inform all staff about the ongoing outbreak, the symptoms of Crypto, how infection is spread, and control measures to be followed.
  • Notify parents of children who have been in direct contact with a child or an adult caregiver with diarrhea.
    • Parents should contact the child’s healthcare provider if their child develops diarrhea.
  • Inform staff and parents of children about Crypto’s potential to be a severe disease in people with weakened immune systems.
    • Immunocompromised people should consult their healthcare provider for further guidance.

Enforce policies to prevent the spread of diarrhea

  • Require any children with diarrhea to stay home until their diarrhea has stopped.
  • Children who are infected with Crypto but who do not have diarrhea may be allowed to return.
  • Move adults with diarrhea to jobs that minimize opportunities for spreading infection (for example, administrative work instead of food preparation).

Terminate all water play activities

  • Stop all activities that involve water, including water tables, splash pads, or other water-related play.
    • Water play can facilitate the spread of germs.
  • Children diagnosed with Crypto should not take part in water-related activities for an additional 2 weeks after their diarrhea has stopped.

Follow good handwashing practices

Fact‎

Crypto germs are not killed by hand sanitizers. Handwashing with soap and running water is the best way to get rid of Crypto germs on hands.
  • Ensure children are washing hands correctly with soap and running water for at least 20 seconds and assist when needed. Handwashing should happen:
    • As soon as children arrive at the childcare setting.
    • After using the toilet or after having their diapers changed.
    • Before eating snacks or meals.
  • Adults should wash their hands:
    • After using the toilet
    • After helping a child use the toilet or changing a child's diaper
    • Before handling or eating food.

Reinforce good diapering practices

  • Separate diaper-changing areas from children's play and food preparation areas.
  • Use disposable gloves and change them after each diaper change.
  • Use disposable paper over diaper changing surfaces and change it after each diaper change.
  • Ensure children wear clothing over their diapers to reduce the opportunity for leakage.
  • Wash hands: both the caregiver's hands and the child's hands should be washed after each diaper change.
  • Where staffing permits, people who change diapers should not prepare or serve food.

Disinfect thoroughly

No disinfectant is guaranteed to be completely effective against Crypto.  However, hydrogen peroxide is more effective than standard bleach solutions.

  • Disinfect items and surfaces
    • Use 3% hydrogen peroxide to disinfect objects and surfaces. Soak objects and cover all surfaces for 20 minutes in the hydrogen peroxide. Rinse thoroughly.
    • Areas that should be disinfected daily: bathroom surfaces, diaper-changing areas, and food preparation surfaces.
    • Items that should be disinfected at least twice a day: toys, tabletops, and high chairs.
    • Wash dishwasher-safe toys in a commercial dishwasher that has a dry cycle or a final rinse that exceeds 113°F for 20 minutes or 122°F for 5 minutes or 162°F for 1 minute.
    • Launder cloth toys in a washing machine and dry on the highest clothes dryer heat setting for 30 minutes.

Important hydrogen peroxide information‎

Do not mix hydrogen peroxide and bleach solutions. The two chemicals may react violently. In certain situations (for example, if an outbreak is caused by two or more types of germs), the health department may instruct you or a childcare facility to disinfect surfaces and objects with both hydrogen peroxide and a bleach solution. If so, disinfect with the bleach solution first and thoroughly rinse with water. Then soak with hydrogen peroxide for 20 minutes and thoroughly rinse with water.


Hydrogen peroxide breaks down when exposed to sunlight. Store hydrogen peroxide in dedicated opaque containers — never reuse containers for a different chemical.