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Advice for people with severely compromised immune systems

Some people may wish to take special precautions with the water they drink. In particular, people with immune systems that are weakened by AIDS, chemotherapy or transplant medications are more vulnerable to microbial contaminants in drinking water such as Cryptosporidium.

Cryptosporidium is a microscopic parasite that lives in the intestine of infected animals and humans. It passes in the stool in its dormant oocyst form.The oocyst is protected
by an outer shell that allows it to survive outside the body for long periods of time and makes it very resistant to chlorine-based disinfectants. It occurs mainly in surface water sources, such as lakes,streams and rivers.In healthy adults,Cryptosporidium can cause illness, but for people with weakened immune systems, it can cause severe illness and even death.

Those who wish to take extra measures to avoid waterborne cryptosporidiosis can bring their drinking water to a boil for a full minute. Boiling water is the most effective way of killing Cryptosporidium.As an alternative to boiling water, people may take the following measures:

Use a point-of-use filter

Consider using point-of-use (personal use, end-of-tap, under sink) filters that remove particles one micrometer or less in diameter. Filters that use reverse osmosis, those labeled as “absolute one micron filters,” or those labeled as certified by an American National Standards Institute (ANSI) - accredited organization to ANSI/NSF Standard 53 for “Cyst Removal” provide the greatest assurance of removing Cryptosporidium. As with all filters, follow the manufacturer’s instructions for filter use and replacement.

Use bottled water


Check the label or call the bottler to find out how bottled water is treated. The following bottled water treatments protect against Cryptosporidium: reverse osmosis, distillation, ultraviolet light,or filtration with an absolute one micron filter. Bottled waters derived from protected well and spring water sources are less likely to be contaminated
by Cryptosporidium than those containing untreated municipal drinking water from less protected sources such as rivers and lakes.

Those who choose to take these precautions should remember that they can be exposed to waterborne pathogens through water used for brushing teeth, making ice cubes, and washing fruits and vegetables – not just through water they drink.