By Jayson Jacoby
firstname.lastname@example.org Baker City Manager Mike Kee said Sunday that although samples of city water taken Wednesday contained cryptosporidium, the lab results don't answer key questions: How, when and where did enough of the parasitic protozoa enter the water supply to make dozens of people sick?
The results the city received Saturday from a Seattle lab showed small numbers of crypto "oocysts" in six of seven water samples, Kee said.
But the numbers of oocysts per sample - ranging from one to three - would not be sufficient to cause the widespread diarrhea, stomach cramps and other symptoms that have afflicted dozens of people over the 10 days or so, according to Dr. Bill Keene, senior state epidemiologist.
Kee said Keene told him that at some point it's likely that a much larger number of oocysts - perhaps in the tens of thousands or more - entered the water supply and then spread unequally in the system.
This unequal distribution, combined with people being variably susceptible to crypto's effects, explains why in some families only one member has been sick even though all members drank city water.
City workers took additional water samples from Goodrich Lake, the city's main reservoir, on Saturday, along with samples of mountain goat feces, Kee said.
Keene will test the goat scat for crypto.
The parasite gets into water through feces, whether animal or human, and both city and state officials say the large mountain goat population near Goodrich is a plausible source of the crypto.
City workers also are taking water samples today from all of the city's other water sources - a dozen streams and springs in the Elkhorn Mountains, and a well that contains water pumped in from the watershed last winter and this spring.
Kee said the city's goal is to rescind the current order for residents to boil water used for drinking, brushing teeth, washing dishes or cooking, as soon as possible.
"But we really need to find out what made this happen," Kee said. "We certainly don't want to go off the boil order and then have another round of people getting sick."
Five of the seven water samples that the city received results from on Saturday also showed giardia cysts.
However, Kee said there's good reason to believe that giardia, another waterborne parasite, is not the source of any of the problems in Baker City.
First, the lab did not test the giardia cysts to find out if they are "viable" - that is, capable of causing illness.
The likelihood is that the cysts are not viable, Kee said, because giardia, unlike crypto, is vulnerable to the chlorine the city adds to its drinking water as a disinfectation.
Giardia lacks the protective oocyst that protects crypto from chlorine.
Kee said health officials told him they would expect lab tests to show giardia cysts, but the chlorine concentration the city adds is sufficient to make those cysts unviable.
Second, Kee said that 10 of the 13 people who have been confirmed to be infected with crypto - most people who have shown symptoms have not had a stool sample tested - were also tested for giardia.
None of the 10 had been infected with giardia, he said.
Kee said at least three people who reported symptoms consistent with crypto have been tested and the tests were negative for both crypto and giardia.
Symptoms of giardia infection are similar to those for crypto, although giardia tends to cause more severe diarrhea, as well as vomiting and gas and bloating.
Kee said both the city and county have sent emergency declaration requests to the state.
This allows the city and county to ask for extra resources if needed, and also gives the agencies more flexibility in spending money if special equipment is needed, for instance.
Kee said officials at St. Alphonsus Medical Center-Baker City told him that the number of people visiting the emergency room with crypto-like symptoms dropped substantially on Saturday.
He said Keene and other experts at the state are trying to figure out not only when the infectious level of crypto entered the city's water, but how.
Kee said he has talked with several people who don't live in Baker City, but who were visiting in early or mid-July, who came down with persistent diarrhea and stomach cramps after they returned home. Those likely cases add to the probability that the city's water supply is the source of the outbreak.
So far, based on interviews with people confirmed to be infected, they have nothing in common except having been in town at the same time.
In 2010 and 2011, three of 24 water samples contained crypto: two had one oocyst each, and one sample had two oocysts. No cases of crypto infection were reported during that period.
According to the federal Centers for Disease Control and Prevention, there are several species of crypto, not all of which have been studied extensively. In the case of two species, though, clinical studies showed that some healthy adults could be infected after ingesting 10 oocysts.
Kee said given the suspicion about mountain goat feces at Goodrich Lake being the source of the crypto outbreak, he expects the city will not use water from that lake the rest of the year.
That could make it difficult for the city to supply enough water to meet demand, and it's one reason the city last week asked residents to voluntarily cease watering lawns and gardens during the day, when evaporation is higher.
If Goodrich remains off-line, Kee said the best case scenario is that all the city's other sources - the watershed streams and the well - will come up clean in crypto tests and thus be available.
In the event some of those sources aren't usable, Kee said city officials are looking at other possible options, including local wells, some of which the city tapped many years ago.
Kee said Sunday that a quorum of City Council members, and of county commissioners, met on Thursday to get information about the crypto situation.
Neither agency sent out a notification to the public or the media about that meeting, as required by Oregon's Public Meetings Law.
Kee said his understanding was that notification wasn't required because neither the council nor the commission made any decisions during the meeting.
But according to the Oregon Attorney General's Public Meetings Law manual, "even if a meeting is for the sole purpose of gathering information to serve as the basis for a subsequent decision or recommendation by the governing body, the meetings law will apply."
In most cases, cities must send out a notification at least 24 hours before a meeting starts.
State law allows emergency meetings, but those still require advance notice, even if it's less than 24 hours before the meeting.