Outbreaks of “crypto,” a parasite found in swimming pools that causes long-term diarrhea, are on the rise, according to a new report from the Centers for Disease Control.

The CDC says outbreaks of the summertime parasite increased an average of 13% each year from 2009-17.

Cryptosporidium is spread through the infected fecal matter of humans or animals. The CDC says people have been getting sick after swallowing the parasite in contaminated water or food or after coming in contact with infected people or animals. It is said to be the leading cause of disease outbreaks in the United States linked to water, specifically outbreaks linked to public pools or water playgrounds.

According to the report:

35% of outbreaks were linked to treated swimming water in places like pools or water playgrounds

13% were linked to contact with infected people in child care settings

15% were linked to contact with cattle, and 3% to drinking raw milk or apple cider

Young children are particularly susceptible to spreading the disease and experiencing severe symptoms, said registered nurse Michele Hlavsa, chief of CDC’s Healthy Swimming Program.

“They don’t know how to use the toilet and wash their hands, or are just learning how,” she said. “But we as parents can take steps to help keep our kids healthy in the water, around animals, and in childcare.”

The concern with crypto, according to the CDC, is that it’s tough to kill. It can survive for days in chlorinated water in pools and water playgrounds, and even on surfaces disinfected with chlorine bleach. Someone sick with crypto can have diarrhea for up to three weeks.

Outbreaks of crypto are most common in the summer, the report says, and anyone with diarrhea should not swim or enter public pools or playgrounds. Children sick with diarrhea should stay at home and away from child care facilities.

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