Swimming Safety Tips to Prevent Recreational Water Illnesses

With summer underway, the Centers for Disease Control and Prevention (CDC) is urging the public to take precautions when swimming to avoiding catching recreational water illnesses (RWIs) from pools and water play areas.

Though swimming offers the health benefits of physical activity, each summer, the United States sees outbreaks spring up that were caused by exposure to contaminated pools, hot tubs, spas, spray parks, small inflatable pools, lakes, and other recreational water sources. From 2011 to 2012, the CDC reported 90 recreational water—associated disease outbreaks, and 1,788 outbreak-related cases of illness in the United States, which resulted in 95 hospitalizations and 1 death. Such outbreaks are a public health issue, and pathogens commonly found in outbreaks from recreational water sources include Cryptosporidium, Escherichia coli, Giardia, Shigella, and norovirus. The pathogens can spread and cause infection when individuals swallow contaminated water or breathe in mists or aerosols from spraying water, causing conditions such as diarrheal illness, respiratory infection, swimmer’s ear, rashes, and other illnesses.

One study recently published in the CDC’s Morbidity and Mortality Weekly Report noted that the number of infections from the microscopic parasite Cryptosporidium, also known as crypto, doubled in the United States from 2014 to 2016. The pathogen is particularly troubling to health officials as it can survive even in well-chlorinated pools; even these pools can become contaminated through exposure to the stool of an individual infected with the parasite. In Portland, Oregon, the public health issue of crypto has gained attention as the local Portland Water Bureau is currently deciding on treatment options for water from the nearby Bull Run Watershed. With low levels of Cryptosporidium found in recent samples collected from the watershed, the bureau must soon decide between the less expensive option of ultraviolet water disinfection and a costlier water filtration system to treat the water from Bull Run.

The CDC notes that children, pregnant women, and immunocompromised individuals are at greatest risk of getting sick and suffering from severe symptoms — and even life-threatening infections – from crypto and other water-borne pathogens. To prevent the spread of illnesses from recreational water sources, the CDC offers the following water safety tips for safe swimming this summer:

• Stay out of the water if you have diarrhea to prevent exposing others to potential pathogens.
• Shower before you get in a pool to remove any sweat, dirt, urine, or feces. This helps keep pathogens out of the water and allows pool chemicals to kill germs properly.
• Do not allow children who are ill with diarrhea or vomiting to use small inflatable or plastic kiddie pools, as these pools do not have filters or properly treated water to prevent the spread of pathogens such as crypto. In the case of feces getting in the pool, be sure to clean the pool thoroughly and let it dry in the sun for at least 4 hours.
• Remind children not to swallow pool water or get it in their mouths.
• Change young children’s soiled swim diapers promptly, as they are not leak proof.
• With children, take a break every hour for bathroom breaks and diaper changes.
• For backyard pools and hot tubs, use home test strips to check that the disinfectant and pH levels of the water are safe for swimming.