Recreational Water Illnesses


Recreational Water Illnesses (RWIs) spread when people contact contaminated water in swimming pools, hot tubs, water parks, water play areas, interactive fountains, lakes, rivers, and/or oceans. Water can be easily contaminated when people swim while they are sick; moreover, lakes and rivers can be contaminated by animal waste, sewage spills, and water runoff following rainfall.

RWIs typically affect a person’s stomach and intestines, skin, or respiratory system; resulting in diarrhea, vomiting, loss of appetite, skin rashes, swimmer’s ear, among other conditions. This kind of illnesses has been on a dramatic rise over the past decade.

There are, however, non-diarrheal RWIs that are caused by germs existing naturally in the environment. If disinfectant is not adequately maintained at the appropriate levels in a pool or hot tub, these germs can increase to the point where they cause illness when swimmers breathe or have contact with water.

There is, for example, a very rare, but fatal, brain infection that can be caused by Naegleria fowleri, also known as Brain-eating amoeba. This amoeba infects people by entering the body through the nose; this usually occurs when people use warm freshwater for swimming or diving.

Infection-producing germs that can lurk in water include Pseudomonas aeruginosa, which causes swimmer’s ear—an infection of the outer ear canal, known medically as Otitis externa—and skin rash. Others include cryptosporidium, Giardia lamblia, Shigella, and E. coli, which can cause diarrhea. Each year, tens of thousands of RWI cases of diarrhea and some few millions of cases of swimmer’s ear occur.

Many people say that adding chlorine to a pool can kill all potentially disease-causing germs, and that is true to a certain extent. Chlorine in properly disinfected pools kills most germs that can cause RWIs in less than an hour, but it takes longer to kill some germs, such as cryptosporidium, which can survive for days in a properly disinfected pool.

The best way to prevent diarrhea is not to swallow water. Also, do not swim when you have diarrhea because you can spread germs in the water and make other people sick. One should take a shower before swimming, and wash hands after using the toilet or changing diapers because germs on body end up in the water.


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