Recreational Water Illness: Frequently Asked Questions
How can swimming make you sick?
Most recreational water illness (RWI) reported is diarrheal illness, which is spread by swallowing contaminated water.
In addition, swimming in water contaminated with germs can also cause infections in your eyes, nose, ears, and in cuts and scrapes.
People in the pool share the water with everyone else in the pool. If someone with diarrhea contaminates the water, swallowing the water can make people sick. Recreational water can also be contaminated by fecal matter rinsed off of the bodies of swimmers. When people are ill with diarrhea their stool can contain millions of germs. Therefore, swimming when ill with diarrhea can easily contaminate the water and, if the pool water is swallowed, can make you sick.
How does water get contaminated?
Pools can be contaminated by persons who swim while experiencing diarrhea and have a fecal accident.
Swimming pools, waterparks, hot tubs, and spas can also be contaminated by germs that are rinsed off swimmer's bodies including their rear ends. In addition, lakes, rivers, and the ocean can be contaminated by sewage spills, animal waste, and water runoff.
Diarrrheal accidents are not easily noticed and as a result could contaminate even the best-maintained pool. Plus, some germs like Crypto (short for Cryptosporidium) are resistant to chlorine and can live in even the best-maintained pools for several days.
What kinds of illnesses can people get from swimming?
- Diarrheal illness
- Skin rashes
- Ear infections
- Eye infections
- Respiratory infections
These recreational water illnesses (RWIs) have been linked to swimming. However, reports to CDC show that diarrhea is one of the most common RWIs. Diarrheal illness is spread when infected germs from human or animal feces gets into the water. If the contaminated water is swallowed it can cause people to become ill.
Can swimming pools spread head lice?
Not likely.
Lice survive by holding onto hair and are not likely to let go when someone's head goes under water. It would be rare to find lice floating in pool water. It is more likely that head lice are spread by sharing towels or other items that have been in contact with an infested person's hair. Teach your children not to share towels, hair brushes, etc., either at poolside or in the changing room.
Be aware that swimming or washing hair within 1-2 days after treating with anti-lice shampoo will make the treatment less effective.
Can people get a recreational water illness (RWI) from swimming in the ocean?
Yes.
Recreational water illnesses (RWIs) have been associated with swimming at ocean beaches. Some common germs can live for long periods of time in salt water. Swimmers should always avoid swallowing the water that they and others swim in.
Can people get a recreational water illness (RWI) from swimming in fresh water lakes and rivers?
Yes.
Lakes and rivers can become contaminated with germs from sewage, animal waste, water runoff, as well as direct human contamination from fecal accidents and germs rinsed off the bottoms of swimmers. Avoid swimming in areas that have been identified as unsafe by health departments. Contact your state/local health department about germ-testing results for local recreational water.
Some germs that live in fresh water normally don't infect humans. For example, Naegleria (nuh-GLEER-e-uh) is a germ that is found throughout the world. Naegleria is found in warm, stagnant bodies of water and can cause severe illness. Naegleria enters the body through the nose when you are swimming underwater or diving into water. Persons can prevent Naegleria infection by not swimming in small shallow ponds or areas posted by local health authorities as "No Swimming." Swimmers should hold their nose or use nose plugs when jumping or diving into water.
Can people get a recreational water illness (RWI) from using hot tubs and spas?
Yes.
Skin infections are the most common RWI spread through hot tubs and spas. Given that hot tubs and spas have warmer water than pools, chlorine or other disinfectant levels evaporate faster. For that reason, it is important that chlorine or disinfectant levels in hot tubs and spas are checked even more regularly than in swimming pools.
Can people get a recreational water illness (RWI) from playing and wading in decorative or interactive water fountains?
Yes.
Several diarrheal illness outbreaks have been caused by playing and swallowing contaminated water in fountains. Not all decorative or interactive water fountains are chlorinated and filtered. Therefore when people, especially diaper-aged children, play in or soak themselves with the water jets, they can contaminate the water with fecal matter. This may spread germs that can make people sick.
Doesn't chlorine kill all germs found in swimming pools, hot tubs, and spas?
Yes, chlorine does kill all germs but it takes time.
A few germs can survive in chlorinated water for several hours to several days in pools, hot tubs, and spas and you can therefore get infected. It is important to maintain proper levels of chlorine to kill germs. However, be aware that even the best-maintained pools can spread illness.
What is a person's chance of getting diarrhea when swimming?
An exact number does not exist.
If pools are properly maintained and chlorinated, the risk is thought to be low for germs that are killed easily by chlorine. However, over the past 10 years, more than 150 outbreaks involving thousands of people have been reported, involving pools, waterparks, hot tubs, spas, lakes, and rivers. Many outbreaks are never detected.
Why do many recreational water illnesses (RWIs) go undetected?
Because people do not think that pool water can make them sick.
It can take several weeks before the germs in the water cause illness, so people often don't connect their illness with swimming. In addition, because diarrhea is so common, most people don't seek medical attention for it, so outbreaks of illnesses often don't get reported to health departments.
The longer the time period between swimming and illness the less likely people are to think that they became sick from swimming. For all these reasons, many outbreaks go undetected.
Is it a good idea to swim when you have diarrhea?
No.
You share the water with everyone in the pool, so swimming when ill with diarrhea can contaminate the water.
Stay out of water that is shared by others if you have diarrhea. Persons who swim while they have diarrhea threaten the health and well being of those sharing the water. This is true because recreational water illnesses (RWIs) are more easily spread when someone is experiencing diarrhea.
Should some people be more concerned than others about the spread of Crypto (short for Cryptosporidium)?
Yes.
Every swimmer should be concerned, but those living with a compromised immune system should be even more concerned.
They should realize that accidentally swallowing Crypto-contaminated water can cause illness. Children, pregnant women, and people with compromised immune systems (such as those living with AIDS, those who have received an organ transplant, or those receiving certain types of chemotherapy) can suffer from more severe illness than others.
So people with compromised immune systems are at greater risk for developing severe or life-threatening illness?
Yes.
If you are living with a compromised immune system (such as those living with AIDS, those who have received an organ transplant, or those receiving certain types of chemotherapy) you are at greater risk of developing severe or life-threatening illness if infected with Crypto (short for Cryptosporidium).
Recreational water illnesses (RWIs) can be spread by swallowing fecally contaminated water. Persons with compromised immune systems should be aware that swimming pools, waterparks, hot tubs, spas, decorative fountains, lakes, rivers, and salt water beaches might be contaminated with human or animal waste that contains Crypto.
Persons with a compromised immune system should consult with their health care provider before participating in behaviors that place them at risk for illness. Avoid swallowing the water when swimming or playing in recreational water.
What if my child has diarrhea?
Don't take your child swimming.
Otherwise, he or she may contaminate the water with fecal matter by simply moving through the water or having a fecal accident. Contaminating the pool puts other swimmers at risk of getting a recreational water illness (RWI). Although swimmers with diarrhea do not mean to contaminate the water, this is how illness is spread.
It may be advisable to see a doctor.
Do swim diapers or swim pants prevent fecal matter from entering the water?
Not likely.
Swim diapers are unlikely to prevent diarrhea (which may contain germs) from leaking into the pool. Even though diapers or swim pants may hold in some feces, they are not leak proof and can still contaminate the pool water. Therefore, it is recommended that you change your child often and make frequent trips to the toilet. Swim diapers or pants are not a remedy for frequent diaper changing.
What should I do if I see fecal matter in the pool?
Immediately notify the pool attendant or lifeguard.
Pool staff should ask swimmers to leave the water immediately. The pool water may be tested and the chlorine levels raised, depending on the policy and initial chlorine level at the pool.
The wait between the closing and re-opening of the pool can be frustrating. Be supportive of pool management as the pool is closed to prevent the spread of recreational water illnesses (RWIs), which can make you and your family sick.
Should I think the water is safe if I don't see fecal matter in the pool?
No. Just because you can't see these germs doesn't mean that they are not present.
Even the best-maintained pools can spread illness. Therefore, the safest pools are pools that are not only well maintained, but also have the commitment of all patrons to practice healthy swimming behaviors.
Remember, chlorine does kill all germs, but it takes time. Some germs can live for hours to several days in swimming pools. Be aware that as a swimmer, you play a crucial role in preventing recreational water illnesses (RWIs).
How can I protect myself, my family, and others from getting sick?
Healthy swimming behaviors are needed to protect you and your kids from RWIs and will help stop germs from getting in the pool in the first place. Here are six
"P-L-E-As" that promote Healthy Swimming:
Three "P-L-E-As" for Everyone zzzzz
PLEASE don't swim when you have diarrhea...this is especially important for kids in diapers. You can spread germs into the water and make other people sick.
PLEASE don't swallow the pool water. In fact, try your best to avoid even having water get in your mouth.
PLEASE wash your hands with soap and water after using the toilet or after changing diapers. You can protect others by realizing that germs on your body end up in the water.
Three "P-L-E-As" for Parents with Young Kids
PLEASE take your kids on bathroom breaks often. Waiting to hear "I have to go" may mean that it's too late.
PLEASE change diapers in a bathroom and not at poolside. Germs can spread to surfaces and objects in and around the pool and spread disease.
PLEASE wash your child thoroughly (especially the rear end) with soap and water before swimming. We all have invisible amounts of fecal matter on our bottoms that could end up in the pool.
-- Article Courtesy of InjuryBoard.com
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