Question of the Week

May 21, 2007


When people think of water safety, they often think of drowning prevention. While this is an important aspect of swimming and boating safety, recreational water activities also brings with them the potential for spreading recreational water illnesses.

"The week preceding Memorial Day has been designated as National Recreational Water Illness Prevention Week. ... Our goal is to highlight the importance of healthy swimming, healthy swimming behaviors, and recreational water illness prevention. This will be done by emphasizing operation and prevention tips for pool operators and pool patrons to ensure a healthy swimming experience."

Whether you own a pool, work at a pool, or will be visiting a pool (or water park), it is important that you are aware of the potential for the spread of disease.

"The third annual National Recreational Water Illness Prevention Week is scheduled for May 21--27, 2007, at the onset of swimming season, to raise awareness regarding the potential for spread of infectious diseases at swimming venues and the need to improve prevention measures. ... During 1978_2004, a steady increase in RWI outbreaks in the United States resulted in approximately 30,000 illnesses. This increase likely can be attributed to a combination of increased water usage, improved outbreak detection, and increased disease transmission. The spread of RWIs is facilitated by emergence of chlorine-resistant pathogens such as Cryptosporidium, poor pool maintenance, and low public awareness of the problem."
U. S. Centers for Disease Control and Prevention

Not all pools are properly maintained, but even perfect pool maintenance cannot prevent the spread of all waterborne illnesses.

"Cryptosporidiosis is a diarrheal disease caused by microscopic parasites of the genus Cryptosporidium. Once an animal or person is infected, the parasite lives in the intestine and passes in the stool. The parasite is protected by an outer shell that allows it to survive outside the body for long periods of time and makes it very resistant to chlorine- based disinfectants. Both the disease and the parasite are commonly known as 'crypto.' During the past two decades, crypto has become recognized as one of the most common causes of waterborne disease within humans in the United States. The parasite may be found in drinking water and recreational water [Recreational water includes water in swimming pools, hot tubs, jacuzzis, fountains, lakes, rivers, springs, ponds, or streams] in every region of the United States and throughout the world."
CDC Division of Parasitic Diseases

Cryptosporidiosis is not the only potential threat. Another example includes:

"Giardia infection is an intestinal infection marked by stomach cramps, bloating, nausea and bouts of watery diarrhea. Giardia infection is caused by the parasite Giardia intestinalis (also called Giardia lamblia). The parasite is found worldwide but is especially prevalent in countries with poor sanitation and unsafe water, where it's responsible for most cases of childhood diarrhea. Yet the giardia parasite isn't just a problem in developing nations. Giardia infection (giardiasis) is one of the most common waterborne diseases in the United States. Though the parasites are often associated with backcountry streams and lakes, they also turn up in municipal water supplies, swimming pools, whirlpool spas and wells."
Mayo Clinic

Swimmers, boaters, and travelers can reduce their chances of contracting Giardia and other waterborne illnesses by following some common-sense precautions.

"[C]ommon-sense precautions can go a long way toward reducing the chances that you'll become infected or spread the infection to others. For your own safety: * Wash your hands. This is the simplest and best way to prevent most kinds of infection. ... When soap and water aren't available, alcohol-based sanitizers containing at least 62 percent alcohol are an excellent alternative. * Purify wilderness water. Avoid drinking untreated water from shallow wells, lakes, rivers, springs, ponds and streams unless you boil or filter it first. * Leave no trace. If you're camping without access to a toilet, bury your waste and your pet's at least 6 inches deep and 200 feet from a water source. ... * Keep your mouth closed. Try not to swallow water when swimming in pools, lakes or streams. * Be wary of tap water. ... If an outbreak of giardia infection occurs in your area, buy bottled water or boil or filter tap water before you use it. * Use bottled water. When traveling to parts of the world where the water supply is likely to be unsafe..."
Mayo Clinic

Even those who are not swallowing the water (or even getting it in their mouths) have the potential to contract some waterborne illnesses.

"Hot Tub Rash [Pseudomonas Dermatitis] is an infection of the skin. The skin may become itchy and progress to a bumpy red rash that may become tender. There may also be pus-filled blisters that are usually found surrounding hair follicles. Because a swimsuit can keep contaminated water in longer contact with the skin, the rash may be worse under a person's swimsuit. ... Hot Tub Rash infections are often caused by the germ Pseudomonas aeruginosa. This germ is common in the environment (water, soil) and is microscopic so that it can't be seen with the naked eye. Most rashes clear up in a few days without medical treatment. However, if your rash persists, consult your healthcare provider. ... Hot Tub Rash is spread by direct skin contact with contaminated water. The rash usually occurs within a few days of swimming in poorly maintained hot tubs or spas but can also be spread by swimming in a contaminated pool or lake."

Whether relaxing in a spa, swimming in a pool, boating, or camping waterborne illnesses are something that people need to be aware of as the summer recreation season approaches.

Questions of the Week:
What can you do to reduce your risk of contracting an illness that can be spread through contact with contaminated water? What can you do to reduce the risk of spreading it to others if you have (or suspect that you have) an illness that can be spread through the water? What should those who will be engaging in recreational water activities know about the potential spread of such illnesses? How would you recommend getting this information to those who would benefit from having it?

Please email me with any ideas or suggestions.
Note: Due to increasing amounts of SPAM sent to this account, please include "QOW" in the subject line when sending me email.

I look forward to reading what you have to say.

Health Community Coordinator
Access Excellence @ the National Health Museum

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