Recreational water illness is the overall term for sickness caused by bacteria or viruses in pools, lakes, rivers and other places people like to swim or play in hot weather. And the way these illnesses are often spread comes down to fecal contamination in the water.
Even this weekend, those vacationing along the Florida panhandle are being warned by the Florida Department of Public Health to avoid swimming in several popular beach areas in Okaloosa County and Walton County due to the fecal bacteria enterococci. The bacteria, which are common in feces of both animals and humans, can sicken swimmers, especially very young people, older people and those with compromised immune systems.
For those of us staying closer to home and swimming in pools, it also pays to keep water safety in mind, said William Schaffner, M.D., professor of Preventive Medicine at Vanderbilt University Medical Center.
"The most common problems people get while swimming are intestinal infections, either bacterial or viral," he said, adding that the most common bacterial cause of illness contracted while swimming is Shigella and the most common viral cause is Norovirus.
Both can make you feel pretty terrible, Schaffner said, running down a litany of misery: "Diarrhea, nausea, vomiting, sometimes fever."
Because the symptoms take hold several hours after infection has occurred, people often don't suspect that being in the water has led to the illness, he said.
Fortunately, a few simple precautions can reduce the risk for everyone.
First, Schaffner said, before you or your children get in a pool, take a look at it. A poorly maintained pool can lead not only to intestinal problems, but also other unpleasantness, such as a skin infection caused by pseudomonas bacteria. "Does it have clear and clean water? If not, you should reconsider getting in," he said.
Everyone getting in the pool should take a shower beforehand.
Anyone who has had stomach problems in the previous 24 hours should not get in the pool.
Parents should be certain that toddlers haven't soiled their diapers — even plastic swim diapers — or their swimsuits. The CDC recommends that parents check children every 30 to 60 minutes and do any diaper changing away from poolside, taking care to wash their hands afterward. And if an accident does happen, if it's in a public pool, let the management know so they can take steps to clean the water and make it safe for everyone again.
Schaffner also said that, from an infection point of view at least, urine in the pool is not a real issue because it is sterile, dilutes quickly and really doesn't pose a health risk to other swimmers.
And Schaffner adds one more important medical prescription.
"None of this should dampen anyone's enthusiasm for the pool," he said. "With a few simple precautions, playing in the water can be safe and fun for everybody."
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