Is The Pool Making You Sick?

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It is that time of year when families and friends visit public swimming pools and water parks for swimming and recreation.  CDC warns … BEWARE!   The number of gastrointestinal diarrhea outbreaks traced back to public water recreation facilities is increasing significantly each year with an annual increase of approximately 14%  from 2009 – 2017 with peak months from June to August. 

Infectious gastroenteritis is not the only infectious disease one can contract at a recreational water facility.  Ear, eye, neurologic, respiratory and skin infections can occur.  Most of the illnesses contracted, however, are gastrointestinal and this will be the focus of this blog.


Chlorine Does Not Make Your Pool Safe

We generally believe that chlorine instantly kills pathogens in well-maintained and monitored public water facilities.  This is not correct.  Some organisms can be present in the water even after treatment with the recommended chlorine disinfection levels.  CDC indicates that Cryptosporidium causes 50% recreational GI illnesses contracted in a public water facility.  This organism, even with recommended chlorine disinfection levels, can remain infectious for 10 days.  Giardia takes 45 minutes to inactivate and hepatitis A virus about 15 minutes. 

Those most susceptible to gastrointestinal waterborne infections include the young, the elderly, the pregnant and the immunocompromised.  The immunocompromised are those most at risk with the most severe and life-threatening illnesses caused by Cryptosporidium infections. 

6 Steps To Minimize The Spread Of Illnesses At The Pool 

It is important that we strive to maintain our public water recreation facilities so that they do not become sources of gastrointestinal infection.  A high bather density that includes children in diapers will increase the potential for contamination.  There are several steps the public can take to protect all of us from recreational water facility gastrointestinal infections.

  1. Don’t swim when you have diarrhea.  Surveys have indicated that approximately a quarter of swimmers would go into a public pool within one hour of a diarrhea episode.  It is recommended with a diagnosis of Cryptosporidium diarrhea there be no use of public water facilities for two weeks. 

  2. Avoid swallowing water in a swimming pool.  The number of Cryptosporidium or Giardia organisms necessary to cause diarrhea is low. 

  3. Shower yourself and wash children thoroughly with soap and water before swimming.

  4. Wash hands with soap and water after using the toilet or changing a diaper.

  5. Don’t change diapers at poolside.
Remember, even the best-maintained pools may transmit disease. As medical professionals, we can take a leading role in providing educational materials to patients and potentially avoid water-related gastrointestinal illnesses.
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About the author

Dr. John Daly

John T. Daly, M.D. received his MD degree at Weill Cornell University Medical College, performed his internship and residency in Anatomic and Clinical pathology at Duke University Medical Center and a residency in Forensic Pathology at the Office of the Chief Medical Examiner in Chapel Hill, N.C. He is board certified in anatomic, clinical and forensic pathology. Through the course of his career, Dr. Daly has had extensive experience directing and advising laboratories of all sizes including physician office practices, Federal Health Clinics, surgical centers, Community Hospitals and the integrated academic health system clinical laboratories of Duke Medicine. He retired as Director of Laboratories of Duke Medicine, and continues his affiliation as a member of the emeritus staff.


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