Weekend Doctor: What's Recreational Water Illness?

By Gina Bailey, BSN, RN
Infection Preventionist, Quality/Infection Control, Blanchard Valley Health System

Summer is here, and now is the time to enjoy the weather and get into the water. But many do not know that while you are in the lazy river or perfecting your cannonball, you are coming into contact with bacteria, viruses and parasites. Most of these will not cause you to become sick, but some can cause what is known as Recreational Water Illness (RWI). 

 

The most common RWIs are diarrhea, skin rashes and swimmer's ear. They occur when you swallow or inhale contaminated water, get contaminated water into your ears or into cuts of your skin. Contaminated water can be found in natural locations like streams, oceans and lakes or in public pools, hot tubs and water parks. Most of the time, these pathogens are killed with chlorine and other pool chemicals, but not always.

In the United States, 50% of the major RWIs are due to giardia and cryptosporidiosis, both of which can cause watery diarrhea, dehydration, stomach cramps, lack of appetite, weight loss, fatigue and nausea. Children, pregnant people and those with weakened immune systems are most at risk for swimming-related illnesses. People with weakened immune systems should talk with their healthcare provider before swimming in lakes, ponds, or public swimming areas.

Knowing the basic facts about RWIs can make the difference between relaxing on your float or the excitement in a splash pad one day and potentially getting ill the next. Diarrhea is the most common symptom of RWIs, and people who are sick with diarrhea—or who have been sick in the last two weeks should not swim. Pool chemicals kill most germs within a few minutes, but cryptosporidium are thick-walled and are not destroyed by chlorine, and giardia can continue to live for an hour in treated pool water. RWIs (skin, ear, eye, respiratory, neurologic, wound and other infections) are caused by germs that live naturally in the environment. If pools, splash pads or hot tubs are not maintained appropriately, these germs can multiply and cause illness.

Oceans, lakes and rivers can be contaminated with germs from pollution, sewage, animal waste, water runoff following rainfall and germs rinsed off of other swimmers. It is important to avoid swallowing the water because these bodies of water are not disinfected. You should also avoid swimming in these areas after heavy rain, watch for cloudy water and stay out if you see any pipes draining into or around the water.

No matter what type of water you choose to enjoy, remember to clean your hands before eating, after using the toilet or changing diapers. Take children on bathroom breaks and check diapers often. Don’t swim when you have diarrhea. Don’t swallow the water. Shower before and after swimming. Stay out of the water if you have an open cut or wound, or use waterproof bandages to completely cover the area. Dry your ears thoroughly after swimming. 

Following these precautions will allow everyone to have more time to enjoy a healthy summer.