How Swimming Can Make You Sick, Part 2

by CDC

(Page 2 of 2)

People Affected

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 should someone do if he or she has diarrhea?

Most important, prevent dehydration by drinking plenty of fluids.

This is especially important for young children, pregnant women, and persons living with compromised immune systems (such as those living with AIDS, those who have received and organ transplant, or those receiving certain types of chemotherapy).

Seek Medical Care Immediately If:

• your diarrhea is bloody
• your diarrhea does not resolve in 5 days
• your diarrhea is accompanied by fever or chills
• you are dehydrated. (Signs of dehydration include: dry or "cottony" mouth, cracked lips, dry flushed skin, headache, irritability, not urinating at least four times a day, no tears when crying, no sweating, or confusion).

A health care provider may prescribe medicine to help replace the fluids your body has lost because of the diarrhea. In some cases, over-the-counter antidiarrheal medications slow the diarrhea.

One of the germs that causes diarrhea is Crypto (short for Cryptosporidium). Health care providers do not routinely test for this germ. Therefore, persons experiencing diarrhea may have to ask their health care providers to test for Crypto. Be aware that there are many causes of diarrhea. A specific diagnosis can only be made by your health care provider.

Remember, for the health and safety of those sharing the pool water, don't swim when you have diarrhea. Diarrhea can contaminate the pool and make people sick.

Parents and Kids

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.

See information above for treatment of diarrhea.

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.

Fecal Matter in the Pool.

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).

Protection Against 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

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

Follow these "P-L-E-As" to protect your child and others from getting sick and to help keep RWIs out of your community:

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.

About the Author

www.cdc.gov
The Centers for Disease Control and Prevention (CDC) is one of the 13 major operating components of the Department of Health and Human Services (HHS), which is the principal agency in the United States government for protecting the health and safety of all Americans and for providing essential human services, especially for those people who are least able to help themselves.