The Ugly Truth about Public Swimming Pools and Recreational Water Illnesses

While reading this morning's newspaper, this headline caught my eye: "Phoenix closes all city pools." The article explained that an intestinal parasite called Cryptosporidium was discovered at one location. There is one confirmed case in addition to 29 others who are suffering diarrhea from the disease. As a precaution, all the city pools will be closed for cleaning at least for the next few days.

Naturally, my first reaction was...YUCK! After voicing my disgust, I wanted to know more about the cleanliness and safety of public pool water. Most of us have joyfully splashed in a public swimming pool or water park at one time or another, but few people consider what could be living in that inviting blue water. We assume the water is highly chlorinated, rendering it germ free. While it is true that chlorination will kill pathogens such as E. coli and shigella, other parasites remain unharmed by even high levels of chlorine, as evidenced by the recent Phoenix outbreak.

In her article "The Germy Truth about Public Swimming Pools", Connie Chettle discusses two pathogens, Cryptosporidium and Giardia, that cause diarrheal illnesses associated with swimming pools and water parks. These bugs are commonly found in recreational water because they can withstand chlorination. Cryptosporidium, for example, is highly resistant to chlorine and survives up to eleven days in chlorinated pool water because it is small enough to escape pool filters. Giardia, on the other hand, is moderately resistant to chlorine and only survives about an hour because its larger structure can be trapped by pool filtration.

Both of these pathogens are transmitted by the fecal to oral route. This means the parasites are transmitted through stool that comes in contact with a person's mouth. In the swimming pool, infected stool gets in the water, most commonly because of children and babies in diapers. The contaminated water is then ingested by other swimmers, leading to infection.

The symptoms of Cryptosporidium and Giardia are similar and usually appear within seven to fourteen days after exposure. They include diarrhea, abdominal cramps, nausea, vomiting, and dehydration. There is no reliable treatment for Cryptosporidium. Most people recover within one month without treatment. Giardia can endure for months, so medication is recommended. Flagyl is the most common medication used to treat Giardia.

Although contamination of pool water is more common than we realize, swimming remains a fun and healthy activity that people all over the world enjoy. Prevention is the easiest way to tackle the transmission of recreational water illnesses. Follow these recommendations from the Centers for Disease Control and Prevention to promote healthy swimming in pools and water parks:

• Don't swim when you have diarrhea. You can spread germs in the water and make other people sick. This is especially important for kids in diapers.
• Don't swallow the pool water. In fact, avoid getting water in your mouth. Stress this point with your children.
• Practice good hygiene. Take a shower before swimming and wash your hands after using the toilet or changing diapers. Germs on your body end up in the water.
• Take your kids on bathroom breaks or check diapers often. Waiting to hear "I have to go" may mean that it's too late.
• Change diapers in a bathroom or a diaper-changing area and not at poolside. Germs can spread to surfaces and objects in and around the pool and cause illness.
• Wash your child thoroughly (especially the rear end) with soap and water before swimming. Everyone has invisible amounts of fecal matter on their bottoms that end up in the pool.

If you are still completely disgusted by what might lurk in the public pool water, my suggestion is to set up a "water park" for your kids in your own back yard. A small plastic pool, sprinklers, and water balloons can be just as fun, less expensive, and much healthier.