Prevent the Spread of Waterborne Intestinal Illness
We tend to flock to waterways and pools during our short swimming season in Wisconsin in search of fun, sun, and relaxation. The last thing we want is to contract a nasty waterborne parasite; however, my infectious disease colleagues and I typically see a spike in waterborne intestinal illnesses in the summer because they are easily spread via busy pools, rivers, beaches, hot tubs, and waterparks.
When a person swims in or swallows water that is invisibly infected with human or animal feces (yes, poop!) cryptosporidium or giardia parasites can enter his or her intestinal tract and cause painful cramps and days or weeks of severe diarrhea. This can lead to dangerous dehydration, weight loss, and even death. At the same time, people who get infected can easily spread the infection to other people if they don’t take precautions.
Medications do exist to help people recover from these illnesses; however, human behaviors are what drive or disrupt their spread. Disrupting the spread of recreational water infections (RWIs) is very important, especially because once they’re out there, these parasitic infections are challenging for pool operators and public health officials to control. Cryptosporidium is a very resilient parasite that can live up to 10 days in a properly chlorinated pool; giardia, for nearly an hour! Be smart about preventing RWIs with these tips:
Do not swim if you have diarrhea or have recently recovered from diarrhea. A single diarrheal incident can introduce millions of germs into the water. If you’ve had a confirmed case of cryptosporidium, to keep others safe, you should wait two full weeks after your symptoms cease before you swim again.
Shower before you enter the water. Many people don’t realize how important this step is in preventing the spread of poop, pee, sweat, and dirt in swimming water. Rinsing off in the shower for just one minute removes most every potentially harmful substance on your body.
If a public beach or waterway has been closed to swimming, respect these closures. Most often, it’s due to feces contamination or other dangerous run-off. Look for posted signs and do not swim or wade in the water, play with the water, or transport it to another location on your shoes, towels, or beach toys. Public health officials work to keep you and your family safe from serious disease, not interfere with your family vacation.
You can check the free chlorine level and pH before getting into a treated pool or hot tub. Most hardware stores sell easy-to-use pool test strips and the instructions spell out proper chlorine or bromine levels. But remember, even proper chlorine levels do not prevent all cryptosporidium or giardia; they are tough bugs.
We can encounter feces in many other places, too. County fairs and petting zoos are rife with manure that can come in contact with little hands that then touch ice cream cones and goldfish crackers. Vigorously wash hands with soap and water before putting them near one’s mouth or food. Do not rely on hand sanitizer because these parasites must be scrubbed off; they are not readily killed with alcohol or chlorine.
The Centers for Disease Control (CDC) recommends smart swimming guidelines called “Every Hour, Everyone Out!” I like it because in addition to infection prevention, it also integrates other sun and safety measures into summer activities:
- Every hour, call children out of the water and take them on bathroom breaks.
- Check kids’ swim diapers and change them in a designated changing area—not poolside—to keep potential contaminants away from swimming water. Parents, wash your hands with soap and water in a designated sink, not the water where others are swimming.
- Take this opportunity to reapply sunscreen.
- Drink fluids on this break to ensure that every member of your group stays properly hydrated.
When we work together and think of others who swim with us or after us, we help keep summer healthy and fun for our families and our communities.
David Brooks, MD, is the chair of the ThedaCare Physicians-Infectious Disease.