Alt-Health: What’s Swimming with You?

On a sweltering summer day when the sweat beads on your skin, nothing looks more alluring than the blue crystal water of your backyard pool. But before you jump, make sure you close your mouth; and for god’s sake, don’t swallow. That cool, sparkling H2O may not be as clean as you think.

Between 2000 and 2014, the CDC reported 493 disease outbreaks related to recreational water, resulting in more than 27,000 illnesses and eight deaths. While some of these incidents could be traced to hot tubs, the vast majority were linked to swimming pools. People can become ill due to consumption of contaminated water, sometimes even when the water has been adequately chlorinated or sanitized. In some cases, organisms can penetrate through the skin.

So, how does this happen? Aren’t all of those pool chemicals supposed to make your water safe? Well, in theory, yes. But there’s a number of wrenches that can be thrown in the works to decrease their efficiency. For instance: peeing in the pool. The Water Quality and Health Council conducted a survey about swimming pool habits among 3,000 adults, and 27% of them admitted that they had urinated in a pool. The number is thought to be even higher among children. Unfortunately, urine will combine with the chlorine in a pool to create other chemicals that both irritate the eyes and leave less active chlorine available to disinfect and kill bacteria and parasites.

The most noteworthy of these pathogens is Cryptosporidium, the main culprit in recreational water-associated outbreaks. It accounts for at least half of reported illnesses. This nasty and creepy looking little parasite can cause a respiratory and gastrointestinal illness called cryptosporidiosis, which produces watery diarrhea and a persistent cough in humans. Swallowing just a mouthful of water with crypto in it can make otherwise healthy kids and adults sick for weeks with dysentery, stomach cramps, nausea and vomiting. To make matters worse, treatment is limited – as of January 2015, nitazoxanide is the only drug approved for the treatment of cryptosporidiosis.

Another problematic pest found in pools is Legionella, which can result in the pneumonia-like respiratory illness known as Legionnaires’ disease, which was responsible for 57 outbreaks and 624 illnesses between 2000 and 2014. An additional threat lurking in both hot tubs and pools is the insidious Pseudomonas, which can yield both swimmer’s ear and an uncomfortable rash. According to the CDC, this pathogen caused 47 outbreaks and 920 infections.

But wait, there’s more! Let’s not forget the fecal related contaminants, Shigella and E. coli. While the former produces Shigellosis, a form of bacillary dysentery that brings fever, nausea, vomiting, cramps and diarrhea to summer swimmers, the latter produces a toxin that damages the lining of the intestines, resulting in hemorrhagic colitis. E. coli can bring on hemolytic uremic syndrome (HUS), a condition that causes acute renal failure, especially in young children. Transmission has occurred from swimming in contaminated recreational waters. Additionally, Hepatitis A, an illness that is commonly associated with raw sewage, can leak into pools when overburdened sewage systems get backed up due to heavy rainfall or flooding.

But parasites, pathogens and floating excrement pale next to the shocking find in a Fall River public swimming pool in 2011. I remember watching the evening news with my mouth hanging open as I heard a story that the body of a Massachusetts woman that went unnoticed for two days in a public swimming pool. Astonishingly, during that time, the pool remained open to the public and the body went unnoticed during a visit by health inspectors. Even more disturbing is that the woman’s fall from a slide was noted at the time by a young boy who reported it to the lifeguard on duty immediately after. No action was taken. A preliminary investigation after the fact showed  that “murky and cloudy” water in the pool helped conceal the body of the woman for the two days that people still swam there.

Why not take some steps to insure your own summer safety?

• Before going to a pool, check the pool’s inspections. Many local and state health departments post online.
• Check water quality yourself with pool test strips, available at the hardware store.
• Don’t swallow the water, and take children on hourly bathroom breaks.
• Shower for at least a minute before you get in the pool; if you’ve had diarrhea, don’t swim for at least two weeks. This is the most common way for fecal infestation to spread.
• Make sure you can see down to the drain at the deep end of the pool. Ya just never know.

And please – if you have a challenged immune system, or see symptoms in young children, see a doctor immediately. Tell them about any recent pool or hot tub activity. You may not be the only person affected, and if you are – you can help keep it that way.