Recreational Water Illnesses

Germs in the places we swim can cause a variety of illnesses, including gastrointestinal, skin, ear, respiratory, eye, neurologic, and wound infections. Germs can get into the water in different ways: when they wash off of swimmers’ bodies, when swimmers have diarrheal incidents in the water, and even when rainwater runs off near local beaches and swim areas. Three of the most common germs that cause waterborne illnesses in Virginia are Cryptosporidium, Giardia, and Vibrio.

cryptosporidiumCryptosporidium (commonly known as “Crypto”), the leading cause of disease outbreaks linked to pools, is a parasite that can survive in properly chlorinated pools for more than 10 days. Crypto is spread by swallowing water polluted with fecal matter containing Crypto. Symptoms of Crypto include watery diarrhea and abdominal cramping, and can last one to two weeks. People at greatest risk for severe illness include young children, pregnant women, and individuals with weakened immune systems. In 2011–2012, >70 outbreaks linked to pools, water playgrounds, and hot tubs/spas were detected in the United States. Half of these outbreaks were caused by Crypto.

 giardiaGiardia is another parasite that can cause diarrheal illness; it can make anyone sick. It can survive for up to 45 minutes even in properly chlorinated pools. Giardia is spread by swallowing water polluted with fecal matter containing Giardia. People infected with Giardia may have no symptoms at all, or may experience a mild illness or severe diarrhea. Diarrhea can last for several weeks or months, leading to weight loss and dehydration.

vibrioVibrio is a group of bacteria that can cause potentially serious illness called vibriosis. The bacteria are naturally found in salt and brackish (i.e., somewhat salty) waters. Vibrio thrive in warm waters and thus cause more infections during the summer months. Vibrio infection can occur when the bacteria enter the body through a break in the skin while a person is in salt or brackish water or while handling raw fish or shellfish caught from these waters. This can cause skin breakdown and sores that become painful, red, and/or swollen. Among people with weakened immune systems or liver disease, the bacteria can enter the blood and cause life-threatening illness with fever and chills, decreased blood pressure, and/or blistering skin lesions. To prevent Vibrio wound infections, it is important to avoid exposing open wounds or cuts to salt or brackish water. If exposed, wash the affected area right away with soap and clean water. Antibiotic ointment or hydrogen peroxide can also be used as directed to clean wounds. If the wound shows signs of an infection, such as swelling or redness, visit a healthcare provider right away.

Legionella are bacteria that can live in the biofilm or slime in pools, spas, and showerheads. They can survive in water that is properly treated with chemicals such as chlorine. Legionellosis and Pontiac fever are severe respiratory infections, caused by Legionella. One can get infected by breathing in infected water droplets. People over 50 with underlying health problems such as respiratory conditions like asthma, chronic conditions such as diabetes, as well as current or former smokers are at a higher risk of developing Legionellosis.

For more information: Legionellosis

PseudomonasPseudomonas aeruginosa infection is caused by strains of bacteria found widely in the environment; the most common type causing infections in humans is called Pseudomonas aeruginosa. This Germ can live in pools and are the most common cause of swimmer’s ear and Hot tub rash.

Swimmer’s ear is an infection that can occur if contaminated water stays in the ear canal for a long time. Swimmer’s ear is common in children and swimmers of all ages. It results in an estimated 2.4 million health care visits per year & nearly half a billion dollars in health care costs. This illness occurs when water stays in the ear canal for long periods of time, providing the perfect environment for Pseudomonas to grow and infect the skin in the ear. Germs, most especially P. aeruginosa, found in recreational water venues are one of the most common causes of swimmer’s ear. Keep ears as dry as possible.

Hot tub rash, also caused by P. aeruginosa, can affect people of all ages. It is an infection that can occur if contaminated water comes in contact with skin for a long time. Symptoms could include Itchy spots on the skin that become a bumpy red rash which is worse in areas that were previously covered by a swimsuit. The rash could also present with Pus-filled blisters around hair follicles. Most hot tub rashes clear up in a few days without medical treatment. Lower your risk of hot tub rash! Remove your swimsuit and shower with soap after getting out of the water.

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Prevent recreational water illnesses by following these simple steps.

  • Don’t swim when you have diarrhea. Just one diarrheal incident can release enough germs into the water that swallowing a mouthful can cause diarrhea lasting 2-3 weeks.
  • Don’t swallow pool water, and don’t drink water directly from streams, lakes, or other bodies of water.
  • Practice good hygiene. Shower with soap before swimming and wash your hands with soap after using the toilet or changing diapers. Germs on your body end up in the water.
  • Avoid exposing open wounds or cuts to salt or brackish water. If exposed, wash the affected area right away with soap and clean water.
  • If you become ill, visit your primary healthcare provider.

For more information, please visit the following websites:

Click the links below to learn more about water health and safety:

Recreational Water Illnesses   ♦  Drowning and Swimming-Related Injuries  ♦  Pool and Spa Safety 

Swimming in Natural Waters  ♦ Healthy Swimming Pledge