Over the course of the past century, the use of modern disinfection systems in pools and environmental improvements in our lakes, rivers and oceans have improved the quality of water in our recreational areas. Despite these improvements, though, there has been an increase over the past decade in the number of outbreaks of illnesses associated with swimming.

RWIs are maladies spread by swallowing, breathing or having contact with contaminated water during recreational water activities. These illnesses can cause a wide variety of symptoms including skin, ear, respiratory, eye, and skin and wound infections. The most commonly reported illness is diarrhea resulting from exposure to microbes such as cryptosporidium, giardia, shigella and E.coli.

Microorganisms can contaminate swimming pools even when they are treated with chlorine. The contamination occurs when the water accidentally is contaminated with fecal matter — for example, when a person who has diarrhea enters the pool. The good news is the germs that cause RWIs are killed by chlorine. Unfortunately the chlorine takes time to work — some germs, like cryptosporidium, are resistant to chlorine and can live in pools for days, so even the best-maintained pools can spread illness. Healthy swimming behaviors must be adopted to prevent microbes from getting into the water in the first place.

When you arrive at the pool and other water recreational areas, use your senses. Is the water clean and clear all the way to the bottom? You should be able to see any painted stripes and the drain on the bottom of the pool or spa. Feel the pool or spa sides. They should be smooth and the tiles should not be sticky or slippery. Be sure that the water is lapping over the grills to be filtered. The old wives’ tale that a pool or spa should have a strong smell of chlorine is wrong. A well-chlorinated pool or spa has no or little odor. A strong chlorine smell usually indicates a pool or spa maintenance problem. You should see and hear pool or spa equipment working, such as pool or spa pumps and filtration systems.

Do not be afraid to ask questions of the pool or spa staff. How often are the chlorine and pH levels checked? At least twice a day is appropriate. Are these levels checked during times of heavy use? What kind of training did the staff receive to prepare them for working at and operating the pool or spa? Are trained pool or spa operators available on the weekends when the pool or spa is used most heavily? What was the health inspector’s grade for the pool or spa after its last inspection?

You may need to be proactive and educate staff and swimmers about RWIs. You can even check the pool water yourself using chlorine test strips that are available at local home improvement stores, pool supply stores and discount retailers. Just follow the directions on the package.

Two other menacing infections that can occur from contaminated water associated with the microorganism pseudomonas are Hot Tub Rash and Swimmer’s Ear. Hot Tub Rash is an infection of the skin that may become itchy, and progress to a bumping, red, tender rash. It may develop into pusfilled blisters. Most rashes clear up in several days without medical treatment. If your rash persists consult a physician.

Swimmer’s Ear is an infection of the ear or outer ear canal. It can cause the ear to become reddened and inflamed and the moving the head or touching of the ear is extremely painful. There also may be pus draining from the ear. Although all age groups can be affected by Swimmer’s Ear it is more common in children and young adults. If you think you have Swimmer’s Ear, see a physician. It can be treated with antibiotic eardrops.

Continue to swim, but be healthy and responsible. Be aware and proactive about reporting problems to the pool or spa management. For more information visit www.medicinenet.com.

Swimming Lessons

Do not enter a swimming pool if you have diarrhea.
Do not swallow pool or spa water; avoid getting water into your mouth at all.
Shower before swimming or using the spa and wash your hands after using the toilet or changing diapers.
Do not wear contact lenses while swimming as microorganisms in the water can cause infections between the lens and the eyes.
Take your children on bathroom breaks or check diapers often.
Change your children’s diapers in the bathroom – not poolside. Germs can spread to surfaces and objects in and around the pool and spread illness.
After a diaper change, wash your children thoroughly with soap and water before allowing them to enter the pool.