Common Waterborne Diseases and Illnesses from Hot Tubs and Pools

10 Different Waterborne Illnesses from Pools and Hot Tubs

The heat of summer and the free time granted by vacations make swimming pools, lakes and hot tubs filled with people looking for a short and refreshing break. The aquatic activities are a classic during these months and an escape route against the much-needed heat. However, not all waters are equal and the risk of suffering a waterborne disease can increase depending on where the expected bath is.

A new study indicates that the presence of chemicals in the pool water does not guarantee the absence of harmful organisms for the human body. The most common symptoms usually involve diarrhea, stomach ache or vomiting.

Out of 633 cases nationwide caused by bacteria, viruses, and other environmental organisms, about 80% of them were tracked in chlorinated waters or other chemical products of swimming pools and hot tubs. The studies, which analyzed outbreaks from 2000 to 2015, found 493 cases in which more than 27,000 people suffered from a disease and eight died of pathogens in recreational waters treated with chemicals. The results did not include diseases related to private swimming pools or cases in which a single person became ill.

Typical Diseases of Swimming Pools and Hot Tubs

1.- Diarrhea

It is a very common infection seen in public pools. As we will see later, cryptosporidium is one of the germs that most affect the waters and people suffer from constant diarrhea since chlorine does not kill it. The intake of contaminated water with norovirus, shigella or lamblia guard, are other causes of diarrhea in children and adults infected with pools and hot tubs.

The water, being contaminated with fecal matter and then ingested, produces an intestinal infection which can also cause vomiting and fever.

How to Avoid Diarrhea?

• Do not be in the pool or hot tub if you have diarrhea, including children with diapers.
• Do not drink the pool or hot tub water.
• After using the bathroom, wash your hands with soap.
• Take a shower before entering the pool.

2.- Otitis

This infection occurs on the outside of the ear and usually appears with contaminated water from public pools. This produces an inflammation that can cause pain if water enters the ear and stays there for many hours. Although it is not transmitted from person to person, it is a problem that affects many children and adults in swimming pools.

How to Avoid Otitis?

• Wear a swimming cap, earplugs to prevent water from entering.
• Your ears should be dry after swimming.
• Place your head to the sides to allows water to exit the ear canal.
• Never insert objects into the ear canal like your fingers.
• Visit your doctor if you have pain.

3.- Athlete’s Foot

It is an infection in the feet that usually appears between the toes and is a product of fungi. This usually causes the skin to be injured and open causing itching, bad smell and sometimes pain. This is transmitted by direct contact with already infected surfaces such as the shower and pool floor.

It is usually treated with creams but if it is very advanced, antibiotic pills may be recommended. To avoid this problem, it is recommended to have good personal hygiene.

How to Avoid an Athlete’s Foot?

• Always have short nails.
• Try to wear sandals in showers and changing rooms.
• Keep your feet clean, dry and fresh.
• Do not exchange sandals with other people.

4.- Dermatitis

It can be caused by Pseudomonas aeruginous. It is a germ that is always in wet environments. The ‘rash’ or pink spots that usually itch, appears after direct contact of the skin with contaminated water a few days after swimming.

The symptoms are itching that can end in reddened and sometimes inflamed skin. It is also characterized by blisters of pus in the hair follicles.

How to Avoid Dermatitis?

• It is important not to wear the wet swimsuit for a long period of time and wash it daily.
• Always use clean towels.
• Take a proper shower after swimming in a pool.

5.- Eye’s Infection

The eyes require special care both on the beach and in the pool to avoid irritations and infections, especially in children and in people who wear contact lenses. It should be taken into account that both chlorine and salt cause irritation, redness and dry eyes.

One of the most common eye infections is conjunctivitis, an inflammation of the membranes that line the inner surface of the eyelids and the anterior surface of the cornea. There are different types of conjunctivitis:

• Allergic: caused by contact with chlorine in swimming pools.
• Bacterial: by urine or fecal bacteria.
• Fungal: by fungi from wet clothes.
• Viral: by mollusks, whose incidence in swimming pools is important especially in children.

How to Avoid Eye’s Infection?

• Protect the eyes with water goggles to avoid contact with irritating substances such as chlorine, salt and possible bacteria present in the water.
• Avoid wearing contact lenses in the water because direct contact with the cornea can produce oxygenation conditions that favor fungal, protozoan and bacterial infections. You can replace them with prescription swimming goggles.

6.- Vulgar Warts (Papillomavirus)

Moisture can cause fungi or plantar papillomas, better known as warts. They are infections caused by viruses that end up disappearing, although they can become very annoying and cause intense pain.

Up to 10% of bathers become infected, especially in the feet. Plantar warts constitute a very common infection especially in children whose skin layers are thinner; and, especially, in summer for the sum of heat and humidity. However, injuries, fatigue, excess heat or poor hygiene can also be the source of this problem.

These types of warts are internal because they usually grow inward showing small lumps with black spots called ‘wart seeds’, which are small coagulated blood vessels. They have their origin in human papillomavirus (HPV) that penetrate through small wounds, cuts or other weak points of the foot.

How to Avoid Vulgar Warts?

• Wash your feet daily with neutral soap and dry them well.
• Apply moisturizer or some antiperspirant product to avoid sudation.
• Do not cut hardnesses.
• Use cotton socks.
• Wear appropriate footwear to avoid injuries.
• Use sandals in bathrooms, public locker rooms.
• Avoid scratching your feet.

7.- Pathogenic Protozoa

These microorganisms are also transmitted by inhalation or ingestion of water. The problem is that they are related to the high level of toxicity created by the use of some chemicals.

The same chlorine with which it is intended to kill microorganisms can be detonating to pathogenic protozoa if used excessively. The case of public pools with excess chlorine is also dangerous. This type of treatment can lead to lung diseases, such as asthma, or dental erosion.

How to Avoid Pathogenic Protozoa?

• It is necessary to avoid the intake of water from swimming pools and hot tubs.
• Maintain good personal hygiene.
• Shower before and after entering a pool.

8.- Molluscum Contagiosum

Molluscum contagiosum is a benign viral disease of the skin, usually asymptomatic, characterized by a relatively small number of papules (usually 2 to 20) in the form of a dome, well defined, flesh-colored to translucent and some with central umbilication lesions are usually seen on the chest, face, and extremities, but can be generalized.

The cause is a poxvirus and humans are the only known source of the virus. This is disseminated by autoinoculation and transmitted by direct contact with the water in a pool or exchange of contaminated materials such as towels.

How to Avoid the Molluscum Contagiosum?

• Cover visible lesions with water-resistant strips.
• Have good hygiene in general.
• Make sure towels are not shared.

9.- Cryptosporidium

Swallowing water, even chlorinated, could result in an infection caused by cryptosporidium. It is a microscopic parasite that can make both adults and children sick and suffer stomach cramps, nausea and diarrhea episodes that last up to three weeks.

How does this happen? Through contact with infected feces: either with contaminated people, animals or food or through contact with recreational waters.

Once the pool or water park is infected with ‘crypto’, it is easy to spread, but especially difficult to kill. While microorganisms such as E. coli and Norovirus die hours after the water is treated, cryptosporidium can survive in chlorinated water for up to ten days. The only way to kill it is to close the pool for days and expose the parasite to even higher levels of chemicals.

How to Avoid the Cryptosporidium?

• Do not enter the pool if you suffer from a gastrointestinal problem.
• Do not swallow the pool water.
• Take a shower before and after entering the pool.
• Wash your hands with soap and water after leaving the bathroom or after changing your child’s diapers.

10.- Escherichia Coli

E. coli is a bacterium that lives in the feces of human beings which is usually common its contagion in swimming pools or hot tubs. People suffering from diarrhea should avoid entering the waters and although the bacterium dies after being treated with chlorine after 30 minutes, it is recommended not to swallow the water.

Urine can also function as a risk factor, this when combined with chlorine, the form of cyanogen chloride and trichloramine, compounds that cause lung, heart, and central nervous system damage. It is known that one in five people urinate in a public pool.

How to Avoid the E. Coli?

The recommendations to avoid contagion are the same as the previous ones. Be aware that if you suffer from diarrhea, you should not enter the pool to not infect others. Always shower before and after entering the water, wash your hands with soap and avoid drinking water from the pool. Also, educate children and if they wish to urinate, should go to the bathroom.