Wisely choose your swimming venue

Your family’s health could sink or swim, depending on where you choose to spend the summer. But a few very basic precautions can greatly reduce your risk of trouble. “Bacterial infections and water-borne illnesses are real risks for those who enjoy swimming, water-skiing or many other recreational water activities,” said Dr. Dennis Maki, professor of medicine and infectious-disease specialist at the University of Wisconsin School of Medicine and Public Health. Bacteria, viruses and parasites can all make you sick in “recreational water.” And it’s not just natural bodies of water. Maki says pools and hot tubs, as well as rivers and lakes, can be sources for gastrointestinal illnesses; skin, ear and eye infections; and respiratory, neurological and viral problems. According to Maki, who is also an epidemiologist, the safest places to swim are generally municipal and private pools which are monitored for their chlorine content. But he cautions that even pools can pose risks because some pathogens, such as cryptosporidium, can live for days even in properly chlorinated water. The most common health issues associated with pools are gastrointestinal illnesses or pseudomonas folliculitis, a skin rash. You might become infected by swallowing pool water, even a small amount. “Water parks can be especially troublesome because so many people swim and play in the water that recirculates and can lose chlorine residual quickly,” said Maki. A study in Wisconsin found that cushioned and padded surfaces, designed to reduce water-park injuries, can also harbor bacteria. Hot tubs probably pose the greatest risk of contracting an infectious illness from water. The warm and stagnant water invites certain heavy contamination by bacteria, fungi and viruses. Hot-tub safety mandates monitoring chlorine and pH levels, as well as draining and cleaning the tub regularly and properly. Natural bodies of water have their own set of concerns. Lakes and rivers are predictably contaminated by runoff from farm fields following heavy rain. Maki said the water can contain very high counts of coliform bacteria and other microorganisms, such as cryptosporidium, that cause gastrointestinal illnesses. With near-drownings, these organisms can cause life-threatening pneumonia. Finally, there is the risk of skin infections. “Swimmer’s itch” (cercarial dermatitis) usually doesn’t require medical care but can be extremely uncomfortable with maddening itching. More serious skin infections predictably follow cuts or abrasions, especially major soft-tissue injuries, and pose the greatest risks to people with compromised immune systems. “Atypical mycobacterium infections can be very difficult to treat,” said Maki, and they require many months of antibiotics or combinations of antibiotics. The Centers for Disease Control recommend safety precautions for prevention of illness related to water recreation: Adults and children with diarrhea should not use swimming pools, hot tubs or water parks. Shower with soap and tap water before swimming or getting into a hot tub and, again, afterwards. Wash your hands thoroughly after using the toilet, before re-entering the water. Avoid swallowing water. Don’t swim in warm, stagnant water or use poorly maintained hot tubs or pools.