While Out Swimming, Beware of Waterborne Diseases

It’s that time of year when our families venture outside to enjoy cooling off in Pocahontas County’s many streams, lakes and rivers or in swimming pools or hot tubs. But, as Doctor Julie Hare, the Medical Director of Pocahontas Memorial hospital’s Rural Health Clinic explains, beware of waterborne illnesses even in chlorinated pools and hot tubs. Doctor Hare explains just what some of these illnesses are in part one of this two part story.

“Now that summer is in full swing and most people are enjoying outdoor recreation this is a good time to talk about recreational associated illnesses – specifically waterborne illnesses” said Doctor Hare.  “Every year people get sick due to organisms encountered while swimming or playing in water. “

“Symptoms of waterborne illnesses are primarily gastrointestinal – nausea, diarrhea, vomiting etc.  But they can also cause respiratory issues and symptoms that are consistent with the common cold or cause rashes.  Most water related illnesses are self limiting, which means they require supportive care only – like rest and staying well hydrated.  Occasionally, some do need medical intervention.  Let’s discuss some of the most common agents that cause waterborne illnesses based on how they present – that is how they make you sick.”

“First, let me say that most waterborne illnesses come from pools and hot tubs, not streams/ponds/ rivers or oceans.  You can pick up bugs there too but, but most people get sick from chlorinated water. One of the most common organisms encountered is a Protozoan (a single celled organism) called Cyrptosporidium.  This is frequently the number one cause of diarrheal illness during the summer.  It can live for days in chlorinated pools and people develop symptoms sometimes up to two weeks after ingesting the organism, making it hard to pinpoint exactly where it came from.  It is not  dangerous to a otherwise healthy person and we generally support people with fluids and rest.  A close second is Giardiasis, this is also a Protozoan and it can live for months in freshwater.  An antibiotic called Flagyl is usually used to treat it.  Gastrointestinal illnesses can also be caused by viruses, but it is estimated only about 10% of these illnesses come from them.  Most people these days have heard of Norovirus, very contagious and again self limiting.  Also adenovirus, Rotavirus and Hepatitis A can be spread through water.  Bacteria are known to causes gastrointestinal illnesses via water contact.  These include E. coli, Shigella and Campylobacter.”

“As I said there are illnesses you can get from water contact that cause respiratory symptoms.  Again, most are self limiting.  However there is a bacteria called Legionella that can cause trouble.  It can be found in fresh water, hot tubs, misting fountains and pooled water from AC units.  This bacteria does have the potential for more severe illness, specifically pneumonia and should be treated with antibiotics.  Some people can become irritated by exposure to chlorine itself, developing a chemical induced lung irritation called pneumonitis.”

“Some organisms can cause skin problems such as rashes.  A bacteria called Pseudomonas aeruginosa is known for causes an itchy bumpy rash called folliculitis and is frequently harbored in hot tubs.   Cercarial dermatitis, i.e. swimmer’s itch, is contracted in natural water sources.  It is caused by a schistosome, a flat worm, that it very tiny.  It cannot live on people and there for is a self limiting issue, but it does manage to give a very itchy rash before passing.”

Keep listening to Allegheny Mountain for part 2 of this story where Dr. Hare tells us about how to avoid getting these diseases.