by DThere

Created on: July 29, 2009   Last Updated: July 30, 2009

Recreational Water Illness (RWI) is caused by organisms that contaminate pool water often resulting in diarrhea (usually appears one or two weeks after a swim), rashes, swimmer's ear (outer ear canal infection) and other illness (Mann, D. 2009, www.webmd.com). According to the National Center for Zoonotic (www.cdc.gove/nczved), the disinfectant times of chlorine treatment (chlorine plus the use of cyanuric acid) for specific types of agents are less than a minute for Escherichia coli (abbreviated as E. coli) 0157:H7, approximately 16 minutes for Hepatitis A (virus), approximately 45 minutes for Giardia (Parasite transmitted by swallowing), and almost 11 days for Cryptosporidium (Also known as 'Crypto', is a parasite responsible for most drinking and swimming waterborne diseases and is most resistant to disinfection). Symptoms of Cryptosporidium infection include diarrhea, dehydration, weight loss, stomach cramps, fever, nausea, and vomiting (Mayo Clinic, 2009,

www.mayoclinic.com/health/cryptosporidium; New Mexico Department of Health, n.d., www.healthyswimmingnm.org/). Treatment includes the application of anti-parasitic drugs such as nitazoxanide and azithromycin that attract the parasites' metabolism; antimotility agents such as loperamide that slow down intestinal movements and increase absorption of fluids; fluid replacement that include the addition of electrolytes (sodium, potassium, and calcium restoration); and retroviral therapies that restore the immune system (Mayo Clinic, 2009). It is recommended that one should not swim until two weeks after diarrhea symptoms subside (New Mexico Department of Health, n.d.).

The Center for Disease Control (CDC, www.cdc.gov) provides guidelines pertaining to RWI. Indications that pool water quality may be compromised include a strong odor in the water which can indicate that there is a maintenance problem. According to the CDC, properly chlorinated water should not have a strong odor. Pool maintenance concerns may also be evident by loud pool pump noises. The CDC also recommends that one should verify the quality of pool staff training and clarify that water pH levels are checked at least twice daily. Also determine the health inspector's grade for the pool from the last inspection. Additionally, the CDC recommends self pH testing. Chlorine levels should be 1 to 2 parts per million (spa water should 2 to 5 parts per million and spa temperature should not exceed 104 degrees F.) with pH levels ranging from 7.2 to 7.8. Particular swimming practices are also recommended by the CDC. These practices include not swimming with diarrhea, avoidance of swallowing water, shower and washing hands prior to swimming or washing hands after handling contaminated items, and not exceeding the maximum allowable swimmers in a pool. Swallowing water is not the only way one can become ill. Breathing vaporized, tainted water exposed to contamination by viruses or parasites or exposure through openings, the eyes, and through cuts can also result in infection (Family Education, 2009, life.familyeducation.com).

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