Water Recreation-Related Illnesses - NYC Health

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Water Recreation-Related Illnesses

Contaminated water in swimming pools, water play areas (such as splash pads or fountains) and beaches can cause swimming-related illnesses. Anyone can get these illnesses.

Such illnesses are usually minor but can result in more serious diseases. Children, seniors, pregnant people and people with compromised immune systems are at higher risk for these illnesses.

These illnesses can spread by swallowing, breathing in mists or aerosols or having contact with contaminated water.

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Types of Illnesses

Different bacteria can be found in the water and make you sick.

The most commonly reported recreational water-related illness is diarrhea caused by bacteria such as:

Cryptosporidium

Giardia

Shigella

Norovirus

E. coli

Vibrio

Other illnesses can include diseases affecting the eye, ear, skin and upper respiratory system. Some illnesses can be severe, such as skin or tissue infections caused by Vibrio, which can occur when a cut or wound is exposed to salty water.

Less commonly recreational water-related illness can be caused by bacterial toxins from exposure to harmful algal blooms (HABs). These toxins (cyanotoxins) are harmful to both humans and pets and symptoms includes vomiting, diarrhea, skin irritation and other allergic reactions.

The chlorine used in swimming pools kills most of the bacteria that cause recreational water illnesses.

Common Infections

Swimmer’s Itch

Swimmer’s Itch is a skin rash that develops when parasites found in the water penetrate your skin. The rash can itch for a week, but is not contagious or usually dangerous.

Most cases of swimmer’s itch do not require treatment. Corticosteroid creams, calamine lotion, and a colloidal oatmeal bath can reduce itching. If itching is severe, contact your health care provider.

You can reduce your risk of swimmer’s itch by drying off with a towel after leaving the water to help remove the parasites and by taking a shower immediately after getting home.

Swimmer’s Ear

Swimmer’s ear (ear ache) is an infection of the ear or outer ear canal caused from contact with contaminated water. It can cause the ear to itch or become red and inflamed so that moving your head or touching your ear is very painful. There may also be pus that drains from the ear.

It usually takes a few days after contact with the water for swimmer’s ear to develop.

People of all ages can get swimmer’s ear, but it is more common in children and young adults.

If you think you have this infection, contact your provider. The condition can be treated with antibiotic ear drops.

To reduce your risk of swimmer’s ear:

Dry your ears after swimming. If it is difficult to get water out of your ear, apply a few drops of an alcohol-based ear product into your ear.

Ask the pool’s manager about the chlorine and pH testing program at your pool. Pools and hot tubs with good chlorine and pH control are unlikely to spread swimmer's ear.

Avoid swimming in locations that have been closed because of pollution.
Avoid putting fingers, cotton swabs or other objects in your ear, like fingers or cotton swabs, that could scratch the ear canal and provide a site for infection.

Serious Illnesses from Polluted Water

If you are swimming in highly polluted water, you may develop the following serious diseases:

amoebic dysentery

cholera

giardiasis

Hepatitis A infection

intestinal parasites

Norovirus Infection

shigellosis

viral gastroenteritis

viral respiratory infections

People with compromised immune systems are more likely to develop illnesses or infection after swimming in polluted water. If you think you have a swimming-related illness, talk to your health care provider.

You can submit an online complaint about the water quality of a beach or pool.

Prevention

Do not swim in areas where there are no lifeguards or when a beach is under an advisory or closure. Follow these steps to prevent swimming-related illnesses for yourself and other swimmers:

Do not swim when you have diarrhea. Do not swim until two weeks after you stop having diarrhea.

Avoid submerging your head while swimming. Do not swallow pool water or get pool water in your mouth.

Shower with soap before swimming.

Wash your hands after using the toilet or changing diapers.

Take children on bathroom breaks or change diapers often. Change children's diapers in a bathroom.

Avoid swimming at beaches during and after rainfall.

Do not swim in or allow children to play in storm drains or stormwater.

Avoid swimming if you have an open wound or infection.

Ask pool operators if chlorine and pH levels are checked at least three times per day. Request information on the latest pool inspection results. You can check pool water yourself using test strips purchased online, at your local hardware or at a pool supply store.

Prevention Tips for Pool Owners and Aquatics Staff

You should regularly monitor water quality. If water quality does not meet legal requirements, you should close the pool until it is corrected. Make educational materials available to all swimmers. Have a written response policy to address feces, vomit and blood contamination incidents.

Chlorine and pH levels should be checked at least three times a day and more often when the pool is in heavy use. These chemicals can also cause injuries if they are not properly handled. Take these steps to protect yourself and swimmers:

Safely store pool chemicals. Keep children and animals away from where they are stored.

Read product names and directions before each use.

Use protective gear, such as safety glasses and gloves, when handling chemicals.

Never mix chlorine products with each other or other substances.

Additional Resources

Healthy Swimming Poster (PDF)

Other Languages: Español

CDC Education and Information for Aquatics Staff

Fecal Incident Response Recommendations for Pool Staff (PDF)

Harmful Algal Blooms

More Information

NYC Beaches Homepage

Beach Monitoring and Surveillance

Skin Cancer

Sea Lice