RWIs can be spread by swallowing, breathing or having contact with contaminated water
Monday, June 05, 2006
Gail Larkin
Staten Island Advance
We were enjoying the water of a local community pool on a hot sunny afternoon when the lifeguard blew the whistle. As he waved everyone out of the pool, I wondered what was going on. I looked around to see if storm clouds were building.
Perhaps we had missed hearing thunder; but the sky was clear without any sign of an approaching storm. A minute later we learned that feces had been found floating in the pool and we had to stay out of the water for several hours. It turned out to be the rest of the day.
Strict health guidelines mandated that the pool be doused with large quantities of chlorine followed by water testing. The lifeguards explained that the health protocols were such that closing the pool was not only mandatory but in everyone’s best interest.

As the weather warms and the end of the school year approaches, swimming and other water-related recreation once again becomes a favorite pastime. While much attention is given to swimming safely in ocean water and pools, water-related illness also needs to be considered.
According to the Centers for Disease Control and Prevention (CDC), recreational water illness (or RWI), can involve public and private pools, hot tubs and spas, lakes, rivers, streams and oceans.
In recent years, even though environmental improvements have been seen in lakes, oceans and rivers, an increase in RWIs have been recorded. Whatever the reason, be it increased numbers of swimmers, changes in temperatures, or some other factors, educating yourself about RWI causes, recognition and prevention can increase the likelihood of a fun and healthy summer season.
CHLORINE AND HEAT
Most bacteria found in the pool can be killed by chlorine. One of the problems seen is that bright and sunny hot days contribute to a faster breakdown of chlorine. This means that some bacteria, including the diarrhea-causing cryptosporidium or “crypto” for short, can last much longer than expected.
Even with adequate chlorine levels, crypto can survive for a few days before it is killed. It has a hard shell around it that makes it less vulnerable to chlorine and other disinfectants.
The higher the water temperature, the faster the chlorine will break down and become ineffective. Frequent chlorine levels and pH levels of recreational water should be measured.
Other common bacteria, including shigella, E.coli, and giardia are more likely to be killed within a few hours. It doesn’t take a large amount of bacteria to get sick, though. Even just a small amount can make for a miserable few days.
For most of the population, a swimming-acquired illness will resolve on its own. But for some, especially those with compromised immune systems such as people with HIV, organ transplants or certain types of chemotherapy, infection with this bacteria could be very serious.
The bacteria can be spread by swallowing even small amounts of contaminated water, breathing around the water and in some cases, skin infections from being in the water.
Hot tub rash, for instance, can occur after relaxing in a hot tub with contaminated water. This results in an itchy, red rash that might include pus-filled bumps on the skin. You can’t always tell that it’s contaminated, but a slimy or sticky spa is a good indication that something is amiss.
According to the CDC, hot tub temperatures shouldn’t exceed 104 degrees Fahrenheit. Higher temperatures cause a too-rapid breakdown of chlorine.
Gail Larkin’s column on Emergency care appears Monday in the Health section. Questions and comments can be addressed to her in care of the Advance.