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The US Centers for Disease Control and Prevention (CDC) categorizes waterborne pathogens into three groups. Group one causes symptoms such as nausea, vomiting, or diarrhea. Group two results in skin reactions like redness, itching, or a rash. And group three leads to symptoms like coughing, a runny nose, and conjunctivitis.
In this article, we have grouped waterborne diseases present in open water according to the same principle. However, some pathogens can cause both skin irritation and respiratory infections, so we have combined them into one group.
If you or someone you love experiences unpleasant symptoms after swimming in a pond, it’s important to read the descriptions of diseases in each group to determine the best course of action.
Gastrointestinal Tract Disorder – Gastrointestinal Tract Inflammation or Intestinal Influenza
Sources of Gastroenteritis in Swimmers
Gastroenteritis, which is an inflammation of the stomach and intestinal lining, is a common illness among swimmers. This condition is mainly caused by noroviruses, while rotaviruses are a less common source. The virus particles can be introduced to the water through the feces, vomit, and unclean hands of sick individuals. In unchlorinated wells or ponds, the virus can remain active for at least two months, which makes it possible for people to become infected by swallowing contaminated water.
Symptoms of Gastroenteritis in Swimmers
Gastroenteritis symptoms in swimmers typically appear 12 to 48 hours after exposure to contaminated water. The most common symptoms include loss of appetite, vomiting, nausea, and diarrhea. Other possible symptoms include headaches, muscle aches, and fevers. These symptoms can range in severity and duration, and prompt medical attention is recommended if they persist or worsen.
Avoiding Infection while Swimming
Swimming in outdoor bodies of water can put you at risk of contracting gastroenteritis. To reduce this risk, it is best to avoid stagnant pools of water, such as crowded ponds where the risk of exposure to noroviruses is higher. Instead, consider swimming in rivers and lakes with running water, as these environments are less likely to harbor harmful viruses.
For the safest swimming experience, opt for public pools, including outdoor ones. These pools typically contain chlorinated water, which kills noroviruses and other harmful pathogens, making them a safer choice for swimming. By following these guidelines, you can help to protect yourself and reduce your risk of infection while enjoying your time in the water.
Dealing with Gastroenteritis: What to Do If You Suspect a Disease
If you suspect that you have contracted gastroenteritis, it is important to take steps to manage the illness and help your body recover. Although there is no cure for the disease, there are ways to reduce discomfort and minimize the risk of complications.
One of the most important things you can do is to maintain your fluid and salt levels. Even if you don’t feel like eating or drinking, it is important to consume small meals and drinks regularly to replenish what you have lost. Consider eating foods like potatoes, noodles, boiled rice, wheat grits, and oatmeal with a little salt, and drinking electrolyte-containing sports drinks or diluted natural juices.
It is also important to stay at home during the illness and for at least two days afterwards to avoid spreading the disease to others. Wash your hands thoroughly before and after using the bathroom, and avoid cooking or sharing utensils with others. After recovery, be sure to wash bed linen and clothes in hot water and clean your home thoroughly to remove any remaining virus particles.
In most cases, people with gastroenteritis recover on their own within 1-3 days. However, if you are pregnant, over 65, or experience any concerning symptoms, it is important to seek medical attention. The same is true for children who show signs of illness. By following these guidelines, you can help your body recover and reduce your risk of complications from gastroenteritis.
If you or anyone you know experiences just one warning symptom, medical attention should be sought. These symptoms include feeling excessively thirsty but unable to drink due to a dry mouth, crying without tears, appearing pale, and breathing heavily as a result of dehydration. Other symptoms to watch out for are an inability to resist vomiting, bloody stools, and if gastroenteritis persists for over a week.
The Shigellosis
Gastrointestinal infections are caused by a bacteria known as Shigella. This bacteria invades the colon’s mucous membranes, leading to severe inflammation and cell death, resulting in symptoms of the disease.
Shigella spreads in water in a similar manner as viruses, accompanied by fecal particles. Swimmers can contract the disease by ingesting contaminated water. Although anyone can fall ill, children have a higher incidence of shigellosis compared to adults.”
The Symptoms of Shigellosis
After swimming, an individual may start to experience symptoms of shigellosis within 1-2 days. These symptoms include stomach cramps, diarrhea (sometimes with blood), and a fever.”
Prevention of Shigellosis Infection
To prevent shigellosis, it is advisable to avoid swimming in crowded ponds, similar to precautions taken for the stomach flu. Swimming in chlorinated pools is considered safer as Shigella cannot survive in chlorinated water.
Managing Suspected Shigellosis
For the majority of individuals, including children, recovery from shigellosis can occur within a week without antibiotics, with measures similar to those taken for the stomach flu helping to alleviate symptoms.
However, antibiotics may still be necessary for patients with chronic autoimmune diseases such as rheumatoid arthritis, type 1 diabetes, or multiple sclerosis, who do not show improvement within three days. If a pregnant woman or person over 65 develops symptoms of shigellosis, they should seek medical attention immediately.
Currently, there are no vaccines available to protect against Shigella infection. Immunity to Shigellae is largely provided by immune responses directed against the specific serotype’s Opolysaccharide.”
Hepatitis A
The Origin of Hepatitis A – The Hepatitis A Virus
The Hepatitis A virus is the cause of the disease. When the virus invades cells, an immune response is triggered. In certain individuals, this can result in the inflammation of the intestinal mucosa and the manifestation of unpleasant symptoms.
Virus particles enter water along with fecal particles or from the unwashed hands of an infected person. These particles can remain infectious in water for several months.
The Symptoms of Hepatitis A
Hepatitis A may not exhibit any symptoms at all.
However, if symptoms do appear, they mimic those of gastroenteritis or amoebiasis. Approximately 2-7 weeks after exposure, a person may lose their appetite, feel weak, and experience nausea, vomiting, abdominal pain, and in some cases, muscle pain. Some individuals may also have a fever of 39.5%. A week after these symptoms appear, urine may become darker and 40-70% of patients may experience yellowing of the skin and eyes, which will reach its maximum intensity in another week. While the other symptoms may disappear, approximately 40% of patients may still experience itching.
Preventing Hepatitis A Infection
Avoid going into ponds or any other type of stagnant water bodies. Swimming in public pools in urban areas is a safer option. There is a vaccine available to protect against Hepatitis A.
Managing Suspected Hepatitis A Infection
Hepatitis A does not currently have a cure, but the majority of people (85%) recover within 2-3 months without treatment. Some individuals may experience symptoms for a longer period, ranging from 6-9 months. Despite this, the disease typically resolves without complications.
If symptoms of gastroenteritis persist for more than a week, it is recommended to see a doctor immediately. This is especially important for pregnant women and those over 65.
To reduce the risk of complications, it is advisable to vaccinate all close contacts of the infected individual within two weeks of exposure, known as post-exposure prophylaxis. This helps prevent the spread of the highly contagious hepatitis A virus.
Amoebic Dysentery or Amoebiasis
Amoebic dysentery is caused by a single-celled parasite called the dysenteric amoeba. The dysenteric amoeba can cause significant harm to the intestinal lining by destroying its cells, resulting in severe inflammation and intestinal issues.
When the amoeba’s cysts are ingested, it leads to infection. These cysts form when the parasite envelops and releases itself into the environment to infect others.
Cysts can contaminate open water sources through fecal matter and unclean hands, and can survive in these environments for several weeks to months. Ingesting water contaminated with just one cyst can lead to illness.
Signs and Symptoms of Amoebic Dysentery
Once inside the body, the parasite’s cysts invade the mucosa in the colon and multiply, leading to the formation of new cysts and resulting in inflammatory conditions that may cause ulcers. Despite secreting cysts, 90% of infected individuals do not experience any noticeable symptoms.
However, 10% of individuals, particularly children, pregnant women, and those with chronic illnesses, may experience abdominal cramps, diarrhea with blood and mucus, and up to 7-10 bowel movements per day within 1-3 weeks of swimming. Approximately half of those experiencing symptoms will lose weight during their illness, and about a quarter will develop a fever. Amoebic dysentery typically lasts between 4-6 weeks, with symptoms resolving before becoming chronic and recurring.
Preventing Amoebic Dysentery Infection
“To avoid becoming infected with amoebic dysentery, it is advisable to avoid bathing in enclosed bodies of water where a large number of people are swimming, as it is theoretically possible to contract the disease in urban pools. Despite the presence of chlorination, it cannot protect against amoebas, making it possible for an unsuspecting individual to spread the disease.
To reduce the risk of infection, it is important to avoid swallowing water while swimming and to take a shower immediately after leaving the water.
When to Seek Medical Attention for Amoebiasis
If you or a loved one is showing symptoms of amoebiasis, it is crucial to seek medical attention. Symptoms of amoebiasis can mimic viral gastroenteritis, but unlike viral gastroenteritis, amoebiasis can persist for years without treatment.
If you or someone close to you experiences symptoms of amoebiasis, or if a gastroenteritis-like illness lasts more than a week, reach out to your doctor immediately. If a pregnant woman or someone over the age of 65 has symptoms, it is recommended to seek medical attention right away.
Giardiasis
Giardia, a simple microbe, causes the disease. Intestinal parasites attach to the intestinal mucosa and cause irritation, resulting in intestinal upset. Swimmers can contract giardiasis and amoebiasis by ingesting contaminated water.
Signs of Disease Among Children and Adults
Half of those affected by the disease remain symptom-free. However, others may experience weakness, nausea, abdominal pain, diarrhea, and in some instances, a high temperature (affecting 15% of cases) within one to two weeks of swimming.
Prevention of Giardiasis
To avoid contracting Giardiasis or Amoebiasis, it is advised to avoid swimming in crowded and enclosed pools as Giardia cysts are resistant to chlorine and can persist in treated water. The risk of infection is higher in untreated water sources outside of cities where the concentration of Giardia cysts may be greater. It is important to note that Giardiasis is more prevalent than Amoebiasis.
Dealing with Suspected Giardiasis
In the majority of cases (84%), both children and adults recover from Giardiasis within 1-4 weeks. However, in some individuals, the symptoms may persist or reappear as the illness becomes chronic. If you or your loved ones are experiencing symptoms similar to Giardiasis or if a gastrointestinal illness persists for more than a week, it is crucial to seek medical attention promptly.
For those who are pregnant or over the age of 65, it is especially important to visit the hospital without delay when the first signs of the disease are noticed.
Colenteritis: Escherichia coli (E. coli)
Colenteritis is caused by specific strains of Escherichia coli (E. coli) bacteria. The bacteria can cause diarrhea when they penetrate the intestinal wall, irritate it, or secrete harmful toxins. E. coli can contaminate water through feces or unclean hands and has been shown to persist in water for close to a year in experiments.
Symptoms of Colenteritis
A person may experience symptoms such as nausea, vomiting, abdominal pain, and diarrhea approximately 1-10 days after swimming in contaminated water. These symptoms are indicative of Colenteritis caused by Escherichia coli (E. coli) bacteria.
Preventing Colenteritis Infection
To avoid contracting Colenteritis, it is advised to steer clear of swimming in stagnant puddles of water. On the other hand, swimming in chlorinated pools is considered safe as the E. coli bacteria cannot survive in chlorinated water.
What to Do in Case of Suspected Colenteritis
Most people recover from Colenteritis within 5-7 days without the need for antibiotics. However, in 5-10% of cases, the illness may progress to a severe complication known as hemolytic uremic syndrome, characterized by paleness of skin, weakness, and difficulty urinating. This condition can be life-threatening and requires prompt medical attention.
If the symptoms persist after a week or if a person is still feeling weak, it is advisable to see a doctor. Pregnant women and those over 65 should contact their physician as soon as they experience symptoms similar to Colenteritis.
ACUTE RESPIRATORY AND SKIN DISEASES
A Pseudomonas-related disease is caused by the group of bacteria known as Pseudomonas, including the species Pseudomonas aeruginosa. These bacteria reside on the skin and can enter water from the skin surface.
While most types of Pseudomonas do not pose a threat to humans, some species have the ability to invade cells and cause parasitic infections. This can trigger an immune response, leading to inflammation and symptoms of the disease. An experiment has shown that Pseudomonas can survive in water for almost five months.
Symptoms of a Pseudomonas-related Disease
The symptoms of a Pseudomonas-related disease depend on the location of the infection. If the bacteria end up on the skin, it can result in a red, itchy rash. If it infects the ear, it may cause otitis media, characterized by inflammation of the ear and symptoms such as pain and fever.
Preventing a Pseudomonas-related Disease
To avoid a Pseudomonas-related disease, it is advisable to avoid swimming in stagnant water and to take a shower immediately after swimming. Clean your swimwear thoroughly before wearing it again. To prevent otitis, dry your ears thoroughly after swimming by wiping the auricle with a towel and tilting your head to each shoulder to let the water drain out. Gently pull on your earlobe to aid in draining. While some strains of Pseudomonas are resistant to chlorine, they are typically found in hospitals and rarely found in recreational water. Thus, swimming in a chlorinated pool is considered safe.
Dealing with Suspected Pseudomonas Disease.
In most cases, a pseudomonas rash will clear up on its own within a few days and can be managed with calamine lotion. However, if the rash persists for more than three or four days, it’s recommended to seek medical attention.
For otitis, prompt treatment is necessary, and one should not delay in seeking medical advice and getting prescribed antibiotic ear drops.
Blue-green algae toxins exposure
Green algae rapidly grow on the surface of stagnant water in ponds, causing the water to become murky and streaked with green, yellow, blue, and sometimes red hues. This rapid growth results in the release of harmful toxins into the water, posing a risk to both humans and animals.
Algae Toxin-Induced Symptoms
The majority of toxins produced by algae result in various symptoms such as skin and eye irritation, and in certain cases, respiratory discomfort such as coughing and nasal congestion. Additionally, ingesting water contaminated with these toxins poses a risk of poisoning and may even cause liver damage.
Preventing Algae Toxin Exposure
To avoid being infected with algae toxins, it is recommended to avoid swimming in ponds that are experiencing an algae bloom. Algae blooms can occur at any time during the summer, but are more common towards the end of the season, especially when warm weather and nitrogen and phosphorus fertilizers from nearby fields combine to promote algae growth.
If you have come into contact with blooming water, it is important to rinse it off immediately with clean water to prevent skin rashes. Taking a shower as soon as possible is the best way to do this.
What to Do in Case of Suspected Algae Toxin Exposure
If you suspect that you have been exposed to algae toxins, here are the steps to take:
- Skin Irritation: If you experience skin irritation, it is likely to resolve on its own within a few days without treatment. However, if the symptoms persist or become severe, it is recommended to seek medical attention.
- Ingestion: If you, a child, an adult, or a pet have consumed blooming water, it is important to seek medical attention immediately, even if symptoms of poisoning have not yet appeared. Algal toxins are more dangerous when consumed, especially in children, and prompt medical attention is essential to minimize the risk of adverse health effects.
Note: It is important to seek medical attention if you suspect that you or someone else has been exposed to algae toxins, even if the symptoms appear to be mild. Early detection and treatment are critical for ensuring a favorable outcome.
SKIN DISEASES
Acute Cutaneous Dermatitis (Swimmer’s Itch)
Acute cutaneous dermatitis, also known as swimmer’s itch, is caused by a parasite called schistosomes. These parasitic worms live in birds and can infect humans who come into contact with contaminated water. When a person swims or wades in contaminated water, the parasite can burrow into the skin, causing an allergic reaction that results in skin rashes, itching, and blistering.
Symptoms of Acute Cutaneous Dermatitis (Swimmer’s Itch)
The transmission of the disease takes place either through a bird consuming contaminated water or through schistosomes entering the human body through the skin. However, humans are not a hospitable environment for avian schistosomes, and even if they accidentally ingest water containing the parasites, the parasites will not be able to endure. The schistosomes are unable to break through the outer layers of the skin and will eventually pass away once inside the body. The most significant effect of this skin penetration is merely skin irritation.
Preventing Schistosome Infection
Swimming in open water where birds reside can pose a risk of schistosome infection. To avoid being infected, it is recommended to avoid these types of bodies of water or, if you must swim, to immediately dry off with a towel after exiting the water. This will help to prevent the skin from being penetrated by the parasite, which can cause itching.
What to Do If You Suspect a Schistosome Infection
If you experience small blisters or itchy spots on your skin after swimming in open water where birds live, it is important to take proper care of the affected area to reduce the symptoms and prevent further infection.
Here are some steps to follow:
- Wash the affected area with soap and water in the shower, avoiding the use of a sponge or washcloth.
- Use alcohol to wipe the area and apply calamine lotion to reduce itching.
- Avoid combing the skin, as this can introduce microbes and cause inflammation.
- If the itching is severe, take an over-the-counter antihistamine tablet, such as Cetrin.
By following these steps, you can help alleviate the symptoms of a suspected schistosome infection and prevent further complications.
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