Recreational Waterborne Illnesses

Summertime draws area residents and visitors alike for a swim in our beautiful lakes, rivers and pools,  to cool off from the daytime heat.  While most outings are relaxing and uneventful, waterborne intestinal, respiratory and skin infections can ruin the best vacation plans.  Knowledge and prevention of these common illnesses can keep an outing this summer as safe as possible.

  1. Gastrointestinal pathogens: Gastrointestinal pathogens cause the majority of waterborne illness.  Cryptosporidium and Giardia are very common microorganisms which are transmitted by swallowing contaminated water.  Chlorine does not completely eradicate these pathogens.  Symptoms typically include diarrhea, abdominal pain/cramps, nausea and vomiting.  Antibiotics are used to treat illness due to Giardia, while the former infection usually resolves on its own.  Various viruses can also cause similar symptoms, as do toxic algae blooms in lakes and rivers.
  2. Respiratory infections: Respiratory infections most commonly due to water exposure include sinusitis and swimmer’s ear.  Both usually resolve without the need for antibiotics, although medication is sometimes used for prolonged and/or complicated cases.  Legionella pnuemonia and amebic menigoencephalitis, on the other hand, are much rarer and can be life-threatening.  The former is caught from exposure to the mist of a contaminated hot tub or fountain, while the latter is acquired from submerging one’s face in an infested natural hot spring.
  3. Skin infections: Common skin infections include hot tub folliculitis, which appears as a fine, pimply rash located under one’s swimsuit, and cercarial dermatitis (swimmer’s itch), which causes whole-body itching.  Both usually resolve on their own without medical intervention.  However, bacterial soft tissue infection, known as cellulitis, is more serious and treated with antibiotics.  This includes infection due to Vibrio vulnificus, which is a bacteria found in warm, southern, brackish waters and can cause life threatening illness.

North Idaho Direct Primary Care places a high emphasis on education and prevention.  Read the table below for guidelines from the CDC-published Model Aquatic Health Code.  This table provides recommendations aimed at reducing one’s risk of illness and injury at public recreational water venues:

If you found this article informative, subscribe to our monthly newsletter by clicking here.  Have a safe and enjoyable summer!


1) Table from American Family Physician Journal. May 1st, 2017 Issue. Recreational Waterborne Illnesses: Recognition, Treatment, and Prevention. http://www.aafp.org/afp/2017/0501/p554.html#afp20170501p554-b38. accessed July 11th, 2017.

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