FAMILY MEDICINE® COLUMN
By John C. Wolf, D.O.
Associate Professor of Family Medicine®
Ohio University College of Osteopathic Medicine

BEING "SMART" ABOUT SWIMMING HYGIENE CAN PREVENT ILLNESS

Question: Last summer I got diarrhea after swimming in the lake, but no one else in my family did. I think it may have been due to something in the water, although there were no warnings about contamination. We have reserved our cabin on the lake again for this summer's vacation. I don't want a repeat of that diarrhea attack. What are the chances that my illness was actually due to swimming in the lake?

Answer: Hurray!! Summer has arrived, and millions of us head off to the beach for a break from our routines. Swimming is usually part of that pleasurable change of pace. Although I can't tell you the cause of your illness during last year's vacation, I can assure you that swimming is generally safe. However, you should be aware of some health concerns.

Water can be contaminated with organisms that cause human illness. Most of these disorders are infectious diseases have either diarrhea or a rash as a major symptom. And some of the harmful viruses or bacteria can survive in fresh or salt water and also in treated water of pools, water parks, and hot tubs and spas.

Chlorine kills a number of pathogens, but it doesn't kill all of them. Chlorine is also unstable, so it must be constantly renewed to stay at the effective level within the swimming water. This is a particularly difficult task for pool operators when the water is warm or there are lots of people in the pool.

Swimming in untreated water can pose additional risks. The water of lakes, ponds, or the ocean can be contaminated by fish, shore animals, improperly functioning sewer systems, and industrial or agricultural run off. Specific contaminates from all of these sources can cause human illness.

Think of swimming as an act of communal bathing without the benefit of soap to help kill harmful bacteria. This is important because we all have some normal intestinal bacteria on the skin around our rectums. An individual with diarrhea caused by an infection has some "germs" present on his or her skin, too. Swimming will disperse some of these disease-causing germs -- what we physicians call pathogens -- into the water. Pools and swimming spots are also contaminated when an infected individual has a "fecal accident" in the water. This is a problem more common with infants and children than it is with adult swimmers. Getting these pathogens on your lips or swallowing a mouthful of contaminated water can spread the infection and give you diarrhea. Perhaps this is what happened to you last summer.

There are a few simple guidelines to help reduce the risk of infections to swimmers and hot tub users. Never go in the water if you have diarrhea. A few of the "germs" causing your illness will get in the water and potentially spread to others. Also, any time you have a bowel movement be sure to wash your hands -- AND BOTTOM, when practical -- with soap and water before going into the pool. You should also take children for frequent bathroom breaks. Don't wait until they say, "I gotta go," because it is often too late by then.

You shouldn't be afraid to go swimming, but you should be smart about it.

Family Medicine® is a weekly column. To submit questions, write to John C. Wolf, D.O., Ohio University College of Osteopathic Medicine, Grosvenor Hall, Athens, Ohio 45701. Past columns are available online at http://www.FamilyMedicineNews.org.