Are You Taking A Dip With Diseases? - Houston Press

During the hot summer months, with the children out of school, many families seek refuge in water parks and public pools to fill their days with something to do away from the warmer temperatures.

Although this may be a fun activity for younger kids and older adults alike, visiting these recreational bodies of water can result in gastrointestinal infection. Especially when parents bring children who currently have or are recovering from diarrhea, said Dr. Michael Chang, pediatric infectious disease specialist at UTHealth Houston, affiliated with Children's Memorial Hermann Hospital.

"Some parents may think the water is treated and it will be fine, and that is true for some germs you can get, but it is not 100 percent," he said. "Parents shouldn't assume their kid is better because they are mildly symptomatic or wearing a swim diaper. That's not good enough if you are sick or recovering from an illness."

Cryptosporidiosis is one of the diseases most commonly contracted in water parks and public pools. Microscopic parasite called Cryptosporidium cause the illness, leading those infected to have watery diarrhea. Other symptoms of the illness include stomach cramps or pain, dehydration, nausea, fever and weight loss, according to the Centers for Disease Control and Prevention.

Bacteria like E. coli and Shigella and viruses like Norovirus, which cause gastrointestinal illness and other symptoms, could also be in this water. However, within minutes of exposure to the chlorine, these are treated – if the pools and parks are properly chlorinated, Chang said.

Dr. Stacey Rose, associate professor of infectious diseases and internal medicine at Baylor College of Medicine, said this is not the case for Cryptosporidium, which can survive standard chlorine treatment.

"This bug seems pretty hard in resisting the anti-infection effects of chlorine," she said. "We chlorinate waters to make them even safer to swim in, but some organisms tend to be a little bit more resistant."

Doctors recommend waiting between three days to a week after symptoms resolve to start swimming in public places again. Mainly because the child, kid or adult could still be shedding the virus up to two weeks after infection, Rose said.

According to Chang, if an outbreak occurs at a pool or park, it will likely cause the facility to shut down for several days, as it will need to go through hyper-intensive chlorination or bromination and filtration protocol to clear the water from the Cryptosporidium.

He said parks or pools with splash pads – areas for children to play with structures that spray, rain and mist water – pose higher risks of exposure to Cryptosporidium, particularly if the water is recollected and recirculated.

When the water is recycled, it is not collected and drained like in a sewer system. It is instead reused, which increases the chance of kids playing to come into contact with contaminated water.

It is not great for children to ingest any water in a public pool or park, but especially in these areas. Chang said parents need to ensure that their children are not swallowing or getting any standing water in their noses.

Rose said to avoid possible infection, kids and adults should take a full body bath right after arriving home. Sometimes, doctors recommend staying out of crowded pools if people want to mitigate the risks.

Immunocompromised people may want to avoid recreational bodies of water as Cryptosporidiosis can result in severe disease and rarely death. These fatal cases usually occur because of pre-existing health conditions, extreme dehydration from the disease or inflammation of the intestines caused by the diarrheal illness.

However, an anti-parasitic treatment is available for those infected. Nitazoxanide comes in a liquid medication or pill form and can be taken by patients between one and 11 years old and those 12 years and older respectively.

Although this drug treats the diarrheal infection caused by Cryptosporidium, most infected patients can recover without it if properly hydrating and resting, Chang said.

Chang said there are small, localized outbreaks every year in the Greater Houston area. So far, there are no known reported cases; however, he said it is still early in the summer. He said those who may have it also may not know because testing for Cryptosporidiosis is not common, which could lead to under diagnosis.

The disease is very contagious, and only a little exposure can result in infection, so parents should consider whether their child is toilet trained, check to see if their swim diapers are collecting any waste and rinse their kids off before leaving these parks or pools.

"It's so hot out, and everybody wants to go, and parents need something for their kids to do while they are out of school," he said. "I get it, but if anyone's got a diarrheal illness, definitely try to avoid any kind of recreational water."

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