How Can We Prevent Recreational Water Illnesses (RWIs)?

Six Steps for Healthy Swimming

Following these healthy swimming steps will help to protect you, your family, and other swimmers from recreational water illnesses (RWIs):

Three Steps for All Swimmers

Keep germs from causing recreational water illnesses (RWIs):

• Don't swim when you have diarrhea. You can spread germs in the water and make other people sick.
• Don't swallow the pool water. Avoid getting water in your mouth.
• Practice good hygiene. Shower with soap before swimming and wash your hands after using the toilet or changing diapers. Germs on your body end up in the water.

Three Steps for Parents of Young Kids

Keep germs out of the pool:

• Take your kids on bathroom breaks or check diapers often. Waiting to hear "I have to go" may mean that it's too late.
• Change diapers in a bathroom or a diaper-changing area and not at poolside. Germs can spread in and around the pool.
• Wash your child thoroughly (especially the rear end) with soap and water before swimming. Invisible amounts of fecal matter can end up in the pool.

Below you will find additional resources, organized by audience group (swimmers and parents, aquatics staff, and public health professionals), to help you learn more about preventing RWIs.

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Prevention Materials

Prevention materials are designed for different audiences to provide ideas and methods for potentially reducing the risk of spreading the germs that cause RWIs. These suggestions should reduce risk and lead to healthier swimming experiences for the general public.

All Audiences

• RWI Prevention Week

General Public (Swimmer Protection)

• Six Steps for Healthy Swimming Fact Sheet
  Six steps for protecting swimmers against recreational water illnesses (RWIs).
• Triple A’s of Healthy Swimming
  Information to help activist swimmers take the lead in preventing RWIs at their swimming facility.
• Pool User Tips Fact Sheet [PDF - 275 kb]
  Look; ask; act; practice...tips for preventing RWIs this summer when using the pool.
• Hot Tub User Tips Fact Sheet [PDF - 376 kb]
  Heed; observe; talk...tips for preventing RWIs when using the hot tub or spa.
• Pool and Spa (Hot Tub) Test Strips Home Test Instructions
  Instructions for using pool and hot tub/spa test strips at home.
• Inflatable and Plastic Pools (Kiddie Pools)
• Swim Diapers and Swim Pants
• Water Play Areas and Interactive Fountains
• Diarrhea and Swimming
• Pinworm and Swimming
• Resources and Publications (Brochures, Fact Sheets, Podcasts, Posters, Videos/TV)

Aquatics Staff

• Crypto Alert: Aquatics Staff [PDF - 65 kb]
• Twelve (12) Steps for Prevention of Recreational Water Illnesses
• Prevention Commentaries
• Your Disinfection Team: Chlorine and pH Fact Sheet
• Design and Operation of Pools and Hot Tubs
• Disinfection and Remediation of Pools and Hot Tubs
• Resources and Publications (Brochures, Fact Sheets, Podcasts, Posters, Videos/TV)
• Pool Operator Training
• Data and Statistics

Public Health Professionals

• Crypto Alert: Health Professionals [PDF - 71 kb]
• RWI Prevention and Response Tools for Public Health Professionals [formerly RWI Health Promotion Toolkit]
• Press Releases
• Prevention Commentaries
• Outbreak Response Toolkits
• Design and Operation of Pools and Hot Tubs
• Disinfection and Remediation of Pools and Hot Tubs
• Model Aquatic Health Code
• Resources and Publications (Brochures, Fact Sheets, Podcasts, Posters, Videos/TV)
• Pool-Spa Inspector Training
• Data and Statistics

Pediatricians and Healthcare Professionals

These articles were written to inform pediatricians about recreational water illnesses (RWIs). They also advise healthcare professionals to instruct parents to keep their children out of recreational water while they are ill with diarrhea.

• 
  Talk to Patients About Recreational Water Health Risks
  Medscape: CDC Expert Commentary
  (provided with permission by Medscape)
• Recreational Water Illness: What Every Clinician Needs to Know
  Clinician Outreach and Communication Activity (COCA) Podcast
  (Continuing Education Credits Available)
• Swimmer's Ear a Mild but Burdensome Illness
  (provided with permission by the American Academy of Pediatrics)
• CDC Dives into Swimmer's Ear Prevention
  (provided with permission by the American Academy of Otolaryngology - Head and Neck Surgery)
• Safe Swimming: Talk to Parents about Preventing Recreational Water Illnesses [PDF - 152 kb]
  (reprinted with permission from the American Academy of Pediatrics)
• Prevention of Recreational Water Illnesses (in Children) [PDF - 534 kb]
  (reprinted with permission from SLACK Incorporated)
• Hydrotherapy Tank and Pool Operation in Healthcare Facilities

Additional reference:

• Castor ML, Beach MJ. (2004). Reducing illness transmission from disinfected recreational water venues: Swimming, diarrhea, and the emergence of a new public health concern. Pediatric Infectious Disease Journal 23:866-870.

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