Notice to Readers: Recreational Water Illness Prevention Week --- May 22--29, 2006

The second annual National Recreational Water Illness Prevention Week will be held May 22--29, 2006, at the start of the yearly swimming season, to raise awareness about the potential for spreading infectious diseases at swimming venues and to improve prevention efforts. An estimated 8.1 million swimming pools are in residential or public use in the United States (1). Each year, U.S. residents make an estimated 360 million visits to recreational water venues (e.g., swimming pools, spas, lakes, and oceans), making swimming the second-most popular physical activity (walking is first) in the country and the most popular among children (2). However, recreational water use also can be associated with drowning, injury, and the spread of infectious diseases.

Recreational water illnesses (RWIs) are spread by swallowing, breathing, or having contact with contaminated water from swimming pools, spas, lakes, rivers, or oceans (3). The most commonly reported RWI is diarrhea caused by pathogens such as Cryptosporidium, Giardia, Shigella, and Escherichia coli O157:H7. Children, pregnant women, and persons with compromised immune systems are at greatest risk for infection with these pathogens. Infection with Cryptosporidium can be life threatening in persons with weakened immune systems (4). Other RWIs can cause various symptoms, including skin, ear, eye, respiratory, and neurologic infections.

During 1984--2002, a steady increase in reported diarrheal RWI outbreaks in the United States resulted in approximately 19,000 illnesses (5). This increase is probably the result of a combination of increased water usage, improved outbreak detection, and increased disease transmission. The spread of RWIs is facilitated by the emergence of chlorine-resistant pathogens such as Cryptosporidium (5), poor pool maintenance (6), and low public awareness of the problem (7). Recommendations for public swimming pools include improved operation, training, and public education to protect swimmers from infectious disease transmission.

Public health agencies and officials are encouraged to become involved in Recreational Water Illness Prevention Week by engaging the public, local aquatic operators, and the media in prevention efforts. Suggestions on how to promote healthy swimming are available at http://www.cdc.gov/healthyswimming/tools.htm. Additional information for public health professionals, aquatics staff members, and the general public is available at http://www.cdc.gov/healthyswimming and http://www.cdc.gov/healthyswimming/rwi_prevention_week.htm.

References

1. Anonymous. United States swimming pool market, 2005. Pool and spa marketing reference directory. Markham, Canada: Hubbard Marketing & Publishing Limited; March 2005:19--21.
2. US Bureau of the Census. Statistical abstract of the United States: 1995. 115th ed. Washington, DC: US Bureau of the Census; 1995.
3. Castor ML, Beach MJ. Reducing illness transmission from disinfected recreational water venues: swimming, diarrhea, and the emergence of a new public health concern. Pediatr Infect Dis J 2004;23:866--70.
4. Chen XM, Keithly JS, Paya CV, LaRusso NF. Cryptosporidiosis. N Engl J Med 2002;346:1723--31.
5. Yoder J, Blackburn B, Levy DA, Craun GF, Calderon RL, Beach MJ. Surveillance for waterborne-disease outbreaks associated with recreational water---United States, 2001--2002. In: Surveillance Summaries, October 22, 2004. MMWR 2004;53(No. SS-8).
6. CDC. Surveillance data from swimming pool inspections: selected states and counties---United States, May--September 2002. MMWR 2003;52:513--6.
7. McClain J, Bernhardt JM, Beach MJ. Assessing parents' perception of children's risk for recreational water illnesses. Emerg Infect Dis 2005;11:670--6.

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Date last reviewed: 5/17/2006