Recreational Water Illnesses

The safety of recreational waters is affected by numerous variables such as the microbiological and chemical quality of water, the number and health conditions of the users, and the correct functioning of all technological installations used for water treatment. By evaluating the various health risks related to exposure to swimming pools, spas, and surface waters, this Special Issue seeks to address the proper management of waters used for recreational purposes, both in natural and built environments. This Issue contains 12 scientific papers. The first four, three of which are literature reviews, illustrate the epidemiological picture of infections related to recreational waters, by describing cases and outbreaks caused by both traditional and emerging microorganisms. The following four papers concern the microbiological monitoring of swimming pools, gardens, estuarine areas, and therapeutic spas. Two of these also analyse the distribution of antibiotic-resistant bacteria and the associated transmission risks. The relationship between microbial indicators and pathogens in recreational water is analysed by the following two papers, one of which is an experimental study on the survival of Salmonella and Escherichia coli in estuarine bank sediments and the other of which is an exhaustive literature review. The last two papers are focused on the development of risk control approaches, including the validation of questionnaire methods to quantify recreational water ingestion and the application of traditional and innovative technologies in water treatment.

This book is a printed edition of the Special Issue "Recreational Water Illnesses" that was published in IJERPH

Volume 4 of the NSPF Aquatic Management Series

Worldwide, the popularity of recreational activities which involve contact with water is continuing to grow. Moreover, ease of travel and change in human behaviour has altered the use of water for recreational purposes. Users should be aware that recreational exposures to pathogens may result in disease. Susceptible populations including people with reduced immune function (e.g., resulting from disease (cancer, HIV), genetic susceptibility, age, etc.) or lack of immunity to locally endemic diseases (e.g., tourists) may be at higher risk of contracting illnesses. In most cases the primary disease symptoms associated with recreational water contact are acute, such as diarrhoea and respiratory infections. Although less frequently reported, more serious and potentially fatal disease is a risk to recreational users of water especially in certain susceptible populations. In addition to diseases which have severe primary outcomes (e.g., primary amoebic meningoencephalitis, typhoid, leptospirosis), a number of infections may lead to sequelae with serious consequences including renal disease (from E. coli O157:H7 for example), cardiac and nutritional disorders. This is the first book to provide a comprehensive review and analysis of potential severe disease outcomes, including acute effects and sequelae, associated with recreational water activities. This book will be useful to all those concerned with recreational water quality, including environmental and public health professionals, local authorities, user groups, and tourists. Water Recreation and Disease sets out to identify the more severe waterborne diseases and their sequelae which may be acquired while undertaking water-based recreation in marine, freshwater, spas/whirlpools and swimming pools. The review systematically brings information together on the ecology and health aspects of a variety of pathogens where cases attributed to recreational use of water have been documented. This is the only available guide to bring together information on the more severe waterborne diseases to assist decision-making in recreational water management. About the author: Dr Kathy Pond, Robens Centre for Public and Environmental Health, University of Surrey, UK

Surveillance for waterborne disease and outbreaks associated with drinking water and water not intended for drinking-- United States, 2005-2006: "Problem/Condition: Since 1971, CDC, the U.S. Environmental Protection Agency (EPA), and the Council of State and Territorial Epidemiologists have maintained a collaborative Waterborne Disease and Outbreak Surveillance System (WBDOSS) for collecting and reporting data related to occurrences and causes of waterborne-disease outbreaks (WBDOs) and cases of waterborne disease. This surveillance system is the primary source of data concerning the scope and effects of waterborne disease in the United States. Reporting Period: Data presented summarize 28 WBDOs that occurred during January 2005-December 2006 and four previously unreported WBDOs that occurred during 1979-2002. Description of System: The surveillance system includes data on WBDOs associated with recreational water, drinking water, water not intended for drinking (WNID) (excluding recreational water), and water use of unknown intent. Public health departments in the states, territories, localities, and Freely Associated States (FAS) (i.e., the Republic of the Marshall Islands, the Federated States of Micronesia, and the Republic of Palau, formerly parts of the U.S.-administered Trust Territory of the Pacific Islands) are primarily responsible for detecting and investigating WBDOs and voluntarily reporting them to CDC by a standard form. Only cases and outbreaks associated with drinking water, WNID (excluding recreational water), and water of unknown intent (WUI) are summarized in this report. Cases and outbreaks associated with recreational water are reported in a separate Surveillance Summary."--Page 39

The new guidelines are meant to protect public health, help evaluate development projects near freshwater and recreational sites and assess potential health aspects of recreational projects.