Preventing Recreational Water Illnesses (RWIs)

When swimming or taking part in water-related activities, you share the water (and germs!) with everyone. Recreational water illnesses (RWIs) are illnesses caused by germs and chemicals found in the water where we swim or participate in other water-related activities. These illnesses are spread by swallowing or having contact with contaminated water. The most common symptoms of RWIs include diarrhea, vomiting, stomach cramps, and fever. RWIs can also cause skin, ear, eye, respiratory, or neurologic symptoms. Learn what you can do to prevent RWIs.

On this page:
Staying Healthy at the Pool, Hot Tub, Splash Pad, and Water Park
Staying Healthy at the Beach and Lake 
Additional Information about RWIs

Staying Healthy at the Pool, Hot Tub, Splash Pad, and Water Park

Preventing Diarrheal Illnesses:
Pools, hot tubs, splash pads, and water parks can easily be contaminated by a person with diarrhea. Swimmers get ill by swallowing contaminated water. Chlorine doesn't kill germs instantly which means germs can spread even in properly maintained pools, splash pads, or water parks. Each of us needs to do our part to help keep ourselves, our families, and our friends healthy!

To help protect yourself and other swimmers:

• Stay out of the water if you have diarrhea.
• Don't swallow the water.
• Shower before and after swimming.

Parents and caregivers of young children should also:

• Take children on frequent bathroom breaks when swimming – waiting to hear “I have to go” may mean that it's already too late!
• Change diapers in changing rooms, not poolside. Wash your hands and the child’s hands after changing diapers.

Preventing Other Types of RWIs:
Recreational water can also cause a wide variety of infections, including skin, ear, respiratory, eye, and wound infections.

To help reduce the risk of hot tub rash (Pseudomonas dermatitis/folliculitis):

• Remove your swimsuit and shower with soap after getting out of the water.
• Clean your swimsuit after getting out of the water.

To reduce the risk of swimmer's ear (otitis externa):

• Keep your ears as dry as possible by using a bathing cap, ear plugs, or custom-fitted swim molds when swimming.
• Dry your ears thoroughly after swimming or showering.
• Don't put objects in your ear canal (including cotton-tip swabs, pencils, paperclips, or fingers).
• Don't try to remove ear wax. Ear wax helps protect your ear canal from infection.
• Consult your healthcare provider about using ear drops after swimming.

Maintenance Issues:
Pools, hot tubs, splash pads, and water parks with improper disinfectant and pH levels are more likely to spread germs. Check with the pool operator to make sure pool chemical levels are being checked regularly.

Do NOT use a facility if you notice the following conditions:

• Strong chlorine smell. You are probably smelling chemical irritants called chloramines (CDC: Preventing Eye Irritation from Pool Chemicals).
• Cloudy water or you can't see the bottom of the pool.
• Foam or a scum line around the pool or hot tub.

These are signs of a maintenance problem. Notify the pool operator, maintenance person, or lifeguard immediately.

Staying Healthy at the Beach and Lake

Swimmers at monitored beaches should look for beach advisory signs before they go in the water. If advisory signs are posted, officials have determined there is an increased risk of getting sick and swimming and wading are not recommended.

While beach monitoring results can provide a snapshot of the water quality at the beach, water conditions can change rapidly and test results are not always representative of the current water conditions. Swimmers at monitored and non-monitored beaches should always follow the advice below to reduce their risk of getting sick.

To minimize the risk of illness:

• Don't swallow the water.
• Shower before and after swimming.
• Avoid swimming after a rain event. Rain can wash contaminants from the land, like septic tank overflows or animal feces, into the water.
• Avoid swimming at beaches where you can see discharge pipes.
• Avoid swimming if you see a blue-green algal bloom.
• Take steps to prevent swimmer's itch and swimmer's ear.

To help keep the water healthy for everyone:

• Stay out of the water if you have diarrhea.
• Shower before swimming.
• Take children on frequent bathroom breaks when swimming – waiting to hear “I have to go” may mean that it's already too late!
• Change diapers frequently and away from the water. Wash your hands and the child's hands after changing diapers.
• Dispose of trash, animal waste, and boat waste properly.
• Maintain septic systems.
• Don't encourage water fowl by feeding ducks, geese, seagulls, or other birds.

Beach goers should also be aware of Naegleria fowleri, an amoeba commonly found in freshwater and soil. It causes a very rare but nearly always fatal brain infection. The organism infects people by entering the body through the nose. Generally, this occurs when people use warm freshwater for activities such as swimming and diving.

The only sure way to prevent infection from Naegleria is to avoid participation in freshwater-related activities. To reduce your risk you can:

• Avoid warm freshwater when the water temperature is high and the water level is low.
• Avoid putting your head under water.
• Hold your nose shut or use nose clips.
• Avoid digging or stirring up the sediment in shallow, warm freshwater areas.

Additional Information about RWIs

• CDC: Preventing Swimming-related Illnesses
  Learn where RWIs are found, how they are spread, and how to prevent them.
  
   
• CDC: What You Can Do to Stay Healthy in Hot Tubs
  Information for pool and hot tub users to protect themselves from recreational water illnesses.
   
• Information for Recreational Water Employees and Managers
  Managers and aquatic employees play an important role in keeping the water safe and healthy for everyone. 
  
   
• CDC: Swim Diapers and Swim Pants
  Swim diapers may give parents and recreational water facility operators a false sense of security. They are not leak-proof and can still contaminate the water. Swim diapers are not a solution for a child with diarrhea or a substitute for frequent diaper-changing. 
  
   
• CDC: What You Can Do to Stay Healthy in Inflatable and Plastic Pools (Kiddie Pools)
  Information about what to do before, during, and after using kiddie pools. Kiddie pools can spread illness and should not be used in child care settings.
• Wading Pool Safety for Parents
  Frequently asked questions about wading pool safety.