Be aware: some surface water can make you sick

Be aware: some surface water can make you sick


Just about everyone can remember a time when a quick jump into the lake ended with water going up their nose. Or, a time when a dive into the pool resulted in a large gulp of pool water.  Whether it’s freshwater or chlorinated, pathogens in surface water can make you ill, putting a quick stop to summer fun. Fortunately, there are things you can do to reduce the chance of illness while still enjoying the water.

Recreational water illnesses can cause a wide range of problems, from gastrointestinal ailments to infections of the skin, ears, respiratory system, eyes or nerves.

While chlorine in a swimming pool does kill some germs, it does not kill all. Some, according to the CDC, are tolerant to chlorine. Swallowing just a little water can make you sick. The CDC notes that cryptosporidium (commonly referred to as crypto), a microscopic parasite, is the leading cause of waterborne disease in the U.S. It can survive in swimming pools for several days – even if those pools are well-maintained.

While chlorine is not a cure-all for waterborne contaminants, it does help kill many types of harmful organisms found in pools and water play areas.

Skin infections are another side effect of germs that can be found in a wide variety of locations, ranging from pools and hot tubs to lakes, rivers and even the ocean. Natural water bodies can be contaminated by sewage spills, animal waste and contaminants spread by runoff during rainfall. Because natural water is not disinfected unless it is filtered by water treatment plants, swallowing water from a lake or river can cause a variety of illnesses.


E. Coli

A bacteria found in the intestines of people and warm-blooded animals, E.Coli pollutes water via waste material such a feces.

The organism can cause gastrointestinal distress and symptoms such as nausea, severe diarrhea and abdominal cramps. The infection usually runs its course in healthy adults within a week. Young children and the elderly are more at risk, and in some cases can develop life-threatening kidney failure.

Swallowing surface water during recreation or drinking untreated water are the most common ways to become infected, but the bacteria can also be spread through contaminated food.

Key to recovery is getting rest and drinking plenty of fluids. However, doctors say that people suffering from an E. Coli infection should avoid anti-diarrheal medication, which can slow the digestive process and the ability for the body to more quickly eliminate toxins.


Caused by parasites called Giardia, these organisms infect the small intestine. Typically, the organism is spread through contaminated food and water. Symptoms include diarrhea, nausea and abdominal cramps.

The CDC notes that this organism is the source of one of the most common waterborne diseases. Infections can sometimes last for weeks. Medication can help combat these parasites, but prevention – but making sure you do not drink contaminated water or eat contaminated food, is the best way to deal with this threat.



Another tiny organism that inhabits the intestines of warm-blooded animals, this parasite spreads through fecal contamination of water. People who are otherwise healthy can suffer symptoms such as diarrhea, vomiting, fever and dehydration. For those with weakened immune systems, the organism can be deadly.

One of the difficulties in treating Cryptosporidium is that it is resistant to chlorine treatment. As with other harmful organisms, preventing infection is the best way to deal with it.  Those who are infected may have symptoms lasting from two to four weeks, but some who are infected do not suffer any illness.


Frequently referred to as “hot tub rash,” this illness occurs when contaminated water is in contact with someone’s skin for a prolonged period. The Pseudomonas germ can cause itchy red rashes on the skin, including areas covered by your swimsuit. It can also result in pus-filled blisters near hair follicles.

The CDC notes that this rash usually improves in a few days, but you should seek medical help for rashes that last longer.


The Shigella bacteria causes an infection which often results in diarrhea, fever and stomach cramps. This usually happens within two days of a person being exposed. The illness usually lasts five to seven days. Some people who are infected do not become sick but can pass the bacteria to others. Frequent handwashing with soap can help stop the spread of this disease.


Legionnaires’ Disease and Pontiac Fever are two of the illnesses caused by this bacteria. The CDC notes that infection results from people breathing in mist or swallowing water contaminated with the Legionella bacteria, and adds that most people exposed to this organism do not get sick. Those age 50 or older, current or former smokers and those with weakened immune systems are more susceptible to infection.

Symptoms of Legionnaires Disease include coughing, shortness of breath, fever, muscle aches and headaches. Other effects include diarrhea, nausea and confusion. Symptoms usually start between two and 10 days after exposure.

Those who develop pneumonia symptoms should seek medical attention without delay. Be sure to mention that you might have been exposed to legionella, have used a hot tub, been away from home or spent recent time in a hospital.

Pontiac Fever symptoms include fever and muscle aches. This is considered to be a milder illness than Legionnaires’ Disease. Symptoms usually begin within three days of exposure and usually last a week or less. Those suffering from Pontiac Fever, unlike Legionnaires’ Disease, do not get pneumonia.



This disease is caused by a bacteria spread through the urine or saliva of infected animals, which the CDC says can sometimes survive in water or soil for months. Symptoms can include high fever, headache, chills, muscle aches, vomiting, yellow skin and eyes, red eyes, abdominal pain, diarrhea and rash. Patients sometimes recover from the illness only to relapse. The second phase of the illness, if it does occur is more severe. The CDC notes that the second phase can result in kidney failure, liver failure or meningitis.

This disease initially lasts at least a few days and as long as three weeks. Pets infected may also show symptoms, but some infected animals display no symptoms.


One of the most dangerous threats – although rare – are Naegleria fowleri, a type of ameba which causes a usually fatal disease called Primary Amebic Meningoencephalitis (PAM). From 1962 to 2016, a total of 143 people are known to have contracted PAM, and only four have survived, according to the CDC. Three of those survivors have been since 2013, as people have become more aware of the disease, diagnosis is made earlier and treatment options have improved. People are infected when the ameba enters their nasal passage and travels to the brain. Symptoms begin one to nine days after infection (most commonly at the five-day mark), and death often occurs within one-18 days later.

Those who have been swimming in a pond, lake or stream and who show symptoms such as severe frontal headache, fever, nausea, vomiting, stiff neck, seizures, altered mental status, or hallucinations should seek immediate medical attention. Because this disease is rare, be sure to alert the doctor and nurse where you have been swimming, and that you are concerned about the possibility of PAM.

The PAM infection occurs when the amoeba makes its way through the nasal passage into the brain and spinal cord, destroying brain tissue. Often mistaken for the flu or meningitis, symptoms of the infection include severe headache, high fever, stiff neck, nausea, vomiting, seizures and hallucinations as the condition worsens. Those infected usually succumb to the disease within a week.

PAM cannot be spread through drinking water or person-to-person. Swimming pools and hot tubs that are properly cleaned, maintained and chlorinated are generally safe, as is salt water.

Officials recommend that those taking part in warm, freshwater-related activities use nose clips or hold their noses shut while jumping into water or doing other activities where untreated water might get forced up the nose. With the ameba often found in soil, it is best to avoid stirring up underwater sediment. If infection is suspected, emergency medical care should be sought immediately.


Staying healthy

Here are suggestions from the CDC on the best ways to avoid becoming sick because of waterborne organisms.

  • Avoid swallowing surface water when swimming or enjoying other forms of recreation.
  • Use nose clips to prevent water from going up your nose when swimming.
  • Stay away from stagnant water.
  • Be sure to obey all signs that prohibit swimming in certain areas. These are posted for your safety.
  • If you are camping or canoeing near surface water, do not drink that water or use it to wash foods unless you first boil and cool this water. There are filters, iodine tablets and chlorine which can eliminate some organisms, but others can only be killed by heat from boiling.
  • Avoid swimming or allowing children to swim if you or they have recently been sick or have had diarrhea. This can allow germs to spread and infect others.
  • Good hygiene – including thoroughly washing your hands after using the toilet or changing diapers – is crucial. Also, you can help keep the water clean by hosing off or showering before swimming. Taking a shower after swimming can help remove any germs that may have attached to you.
  • Be sure to take frequent bathroom breaks when swimming – especially for children. Make sure that young children wear a swim diaper.

If you have been swimming and become ill, sick medical treatment to help shorten the time you are sick and to alleviate the symptoms.

More information on waterborne illnesses can be found here.