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Publications, Data, & Statistics

Reports, recommendations, and other studies can be important resources for investigating and preventing waterborne disease outbreaks. Below are a list of published documents that focus on recreational water illnesses, organized by topic area. These documents appear in the Morbidity and Mortality Weekly Report (MMWR), Emerging Infectious Diseases (EID), Eurosurveillance, and other open-access publications.

Publication Highlight

MMWR logo

Hlavsa MC, Roellig DM, Seabolt MH, Kahler AM, Murphy JL, McKitt TK, Geeter EF, Dawsey R, Davidson SL, Kim TN, Tucker TH, Iverson SA, Garrett B, Fowle N, Collins J, Epperson G, Zusy S, Weiss JR, Komatsu K, Rodriguez E, Patterson JG, Sunenshine R, Taylor B, Cibulskas K, Denny L, Omura K, Tsorin B, Fullerton KE, Xiao L. Using molecular characterization to support investigations of aquatic facility–associated outbreaks of cryptosporidiosis — Alabama, Arizona, and Ohio, 2016. MMWR Morb Mortal Wkly Rep. 2017;66(19):493-7.

Publications

Disease & Outbreak Tracking

Listed below are reports of swimming-related disease outbreaks, swimming safety, and pool operation.

Prevention Commentaries

These commentaries were written to inform public health and healthcare professionals and aquatics staff about the need for action on building and supporting recreational water illness (RWI) prevention plans.

Diarrhea & Vomiting

Listed below are reports covering diarrhea-related topics, including disease outbreaks, swimming safety, and pool operation.

Skin, Ear, & Eye Illness

Listed below are reports related to skin, ear, and eye illnesses, including disease outbreaks, swimming safety, and pool operation.

Respiratory Illness

Listed below are reports related to respiratory illnesses, including disease outbreaks, swimming safety, and pool operation.

Neurologic Illness

Listed below are reports related to neurologic illnesses, including disease outbreaks, swimming safety, and pool operation.

Wound Infections

Listed below are reports related to wound infections, including disease outbreaks.

Other Illnesses

Listed below are reports related to other illnesses, including disease outbreaks, swimming safety, and pool operation.

Swimming Pool Operation & Disinfection

Listed below are reports related to swimming pool operation and disinfection.

Microbial Testing & Disinfection

Listed below are reports related to microbial testing and disinfection.

Swimming Pool Chemicals

Listed below are reports related to swimming pool chemicals.

Injuries & Outdoor Health

Listed below are reports related to injuries and outdoor health.

International Recreational Water

Listed below are reports related to international recreational water.

RWIs, Swimmer Hygiene, & Behavioral Science

Listed below are reports related to international RWIs and behavioral science.

Historical CDC Manuals

These manuals were developed by CDC during the 1950s, 1960s, 1970s and early 1980s. Much of the information in the manuals may still be helpful to aquatics staff, designers, and public health professionals. However, CDC’s Healthy Swimming and Model Aquatic Health Code websites have the most current information on water quality, disinfection, and operation for aquatic venues, thus superseding information found in these earlier manuals.

Suggested Health and Safety Guidelines for Recreational Water Slide Flumes (July 1981)

slide flumes

Message: Guidance to assist state and local health agencies develop practical water slide slume safety and health regulations.
Audience: State and local health agencies.

Document:

Suggested Health and Safety Guidelines for Recreational Water Slide Flumes (July 1981) [PDF – 28 pages]

Suggested Health and Safety Guidelines for Public Spas and Hot Tubs (April 1981, Revised January 1985)

Spas and hot tubs

Message: Guidance to assist state and local health agencies develop practical spa and hot tub safety and health regulations.
Audience: State and local health agencies.

Document:

Suggested Health and Safety Guidelines for Public Spas and Hot Tubs (April 1981, Revised January 1985) [PDF – 41 pages]

Swimming Pools: Safety and Disease Control through Proper Design and Operation (June 1976, Reprinted March 1988)

swimming pool design 1

Message: Information on design, construction, operation, maintenance, and the effect of each on disease control practices and safety procedures.
Audience: State and local health agencies.

Document:

Swimming Pools: Safety and Disease Control through Proper Design and Operation (June 1976, Reprinted March 1988) [PDF – 110 pages]

Swimming Pools and Natural Bathing Places: An Annotated Bibliography (1957-1966)

natural bathing places

Message: Construction and operation of swimming pools and outdoor bathing places.
Audience: State and local health agencies.

Document:

Swimming Pools and Natural Bathing Places: An Annotated Bibliography (1957-1966) [PDF – 61 pages]

Swimming Pools: Disease Control Through Proper Design and Operation (July 1959)

swimming pool design 2

Message: Guidance for the proper construction, operation, and maintenance of public swimming pools.
Audience: State and local health agencies.

Document:

Swimming Pools: Disease Control Through Proper Design and Operation (July 1959) [PDF – 156 pages]

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