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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.
Anonymous. United States swimming pool market, 2005. Pool and spa marketing reference directory. Markham, Canada: Hubbard Marketing
& Publishing Limited; March 2005:19--21.
US Bureau of the Census. Statistical abstract of the United States: 1995. 115th ed. Washington, DC: US Bureau of the Census; 1995.
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.
Chen XM, Keithly JS, Paya CV, LaRusso NF. Cryptosporidiosis. N Engl J Med 2002;346:1723--31.
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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