A report from the CDC revealed there were 27,000 illnesses caused by almost 500 outbreaks in recreational water between 2000 and 2014.
And of all the outbreaks from waterborne germs between 2000 and 2014, one-third occurred in pools or hot tubs at hotels, the officials said.
Nearly half of the hotel outbreaks (41%) were associated with hot tubs and or spas.
The parasite Cryptosporidium and the bacteria Pseudomonas and Legionella cause most outbreaks that begin in swimming venues in the United States.
Legionella, the source of Legionnaires' disease, is another cause of waterborne diseases that led to six of the eight deaths the CDC reported. The number of respiratory disease outbreaks caused by Legionella increased over time and skin infection outbreaks caused by Pseudomonas decreased over time.
Among 363 outbreaks with confirmed etiology, the majority (58%) were caused by Cryptosporidium (which causes diarrhea and gastrointestinal illness).
Sixteen percent of outbreaks are caused by Legionella and 13 percent are caused by Pseudomonas, which cause hot tub rash and swimmer's ear. "Pools that use something called the model aquatic health code that CDC developed go beyond Chlorination", said Dr. Dorevitch. Pool operators need to maintain proper cleaning practices and disinfectant levels to prevent bacteria from growing and causing illnesses in swimmers.
Those most susceptible to Legionella include people aged 50 or older, current or former smokers, people with chronic lung disease and those with weakened immune systems. Swimmers and parents of young swimmers play an essential role in preventing Crypto outbreaks. These people should see a doctor right away if they develop pneumonia symptoms and let the doctor know about any possible exposures to Legionella, including recent hot tub use. If Crypto is the cause of the diarrhea, wait until 2 weeks after diarrhea has stopped to go swimming. The CDC recommends that swimmers and kids with diarrhea should stay out of public pools, such as hotels, for at least two weeks.
"Multiple factors contribute to Legionella and Pseudomonas growth in hot tubs/spas, including inadequate disinfectant concentration; warm (77°F-108°F [25°C-42°C]) water temperatures (which facilitate pathogen amplification and make it hard to maintain adequate disinfectant concentration); water aeration (which depletes halogens); and the presence of biofilm on wet venue surfaces, scale, and sediment", the authors wrote. A new report by the CDC warns that some infectious bacteria are resistant to chlorine.
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