YAKIMA, Wash. -- When summer temperatures rise, people cool off by diving in the local pool, swimming in a lake or river or camping outside, sometimes drinking water from a nearby stream.
While water recreation is fun, it comes with risks — some you may not realize.
“If you’re swimming where other people or animals are swimming or defecating, you run the risk of waterborne illnesses,” said Holly Myers, environmental health director at the Yakima Health District.
Waterborne illnesses can come from swallowing contaminated water while swimming or drinking untreated water during outdoor recreation.
Such illnesses include giardiasis and cryptosporidiosis, which are caused by swallowing water containing fecal matter contaminated with microscopic parasites. This can happen in natural waters such as lakes or rivers, or in pools, hot tubs and other man-made water features.
In 2016, 672 cases of giardiasis, more commonly known as beaver fever, and 131 cases of cryptosporidiosis, sometimes called crypto, were reported statewide, according to the state Department of Health. Yakima County reported 21 giardiasis cases and three cryptosporidiosis cases that same year.
Swimming in lakes, rivers or ponds also comes with the risk of skin infections.
“If it’s a natural body of water, there’s not a lot of control over what’s inside it,” said Krisandra Allen, epidemiologist with the state Department of Health.
Unbeknownst to swimmers, tiny fork-tailed wormlike parasites called schistosomes could be lurking in the water.
“It’s kind of fascinating,” Allen said. “Swimmer’s itch is caused by parasites that have a complicated life cycle involving snails.”
The parasites burrow beneath the skin, causing itchy red spots known as swimmer’s itch or cercarial dermatitis. They’re found in shallow bodies of water, lakes and waterways that have the right combination of snails, waterfowl and warm water to thrive.
Swimmer’s itch is widely reported around the Pacific Northwest during the summer when the weather is warm and more people are recreating in water, according to a Washington State University news release.
For summer swimming and other water recreation, here are six common waterborne illnesses and infections to watch out for:
■ GIARDIASIS. Giardiasis is caused by swallowing water contaminated with fecal matter containing the parasite Giardia, found in swimming pools, water parks, interactive fountains, water play areas, hot tubs, lakes, rivers, springs, ponds, streams and oceans. It can cause prolonged diarrhea for one to two weeks, abdominal pain, nausea, fatigue and weight loss. Children under age 5 are infected more frequently than adults. The illness can go away on its own or be treated with anti-protozoal medication.
■ CRYPTOSPORIDIOSIS. This is caused by swallowing water contaminated with fecal matter containing the parasite Cryptosporidium, found in swimming pools, water parks, interactive fountains, water play areas, hot tubs, lakes, rivers, springs, ponds, streams and oceans. It can cause prolonged diarrhea for one to two weeks, abdominal pain, nausea, vomiting, weight loss and fever. Young children, pregnant women and individuals with weakened immune systems are more likely to become seriously ill when infected. An anti-protozoal drug is available for persistent symptoms.
■ SWIMMER’S ITCH. Swimmer’s itch, or cercarial dermatitis, is caused by tiny wormlike parasites called schistosomes found in shallow bodies of water, lakes and waterways that have the right combination of snails, waterfowl and warm water to thrive. They penetrate human skin, causing itchy red spots, which don’t spread and aren’t contagious. The parasites die shortly after they gain access to the body. Itching can last anywhere from a few days to a few weeks. Children are most often affected because they tend to swim, wade and play in the shallow water more than adults. Treatments for symptoms include applying a cool compress, bathing in Epsom salts, rubbing on hydrocortisone cream or a homemade paste of water and baking soda. An antihistamine such as Benadryl also can relieve symptoms. Drying off with a towel immediately after leaving the water and, if possible, rinsing off in a shower is an easy way to help prevent swimmer’s itch. This can remove the parasites before they have a chance to penetrate the skin.
■ HOT TUB RASH. Hot tub rash is caused by swimming or sitting in poorly maintained hot tubs or spas contaminated by the germ Pseudomonas aeruginosa. Symptoms include itchy spots on the skin that become a bumpy red rash, and pus-filled blisters around hair follicles. Most rashes clear up in a few days without medical treatment.
■ SWIMMER’S EAR. Swimmer’s ear, or otitis externa, is an infection of the outer ear canal caused when water stays in the ear canal for long periods of time, allowing germs to grow and infect the skin. Symptoms include itchiness inside the ear, redness and swelling of the ear, pain when the infected ear is tugged or when pressure is placed on the ear, and pus draining from the infected ear. Swimmer’s ear is more common in children and can be extremely painful. It can be treated with antibiotic ear drops.
■ CAMPYLOBACTERIOSIS. Campylobacteriosis is caused by drinking contaminated and inadequately treated water containing Campylobacter bacteria. Symptoms include diarrhea, sometimes containing blood, abdominal pain, fatigue, fever and vomiting. Most people will recover without treatment; however, serious complications can occur. Those with weakened immune systems are at increased risk for infection. In 2016, 1,911 cases were reported statewide, including 142 in Yakima County, according to the state Department of Health.
Here are four less-common waterborne illnesses to watch out for:
■ LEGIONNAIRES’ DISEASE. Legionnaires’ disease, or Legionellosis, is caused by breathing in water droplets contaminated with Legionella bacteria in man-made water systems such as hot tubs and decorative fountains. Symptoms include cough, muscle aches, fever, shortness of breath and headache. People who are 50 years or older, current or former smokers, or those who have chronic lung disease or immunosuppression are especially at risk. Treatment is with antibiotics, and most people who get sick need care in a hospital but make a full recovery. However, about 1 out of 10 people who get Legionnaires’ disease will die from the infection, according to the Centers for Disease Control and Prevention. In 2016, 72 cases were reported statewide, with 10 deaths, according to the Department of Health.
■ NOROVIRUS. Norovirus is caused by swallowing water in lakes and natural bodies of water contaminated with the fecal matter or vomit of a person infected with norovirus. Symptoms include nausea, vomiting, diarrhea and stomach cramps. Most people with norovirus get better within one to three days. There is no specific medicine to treat people with norovirus.
■ E. COLI INFECTION. An E. coli infection can be caused by swallowing water while swimming in lakes or pools containing the bacteria. Symptoms include severe diarrhea and bloody stool. Most people get better within five to seven days, but some infections can be life-threatening.
■ SHIGELLOSIS. Shigellosis is a caused by swallowing water while swimming in lakes and rivers or drinking water that is contaminated with fecal matter containing Shigella bacteria. Symptoms include diarrhea (sometimes bloody), fever and stomach pain. People usually get better without antibiotic treatment in five to seven days. Health care providers may prescribe antibiotics for people with severe cases of shigellosis to help them get better faster.