//fpnotebook.com/
Waterborne Illness
Aka: Waterborne Illness, Recreational Waterborne Illness, Water-borne Diarrheal Infection, Water-borne Transmission, Swimming Related Illness
- See Also
- Foodborne Illness
- Infectious Diarrhea Causes
- Diarrhea
- Traveler's Diarrhea
- Gastrointestinal Disease in Returning Traveler
- Vector Borne Disease
- Pet-Borne Infection
- Fever in the Returning Traveler
- Marine Injury
- Skin Infection
- Risk Factors
- Travel to endemic areas of Waterborne Illness
- Hiking in wilderness areas (especially drinking from mountain streams)
- Public pools
- Hot Tubs
- Ingested water
- Untreated water
- Unpasteurized dairy products
- Precautions
- Chlorination does not completely eliminate the risk of waterborne infection
- Cryptosporidium can survive 10 days in water at CDC recommended levels of chlorination and pH
- Giardia oocysts can survive in chlorinated swimming pools and hot tubs
- Adenovirus (strains 4 and 7) is commonly associated with swimming pool related Diarrheal outbreaks
- Causes: Waterborne Diarrheal infection
- Bacteria
- Escherichia coli (rapid onset 12-72 hours)
- Nontyphoidal Salmonella (rapid onset 12-36 hours)
- Shigella (Intermediate onset 1-3 days)
- Yersinia enterocolitica (slow onset 3-7 days)
- Campylobacter jejuni (Intermediate onset 3-5 days)
- Leptospira (onset delayed 4-19 days)
- Brucellosis
- Vibrio Cholera
- Aeromonas
- Virus
- Hepatitis A (delayed onset 15 to 50 days)
- Norovirus (rapid onset 12-48 hours)
- Adenovirus
- Rotavirus
- Protozoa
- Giardia (Onset delayed 5-25 days)
- Giardia lamblia
- Giardia intestinalis
- Cryptosporidium parvum (Onset delayed 2-10 days)
- Entamoeba histolytica (Amebiasis)
- Other
- Algae bloom (cytotoxin mediated)
- Causes: Swimming Related Illness
- Gastrointestinal Illness
- See above
- Giardia lamblia or intestinalis (Onset delayed 5-25 days, common)
- Cryptosporidium parvum (Onset delayed 2-10 days, common)
- Leptospira (onset delayed 4-19 days)
- Escherichia coli (rapid onset 12-72 hours)
- Hepatitis A (delayed onset 15 to 50 days)
- Norovirus (rapid onset 12-48 hours)
- Adenovirus
- Rotavirus
- Algae bloom (cytotoxin mediated)
- Respiratory Illness
- Legionella
- Legionella pneumonia
- Pontiac Fever (Influenza-like illness)
- Chemical Pneumonitis (Chlorine gas)
- Acute Otitis Externa (Swimmer's Itch)
- Sinusitis
- Sinus symptoms in 40% of swimmers (but resolves spontaneously in nearly all)
- Serious infections are rare (e.g. Primary Amebic Meningoencephalitis, Vibrio alginolyticus)
- Neurologic Illness
- Primary Amebic Meningoencephalitis (rare, Naegleria fowleri Sinusitis complication)
- Skin or soft tissue infection
- Swimmer's Itch (Cercarial Dermatitis, schistosome mediated)
- Hot Tub Folliculitis (Pseudomonas aeruginosa)
- Cellulitis
- Typical Bacterial Cellulitis (Staphylococcus, Streptococcus)
- Aeromonas Hydrophila
- Pseudomonas aeruginosa
- Mycobacterium marinum (Nodular Lymphangitis)
- Vibrio vulnificus (risk of Necrotizing Fasciitis)
- Prevention
- See Water Disinfection
- See Prevention of Waterborne Illness
- References
- Barr (2014) Am Fam Physician 89(3): 180-9 [PubMed]
- Perkins (2017) Am Fam Physician 95(9):554-60 [PubMed]
- Scallen (2011) Emerg Infect Dis 17(1): 7-15 [PubMed]