Report: Swimming-Related Disease Outbreaks Linked to Hotel Pools

A recent CDC report demonstrates that many swimming-related disease outbreaks occur at hotel pools or hot tubs.^1,2Healthcare professionals can play an important role in educating patients regarding healthy swim habits, and outbreak prevention strategies.

There have been 493 outbreaks associated with treated recreational water during 2000-2014, which caused at least 27,219 illnesses, and 8 deaths.²Outbreaks associated with pools and hot tubs are determined when similar illnesses occur in 2 or more individuals linked to the same location and time of exposure to pathogens or chemicals. Hotels were found to be the leading setting, associated with 157 (32%) of the outbreaks. About 50% of the outbreaks occurred June-August, the peak swimming season.²

The most common infectious cause (58%) of the outbreaks in pools, hot tubs, and water playgrounds wasCryptosporidium, which causes gastrointestinal adverse effects including diarrhea.²Cryptosporidiumsymptoms usually occur around 7 days after becoming infected, and generally include the following:

• Watery diarrhea
• Stomach pain
• Dehydration
• Nausea
• Vomiting
• Fever
• Weight loss

Educate patients to manage the diarrhea by drinking plenty of fluids to prevent dehydration. Oral rehydration solutions, such as Pedialyte® for infants and children, and Gatorade for adults, should be used to replenish electrolytes lost through diarrhea. Alinia (nitazoxanide) is FDA approved for the treatment of diarrhea caused byCryptosporidium.³Individuals with severe dehydration may need to be hospitalized and receive intravenous fluids.

Prevention is key to reduce the risk of pool-related outbreaks. Healthcare professionals can encourage parents to follow prevention strategies that include not swimming with diarrhea, checking teh pool inspection scores, and avoid swallowing water.¹

Additional prevention strategies, and more information about cryptosporidiumoutbreaks can be found atPharmacyTimes.com.

References

1. Centers for Disease Control and Prevention. 1 in 3 swimming-related disease outbreaks occur at hotels.www.cdc.gov/media/releases/2018/p0517-swimming-related-diseases.html. Accessed May 18, 2018.
2. Hlavsa MC, Cikesh BL, Roberts VA, et al. Outbreaks Associated with Treated Recreational Water-United States, 2000-2014.MMWR Morb Mortal Wkly Rep2018;67:547-551.DOI:http://dx.doi.org/10.15585/mmwr.mm6719a3.
3. Centers for Disease Control and Prevention. Parasites-Cryptosporidium.https://www.cdc.gov/parasites/crypto/. Accessed May 18, 2018.