The risk of contracting infectious diseases in public swimming pools. A review

Abstract

Summary.A review of pathogenic microorganisms presenting risk of infection in pool based artificial recreational water venues is extracted from the available scientific literature. The microorganisms are grouped both according to their way of spread and their survival and growth strategies and their characteristics relevant for the pool and spa based recreation are discussed. In order to put the proposed risks on a solid basis, among others a ten year excerpt of the waterborne disease statistics of the Centers for Disease Control and Prevention (CDC) is used throughout the article.Key words: man-made water recreational environment, risk of infection, waterborne disease outbreaks, swimming pool, hot tub.Riassunto (Il rischio di contrarre malattie infettive nelle piscine pubbliche. Una rassegna). Viene presentata una sintesi della letteratura scientifica disponibile sui microorganismi patogeni potenzialmente infettivi, in ambienti acquatici ricreativi artificiali, come le piscine. I microorganismi sono raggruppati sia in base alle loro vie di diffusione che in base alle loro strategie di sopravvivenza e di crescita; successivamente vengono discusse le loro caratteristiche più importanti negli ambienti ricreativi considerati, piscine e terme. Per fornire adeguate e solide basi scientifiche ai tipi di rischi presentati, vengono analizzate, oltre ad altri documenti, le statistiche relative a dieci anni di osservazione di malattie legate all'acqua del Centers for Disease Control and Prevention (CDC).Parole chiave: ambienti ricreativi acquatici artificiali, rischio di infezione, epidemie di malattie legate all'acqua, piscine, vasche da idromassaggio.

Should we advise patients with sutures not to swim?

“…9 Reported infections from marine 10 and fresh water pathogens 6 are predominantly caused by injury sustained within the water or from pre-existing wounds that have not been sutured. 10 Evidence to help in the quantification of the risk of aquatic microbes entering the skin through an adequately closed wound is lacking.…”

“…10 The range of comorbidities that might influence the risk of infection are diffuse, including those that influence local conditions in the skin (for example, eczema) and systemic immunodeficiency (for example, diabetes mellitus). 9 Certain immunodeficiencies are associated with a particular predisposition to infection with aquatic pathogens (for example, iron overload) and infections with Vibrio, 13 cellular immunodeficiency (such as chronic granulomatous disease), and mycobacterial infections. 9 Aquatic derived wound infections are rare but can be devastating, resulting in severe illness, septicaemia, limb amputation, or death.…”

“…9 Certain immunodeficiencies are associated with a particular predisposition to infection with aquatic pathogens (for example, iron overload) and infections with Vibrio, 13 cellular immunodeficiency (such as chronic granulomatous disease), and mycobacterial infections. 9 Aquatic derived wound infections are rare but can be devastating, resulting in severe illness, septicaemia, limb amputation, or death. 5 Evidence to help in the quantification of this risk for patients with comorbidities is lacking.…”

Adenovirus inactivation by in situ photocatalytically and photoelectrocatalytically generated halogen viricides

“…These works have revealed the virucidal effect of PC processes at nanostructured TiO 2 on the inactivation of different viruses, including phage MS2, phage PL-1, and bacteriophage Qb [3,15,16]. Nevertheless, PC inactivation of adenovirus has not been previously attempted, despite being indicated in the ''Drinking Water Contaminant Candidate List'' [17] because of their prevalent potential health risks and important role for water epidemiology [18][19][20]. Moreover, adenoviruses are highly resistant to common treatments when compared to other viral pathogens of concern in wastewater and drinking water [21,22], due to their DNA's double-stranded nature [23].…”

Survival of Viruses in Water

“…Together with other enteric viruses, they are one of the main causes of diarrhea, which has been ranked as the world's leading cause of mortality in children under 5 years of age. Other frequently reported human pathogens associated with water transmission include adenovirus, rotavirus (responsible for 527,000 deaths of children under 5 years of age in 2004 [5]), and hepatitis A virus, along with a number of other enteric viruses, such as coxsackievirus, echovirus, reovirus, astrovirus, etc. Influenza viruses or other viruses linked to aquatic animals or plants are also transmitted through water.…”