Welcome everyone and thanks for joining to help us kick start Healthy and Safe
Swimming Week we are alive for the next 15 to 20 minutes to answer your
questions I'm Brittany Behm your moderator for today and I'm joined by
CDC expert Michele Hlavsa. She is chief of our Healthy Swimming Program here at
CDC. Last week CDC released new data that showed mixed progress in preventing
outbreaks linked to pools hot tubs and water playgrounds. Today we're going to
talk about some of these findings and also provide tips to avoid getting sick
from swimming this summer. Michelle can you first tell us about some of the key
findings from this report? So, big picture, there were almost 500 outbreaks
linked to pools hot tubs or spas or water playgrounds that were reported to
CDC for the years 2000 to 2014. When we looked at outbreaks by individual causes
we saw some outbreaks went up in numbers over the years, some went down and some
stabilized or stayed level. Hmm so what were some of the germs that were causing
illness? Well the top three causes were germs.
There's Cryptosporidium a parasite that causes diarrhea,
there's Legionella the bacteria that can cause a severe pneumonia known as
"legionnaires disease" and pseudomonas the bacteria that causes skin infections or
a rash and outer ear infection commonly known as swimmers ear. So how do people
get those germs from the pool? So there are different ways to get these germs
when swimming in a pool. for example, cryptosporidium you get when someone
who's infected with crypto-- "crypto" for short you know going into the pool,
having diarrhea in the pool and then other swimmers
unfortunately drinking that contaminated water what about those other bacteria. So
for legionella, it's about inhaling vapors, or mists, or
aerosols that contain the bacterium. For pseudomonas
it's about your skin coming in contact with contaminated water. What we see
often times with hot tub rash is the rash will look like the shape of the
bathing suit because the bathing suit is holding the contaminated water against
the skin. With swimmers ear, it's just water--
being you know, staying in the ear. Right. Are some people more likely to get these
type of diseases than other people? So young children who haven't been exposed
to certain germs before, pregnant women who have an altered immune system, and
older people who have an aging immune system, once they get infected might have
more severe symptoms. People with a weakened immune system if they get
crypto, they could have life-threatening symptoms and people who are fifty years
of age are older people who are cancer patients, people who have chronic
diseases, particularly chronic lung diseases or people who have a weakened
immune system they're more likely to get sick when infected with legionella.
So does chlorine not kill these types of germs in the pool?
Well levels that CDC recommends at levels at most state and local health
departments recommend most germs are killed within minutes. Crypto is a big
exception to this. Crypto can survive for days in a well maintained pool. Wow what
about the other ones? In and of themselves legionella and
pseudomonas are killed within minutes with chlorine just like most germs but
Legionella and Pseudomonas are really good about creating a biofilm around
themselves, or slimy layer that protects them for chlorine. So if the chlorine
level drops they build this biofilm they grow in the-- they grow on surfaces, and
then when the chlorine level comes back up, they're able to-- they're protected
from the chlorine. Is there any way for us to know whether there's biofilm in a
pool? Well the best way to check it out is to check the wall of the hot tub or
the spa where at the top of the water meets the wall if it's slimy there's a
biofilm there and then the pool hasn't or the hot tub has not been cleaned or
scrubbed recently enough. Mmm gross. I know my family and I are probably going
to go swimming a lot this summer; are there some benefits of swimming that you
can talk about? Well you just mentioned one, it's a great way to have fun with
family and friends but there's also the opportunity to get some physical
activity in we recommend two and a half hours at least of physical activity a
week. And why not make it water-based and fun? So let's get practical. What is
something we should all be doing before we get into the water? Before you
get into the water you can, well before you even consider getting in the water,
don't swim or get into the water or don't let your kids swim if sick with
diarrhea. We don't want to share that with anyone. Check your inspection score
before going to a public pool or hot tub or water playground by a "public pool". I
mean a pool that's not in someone's backyard where multiple families would
go kind of at a hotel, or water park, or your town pool. Your state or local
health department might post the inspection results on their website or
might require the pool or hot tub to post it at the waterside. We check
inspection scores before we go out to eat. We should be checking inspection
scores before we jump in the water. Right. What about those little test strips that
you can find some places? Well that's another step you can do before you get
and do your own mini inspection and you take the test strips and you check the
chlorine or bromine level before you get in and the pH. The pH is going to be
important because it's going to determine how effective the chlorine or
bromine are at killing germs in the water. Where can you get those strips? You
can go to a pool supply store or hardware store a big-box store. About a
hundred of them go for ten dollars. interesting. And, oh, sorry go ahead.
Oh, and I was gonna I was just gonna add, to let everyone know, what you can do is
you dip the strip in the water, and then compare the colors on the pads of the
strip to the colors on the bottle, and depending upon where the color is, that's
what chlorine level or bromine level you have and that's the pH you have in the
water. Interesting; seems easy. What about once we're in the pool, in the
water, what do we do? Well once you're in the water don't swallow the water you're
swimming in. If we have to tell people not to swim with diarrhea, we shouldn't
be drinking the water. And as far as parents of young swimmers, they should
remember not to put toys in the water that encouraged drinking that water. Also,
they should be taking their children on bathroom breaks every hour. And if they
have a little one that's still in diapers,
check that diaper every 30 or 60 minutes and change the diaper away from the
water. Good advice. I have a five-year-old daughter and we're going to be doing
water playgrounds this summer. Is there any specific advice for water
playgrounds? The most important piece of advice specific to water playgrounds is
don't sit on the jets. That is recycled water in many water playgrounds. So what
we're basically doing when we sit on jets is we're rinsing off our bottoms.
We're rinsing out that diaper and then sharing that water. So stay off the jets.
Okay. Good advice. So we're going to take some questions from live from Facebook
right now. Be sure to ask a question online. Our first question comes from
Louise, "I swim year-round in a public pool. I wear goggles.
What other personal protective equipment is there?" I think the most important
thing you can do is to do your own inspection before getting in the water.
Using those pool test strips to make sure the chlorine is where it needs to
be, or bromine, and make sure the pH is where it needs to be. That's the most
important step you can take before getting in. Okay, great.
And another question from Mary do we have any recommendation on the best type
of test strips to use? My number one recommendation with test strips is to
follow the manufacturers directions. Make sure that you hold the test strip the
way you're supposed to. O,kay got it. And we have another one that asks
about clothes or bracelets that change color or indicate somehow that the water
has been contaminated. Do we have any technology that-- do we know of
anything like that that has clothing or bracelets that change color based on
water contamination? I wish we did. Yeah. But unfortunately, no. I mean, even there's
that urban legend that there's a special chemical in the pool that changes color
when someone pees in the pool, unfortunately that doesn't exist. Gotcha;
okay. What about like free-living amoeba, is that ever an issue in in swimming
pools? Naegleria fowleri or --which is
commonly known as a brain-eating ameba should not be an issue in a
well-maintained pool. Okay great. And what about this something I always
think about the red eye we get in the pool what's that from? A lot of people
think that's chlorine, but actually, that's chlorine mixed with what we
swimmers bring into the water so if we pee in the water, if we don't shower
before we get in the water, we bring stuff into the pool that mixes with
chlorine forms an irritant, and that's actually
what's making our eyes red, not the chlorine in and of itself. Interesting. We
have a question from Andrea Nicole, "is it worthwhile to use a test strip in a
spray park?" Definitely. Spray parks are where the jets are shooting water up out
of the concrete basically. And when you shoot that water up you're
introducing air into the water and you're depleting the chlorine or the
bromine in the water. So it's harder to maintain the disinfectant level in the
water. So I would be especially careful to change --to check the water in there;
that and you also have little kids in the water, and those kids are, you know,
bringing their germs into the water, and they're drinking the water, so-- Well,
speaking of kids, what do you think about swim diapers? Do they work to prevent
some of this illness? Not exactly. Germs can be slowed down in terms of
what swim diapers are able to do. They're able to contain solid poop, you know,
within the diaper first a set amount of time. Right. But when they've conducted
studies looking at swim diapers, within minutes, germs are getting out of those
swim diapers. If water's getting in it's getting out unfortunately. Right. Well
what about pee? Is pee just as bad as poop in the water? Pee brings its own problems,
different problems into the pool. So I mentioned earlier when pee mixes with
chlorine it forms an irritant and makes your eyes red. What it's also doing is
that it's using up the chlorine that would otherwise kill germs. Gotcha; okay.
What about if there's like leaves and bugs in the pool, does that mean that
it's not a well-maintained pool and should we be concerned about that? My
concern with with stuff in the water like leaves and bugs would be that the
chlorine is being used up. The chlorine is interacting with the leaves and with
the bugs and there's less chlorine to kill germs in the pool. Right. We have a
question from Louise about parts per million of chlorine and pools what's the
safe level for chlorine? So we at CDC recommend at least one part per million
of free available chlorine in water and that's the form of the chlorine that
kills germs. And we recommend that for pools and for water playgrounds. For hot
tubs we recommend at least three parts per million. Gotcha; thanks. So
what is CDC doing in general to help prevent some of these water related
outbreaks? So what we've done is we've done studies looking at how we get-- how
we kill cryptosporidium. If the levels that we normally keep chlorine at aren't
working how are we going to prevent crypto from spreading and causing
infections and outbreaks? And so we did a study to look at how best to kill chlorine--
to kill crypto. And we found that you know raising the chlorine level to a
much higher level for a really long period of time when there's no swimmers
in the water is a is the best way to deal with it once it's in the water. But
of course, the main message is, "Don't swim with diarrhea. Keep it out of the water
in the first place." Gotcha. I know we're talking about
disease today but what about drowning and other injuries? Are there things we
should be on the lookout lookout at the pool for preventing drowning? The best
way to prevent drowning is to learn how to swim. And if you're a parent of a
young swimmer, stay close to the young swimmer and pay close attention to
that young swimmer. Put that phone down. You know the smartphone can wait till
later, the texting and all that, because people drown and they drown quietly and
quickly. Right. What about athletes foot? Is that ever a problem in pools? With
athlete's foot I'd be more worried about keeping the flip-flops on in the locker
room and while showering. Got it. How about are there any ways, tips to not
be distracted around the pool? Like if you're watching your kids--ya know. Get
rid of that put that smartphone down. I think that's the number one way make
sure you're paying close attention to your little one you're close by. Gotcha.
We have another question from Alexander. "Do you know how dirty our local ocean
beach is," so any way to determine if your beach is-- kind of has dirty contaminants
in it? So our ocean beaches should be monitored for their water quality. And
some beaches have chosen to post their scores online, much like we post
inspections online. If there is something wrong with the water quality, there
should be a sign posted on the beach saying, you know, "The beach is closed to
swimmers due to water quality," or something to that extent. Gotcha. Are
there any policies about, you know, laws or ordinances, and where places have--
where people have to shower before going into the pool; like are they required to
do, or is it just a recommendation? It depends on what what your community
requires. Some communities require signs to be posted. I know at my gym there's a
big sign before you you exit the door to the pool area saying you need to shower.
And the lifeguards actually sends you back into the back into the locker room
if you're not wet. Interesting, okay. Well I think we are about done for today.
Michelle I really appreciate you being here. Is there anything else you'd like
to tell everyone? I encourage everyone to go swimming this year and especially
this summer but just do it in a healthier and safer way. Thank you so
much. Well thank you all for joining us today, and for your great questions. If we
didn't get to any of your questions we'll respond as soon as possible today.
Have a healthy and safe summer everyone.