Disease Transmission and Swimming Pools

Public Health Issues

Current epidemiologic evidence indicates that correctly constructed and operated swimming pools are not a major public health problem. They are preferable to bathing beaches because of the engineered controls designed into pools. Poorly designed or operated pools, however, can be major public health hazards.

Data from CDC between 1999 and 2000 show that 59 disease outbreaks from 23 states were attributed to recreational water exposure and affected an estimated 2,093 people. Of the 59 recreational outbreaks, 44 (74.6%) were of known infectious etiology. Of the 36 outbreaks involving gastroenteritis, 17 (47.2%) were caused by parasites; 9 (25.0%) by bacteria; 3 (8.3%) by viruses; 1 (2.8%) by a combination of parasites and bacteria, and the remaining 6 (16.7%) were of unknown cause. Of the 23 nongastroenteritis-related recreational outbreaks, seven were attributed to Pseudomonas aeruginosa, four to free-living amoebae, one to Leptospira species, one to Legionella species, and one to bromide. Sixteen of the 17 parasitic recreational water outbreaks involving gastroenteritis; nine (24.3%) were outbreaks of dermatitis; and six (16.2%) were caused by Cryptosporidium parvum.

The seventeenth outbreak was caused by Giardia lamblia (intestinalis). In 1999, an outbreak of Campylobacter jejuni was associated with a private pool that did not have continuous chlorine disinfection and reportedly had ducks swimming in the pool.

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