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Where are Recreational Water Illnesses (RWIs) Found?

RWIs are caused by germs spread through contaminated water in swimming pools, water parks, water play areas, hot tubs, decorative water fountains, oceans, lakes, and rivers.

Swimming Pools, Water Parks, Water Play Areas

The most common RWI is diarrhea. Swallowing water that has been contaminated with feces containing germs can cause diarrheal illness.

Swimmers share the water -- and the germs in it -- with every person who enters the pool. On average, people have about 0.14 grams of feces on their bottoms which, when rinsed off, can contaminate recreational water. In addition, when someone is ill with diarrhea, their stool can contain millions of germs. This means that just one person with diarrhea can easily contaminate the water in a large pool or water park. People may not realize that although there is no standing water in interactive fountains/water play areas, the spray water will rinse any contaminants (for example, diarrhea, vomit, and dirt) down into the water holding area and be sprayed again. In other words, the water is recycled through the system.

Swallowing even a small amount of recreational water that has been contaminated with feces containing germs can make you sick.

To ensure that most germs are killed, check chlorine or other disinfectant levels and pH regularly as part of good pool operation.

Hot Tubs

Skin infections like "hot tub rash" are a common RWI spread through hot tubs and spas. Respiratory illnesses are also associated with the use of improperly maintained hot tubs.

The high water temperatures in most hot tubs make it hard to maintain the disinfectant levels needed to kill germs. That's why it's important to check disinfectant levels in hot tubs even more regularly than in swimming pools.

The germs that cause "hot tub rash" can also be spread in pools that do not have proper disinfectant levels and in natural bodies of water such as oceans, lakes, or rivers.

Decorative Water Fountains

Not all decorative fountains are chlorinated or filtered. Therefore, when people, especially diaper-aged children, play in the water, they can contaminate the water with fecal matter. Swallowing this contaminated water can then cause diarrheal illness.

Oceans, Lakes, and Rivers

Oceans, lakes, and rivers can be contaminated with germs from sewage spills, animal waste, water runoff following rainfall, fecal incidents, and germs rinsed off the bottoms of swimmers. It is important to avoid swallowing the water because natural recreational water is not disinfected. Avoid swimming after rainfalls or in areas identified as unsafe by health departments. Contact your state or local health department for water testing results in your area or go to EPA's beach site.

Return to Recreational Water Illnesses (RWI)

See what others are saying

Comment from: Sheri, 35-44 Female (Patient) Published: February 24

It doesn"t matter what type of public pool it is, chlorinated or not, I always get recreational water illness. I"m also unable to drink water from a tap; I have to boil all my water. I always end up with some type of stomach type virus. It starts out just not generally feeling well; then I feel sluggish with an upset stomach and end in diarrhea. Usually it lasts a few days but can last up to a couple of weeks. I have to avoid all public water places. Unfortunately I have just purchased a spa pool, and even with the correct chemicals I"m experiencing the same thing and it"s just me and my partner. Would love a pill to take prior to getting in the pools; that would be nice.

Was this comment helpful?Yes
Comment from: Miss b, 35-44 Female (Patient) Published: July 14

I developed a rash (recreational water illness) all over my body after going to Sesame Place.

Was this comment helpful?Yes

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