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Rec.Water Illness Prevention & Fecal Accidents

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For an Appointment or Information Call

Gerry Scott, R.S.
Program Manager
(216) 201-2000 ext 1259
gscott@ccbh.net
Vince Caraffi, RS, MPH
Supervisor
(216) 201-2000 ext 1209
vcaraffi@ccbh.net

The Cuyahoga County Board of Health makes every effort to assure that patrons of aquatic environments enjoy a safe, healthy experience. Our efforts include working with pool operators to help them gain an understanding of various aspects of the pool facility from water quality to safety. We consider ourselves to be a resource to pool operators and invite questions or concerns they may have. Another great resource in this area is the Centers for Communicable Disease and Prevention (CDC). The “healthy swimming” pages of their website include downloadable brochures and posters, as well as a wealth of information regarding swimming health issues.

Although swimmers do not intentionally drink swimming pool water, accidental ingestion of pool water must be assumed when dealing with disease prevention. It is for this reason that the required disinfection of pool water through chlorination or bromination has been aimed at achieving drinking water quality at swimming pools. In cases where an individual with diarrhea goes swimming in a pool, fecal matter containing harmful organisms may be introduced into the pool water. This water may be swallowed by other bathers before contact with the chlorinated water. The contact time necessary to kill such organisms in a properly sanitized pool is normally less than one minute. It is important to stress to parents that children who are ill in any way, particularly if they have diarrhea, must not be allowed to go swimming. This greatly minimizes the potential disease exposure to others in a pool.

Concerned pool operators may ask “What do I do if a child has a fecal accident in my pool?”

This can be a difficult problem to deal with, and responses are sometimes based more on emotion than fact. The action taken should be a measured response based on the facts at hand. Nearly all disease organisms will be killed in less than a minute if the proper levels of disinfectant are present and if the disinfectant has sufficient contact time with the organisms. However, fecal accidents involving diarrhea must be handled with caution. Cryptosporidiosis (Crypto) is a disease that spreads quickly in an aquatic environment and is very resistant to normal operating levels of chlorine or bromine. Since diarrhea is the primary symptom of Crypto, pool operators must close the pool to swimmers and superchlorinate (or hyperchlorinate) it based on the CDC guidelines (see below). You can click here to view a fact sheet on Crypto.

With these facts in mind, the Cuyahoga County Board of Health suggests the following steps be taken if it is discovered that a fecal accident has occurred in a pool or spa:

FORMED STOOL INCIDENTS:

  • Have all swimmers exit the pool or spa.
  • Use a net to remove all visible fecal material and properly dispose of it. VACUUMING IS NOT RECOMMENDED.
  • Measure the disinfectant and pH levels.
  • Add a sufficient amount of disinfectant to raise the level to 2 to 3 parts per million (ppm), making sure that a portion of the disinfectant is applied to the area where the fecal matter was discovered.
  • Allow swimmers to reenter the pool after approximately 30 minutes.

DIARRHEAL INCIDENT:

  • Have all swimmers exit the pool or spa.
  • Use a net to remove all visible fecal material and properly dispose of it. VACUUMING IS NOT RECOMMENDED.
  • Measure the disinfectant and pH levels.
  • If necessary, before attempting the hyperchlorination consult an aquatics professional to determine the feasibility, the most optimal and practical methods, and needed safety considerations.
  • Raise the free chlorine concentration to 20 ppm and maintain pH at 7.5 or less and a temperature of 77oF (25oC) or higher. The free chlorine and pH should remain at these levels for at least 12.75 hours to achieve the CT inactivation value of 15,300. Crypto CT inactivation values are based on killing 99.9% of Crypto. This level of Crypto inactivation cannot be reached in the presence of 50 ppm chlorine stabilizer, even after 24 hours at 40 ppm free chlorine, pH 6.5, and a temperature of 77oF (25oC). Extrapolation of these data suggest it would take approximately 30 hours to kill 99.9% of Crypto in the presence of 50 ppm or less cyanuric acid, 40 ppm free chlorine, pH 6.5, and a temperature of 77oF (25oC) or higher.
  • Confirm that the filtration system is operating while the water reaches, and is maintained, at the proper chlorine level for disinfection.
  • Backwash the filter after reaching the CT inactivation value. Be sure the effluent is discharged directly to waste and in accordance with state or local regulations. Do not return the backwash through the filter. Where appropriate, replace the filter media.
  • Allow swimmers back into the water only after the required CT inactivation value has been achieved and the free chlorine and pH levels have been returned to the normal operating range allowed by the state or local regulatory authority.

If you have multiple pools that use the same filtration system, all pools will have to be closed to swimmers. Do not allow anyone to enter the pool(s) until the disinfection process is completed.

More information on swimming pool diseases as well as other topics related to swimming safety may be found on the Centers for Disease Control (CDC) Healthy Swimming website.

The U.S. Consumer Product Safety Commission (CPSC) is charged with protecting the public from unreasonable risks of injury or death from thousands of types of consumer products, including those associated with pools and spas.  Information on pool and spa safety is available on the CPSC Pool Safely website.



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