PM Pediatrics
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Dr. Christina Johns
Senior Medical Advisor, PM Pediatrics

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3 water illnesses you might not have thought of yet with illustration waves

3 Water Illnesses You Might Not Have Thought of Yet

I’m not sure if you saw last week’s “Healthy and Safe Swimming Week” campaign from the CDC , but it was awesome.

In an attempt to raise awareness about pool contamination, they made several clever infographics like this:

CDC image stating "it only takes 1 person with diarrhea to contaminate the pool" visit cdc.gov/healthyswimming for more information

And this:

CDC image stating "it only takes 1 person with diarrhea to contaminate the pool" visit cdc.gov/healthyswimming for more information

Aren’t these fantastic? They really get the important message across that it only takes ONE person to contaminate the water and potentially get many people sick.

The campaign further publicized the importance of regular public pool inspections and pool chemical safety as well. Useful information, and a slightly different thread from the current running topics of drowning prevention and general pool safety such as touch supervision and using US Coast Guard approved personal flotation devices, etc. All important stuff.

This campaign really got me thinking about some of the other aspects of water safety, like skin reactions and infections, and while I’m not sure I have a bunch of clever slogans at the ready, what I can do is put together a little more news you can use as you enjoy the water this summer.

illustration of waves

First, I’m going to call out the “flesh eating bacteria” that gets some press each year, and with good reason.

This skin infection, although rare, can be quite serious and is due to invasion of the skin layers by a class of bacteria that live in sea water called Vibrio vulnificus. The most common point of entry is by eating raw or undercooked shellfish, particularly oysters, but the infection can also be transmitted when the bacteria invades the skin through a scratch, cut, or other interruption of that protective layer. People most at risk are those with a weakened immune system, but anyone with an open wound should either stay out of warm brackish or salt water or at least wash vigorously after swimming with soap and water. If the skin around the scratch or cut starts to look red and angry, medical attention should be sought right away. For this infection, treatment must be started early to decrease the chances of serious illness and possible loss of the affected extremity if the infection localizes to a limb. This type of bacteria tends to cause “necrosis” (25 cents) or devitalization of tissue and if that happens the skin must be removed before it gets further damaged. Prevention of this (albeit rare) infection is best: just being mindful of being in the sea water with an open wound and paying attention to careful wound hygiene and any skin changes around the cut or scratch that may develop are key.

illustration of waves

Another water “illness” that deserves attention today is “Swimmer’s Itch,” or cercarial dermatitis.

Ever heard of it? Even after living on the Chesapeake Bay for almost 20 years I’ve only learned about this one relatively recently. Swimmer’s itch is a skin rash caused by a reaction to parasites that preferentially affect birds and other animals, not people. However, the parasite gets into the water via snails (either fresh, brackish or salt water) and when it comes into contact with people it can burrow into the skin and cause a red bumpy rash that can sting or itch. It’s important to know that this isn’t an infection per se, but rather simply an inflammatory reaction to the presence of a foreign invader in the skin.  It is not contagious and cannot be spread from one person to another. Most of the time the rash will go away on its own, but sometimes using a cool cloth as a compress or adding some cortisone cream on top can minimize any symptoms. The only real complication with swimmer’s itch is the potential for a secondary bacterial skin infection due to the disruption in the skin barrier, which opens the doors for other germs to invade the skin layers and cause an infection. When this occurs the area around the rash starts to get more uniformly red and extend beyond the area of the rash. It’s always reasonable to have a clinician take a look if you’re not sure whether a rash is getting secondarily infected, as sometimes it can be tricky to determine. The best way to avoid swimmer’s itch is to avoid marshy areas or other bodies of water where snails are most commonly found, and always wash off right away after swimming.

illustration of waves

I wouldn’t be a girl from the Chesapeake Bay if I didn’t call out the painful rash from sea nettles.

More common further into the heat of summer when the salinity of the water rises, these clear/white jellyfish have tentacles that can wrap around the body and impart an irritating sting from body parts called nematocysts. If you get tangled in a tentacle the best thing to do is to get out of the water and slowly remove the tentacle by scarping it off with something like a credit card and washing the affected body part with the water. Use sea water and not fresh water, which can make the situation worse. Typically the pain goes away all on its own after about an hour but sometimes the redness can remain for a day or two. There are lots of folk remedies that many people swear by such as vinegar, baking soda, and meat tenderizer.  These aren’t harmful and might be worth a try, but the symptoms associated with a sea nettle sting nearly always go away with time. Avoidance of swimming in nettle infested waters or wearing protective wet suits or even pantyhose are really the best ways to go when they are in high season.

illustration of a sea nettle

A hearty round of thanks to the CDC for always challenging me to think. Good for them for having that effect on me and no doubt many others—their recent campaign started out with the reminder not to swim with diarrhea and turned into my own little review of a variety of water illnesses and issues that don’t get quite the prime time coverage that the others do. I hope it’s as helpful to you as it was to me. I’d love to hear about anyone’s recipe for a salve for stinging nettles as I’m sure to get exposed to some this year.

Happy Reaction-free Swimming!

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