How to Stay Safe and Infection-Free While Swimming

A small child learning to swim in a pool

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When thinking about protecting their kids while swimming, most parents think about using life jackets, swimming lessons, and childproofing their pool. But water-borne infections are a concern as well. How can you keep your kids safe in the water and free from these germs?

Many people overlook the fact that kids can get sick from the germs in the water of pools, lakes, and water parks. Taking some simple steps can help keep your kids (and everyone else) safe while swimming.

Germs in Water That Can Cause Infections

One danger when swimming is that water can be contaminated with germs that can cause recreational water illnesses (RWIs), including:

  • Diarrhea: Swallowing water contaminated with parasites, bacteria, and viruses, including Cryptosporidium, Giardia, Salmonella, Shigella, Norovirus, or even E. coli 0157: H7 can cause diarrhea. These germs can get in the water when someone with an infection has a stooling accident in their diaper or in the water, has some of the germs or feces on their bottom, or the water is contaminated with sewage.
  • Acute respiratory illnesses: Water contaminated with Legionella bacteria, Pseudomonas bacteria, and algal toxins may cause respiratory illness (such as coughs and congestion).
  • Pink eye: The category of viruses known as adenoviruses can cause not only pink eye, but also croup, colds, sore throats, and diarrhea.
  • Molluscum contagiosum: Molluscum contagiosum is a rash similar to a wart which is caused by a poxvirus. Although it may not be spread in swimming pool water, it can likely be spread by sharing swimming pool towels and toys with a child who has molluscum.
  • Primary amebic meningoencephalitis (PAM): This is a rare, although extremely serious and often fatal infection caused by the Naegleria fowleri ameba that is sometimes found in warm freshwater ponds and lakes. It is sometimes called "brain-eating ameba."

Chlorine and Water Germs

Doesn't chlorine kill all of these germs in the water? Chlorine or bromine does kill most of these germs, but it can take up to an hour for them to work. And some pools may not be properly maintained (they do not have the right level of chemicals).

That means that if a child with diarrhea gets in the pool and your child gets in right after them, that may not be enough chlorine in the pool or time for the chlorine to kill any germs from the sick child. And unfortunately, it can take more than a week for chlorine to kill the Cryptosporidium parasite.

Purchase test strips to check the chlorine level and pH of any water you plan to swim in.

Preventing Recreational Water Illnesses

In addition to teaching your child to not swallow water when swimming or playing in the water, you can help keep your child and everyone else healthy in the water.

  • Keep your child out of the water when they have diarrhea, pink eye, hepatitis A, or other contagious diseases.
  • Don't let your child in the water if they have an open wound, since it could become infected.
  • Don't let your child in the water if they have a draining wound, especially MRSA, since it could infect others.
  • Don't share pool or beach towels.
  • Encourage your child to take a shower or bath before swimming.
  • Require your child to wash their hands after using the bathroom, especially if they are going to get back in the water.
  • Take younger children to the bathroom frequently so that they are less likely to have accidents in the water.
  • Keep in mind that swim diapers and swim pants are not leakproof and may allow germs to seep into the water. So check and change them frequently.
  • Don't change diapers by the pool. Instead, take your child to the bathroom to change their diaper. Wash your child's bottom well and wash your hands too.
  • Cover molluscum lesions with a watertight bandage.
  • Dry your child's ears after they swim.

Incidence of Waterborne Diseases

How common are these infections? It is hard to say, as not all infections that kids catch from swimming are obviously caused by contaminated water, nor are they reported. From 2000 to 2014, 493 outbreaks associated with treated recreational water caused at least 27,219 cases of illness and eight deaths. Some types of illness are increasing (such as legionella) while others (such as crypto) are stable. 

Water Safety Tips

Of course, keeping your child safe in and around the water is also very important. Proper supervision is one of the best ways to keep your kids safe in the water. That means watching your kids when they are in or around water, even if they know how to swim. Remember that swim lessons don't make kids, especially younger kids, drown proof.

Other important water safety tips include:

  • Secure your home swimming pool so that it is enclosed by a permanent, four-sided fence, at least 4 feet tall with a self-closing and self-latching gate that is difficult for younger children to open. The fence should not be made of a material like chain link that is easily climbed.
  • Also, make sure that your child can't easily get out of your house to the pool area. That way, you have a "layers of protection" system and if one safety layer breaks down, such as someone leaves the gate to the pool open, your child still can't get out to the pool.
  • Have everyone wear Coast Guard-approved life jackets, and not just floaties, on boats, jet skis, and on other personal watercraft.
  • Only let kids dive in areas that are clearly marked for diving or when you know how deep the water is.
  • Only swim in designated areas in the ocean and are aware of how to escape rip currents, which can pull you out to sea, by swimming parallel to the beach (sideways), until you are out of the rip current and can swim back to shore.
  • Learn CPR.
  • Apply sunscreen or sunblock on your children at least 15 to 30 minutes before going out in the sun to avoid sunburn, and then reapply it at least every two hours, especially if your child has been in the water.
  • Have a phone nearby, so that you can quickly call for help when necessary.
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Article Sources
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  1. Centers for Disease Control and Prevention. Recreational water illnesses. Updated June 4, 2020.

  2. Centers for Disease Control and Prevention. Molluscum contagiosum. Updated May 11, 2015.

  3. Centers for Disease Control and Prevention. Parasites - Naegleria fowleri - primary amebic meningoencephalitis (PAM) - amebic encephalitis. Updated February 28, 2017.

  4. Centers for Disease Control and Prevention. Disinfection & testing. Updated May 4, 2016.

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  6. Centers for Disease Control and Prevention. Steps for healthy swimming. Updated June 5, 2020.

  7. Hlavsa MC, Cikesh BL, Roberts VA, et al. Outbreaks associated with treated recreational water — United States, 2000–2014. MMWR Morb Mortal Wkly Rep. 2018;67(19):547-551. doi:10.15585/mmwr.mm6719a3

  8. US Coast Guard Boating. Life jacket wear/wearing your life jacket.

  9. American Heart Association. CPR & ECC.