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Section 2. Recommendations for Care of Children in Special Circumstances
Prevention of Illnesses Associated with Recreational Water Use
Disease transmission through consumption or use of recreational water (eg, swimming pools, water slides, splash pools, lakes, oceans) continues to be a source of illness in the United States. Since the mid-1980s, the number of outbreaks related to recreational water activities has increased significantly, particularly in disinfected swimming venues (eg, swimming pools).
85 Therefore, preventing recreational water-related illness increasingly is becoming important for the health of children and adults. Recreational water illnesses (RWIs) are caused by swallowing, breathing, or having contact with contaminated water from swimming pools, spas, lakes, rivers, or oceans. Illnesses caused by recreational water exposure include infections of the gastrointestinal tract, respiratory tract, central nervous system, skin, ears, and eyes. During 2005–2006, 78 waterborne disease outbreaks associated with recreational water were reported in 31 states, causing illness in 4412 people and resulting in 116 hospitalizations and 5 deaths. Of these 78 outbreaks, the majority (74%) were associated with inadequately treated or disinfected recreational water
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Red Book 2009 2009: XXIX.