Public Swimming Pools - Properly Maintained or Cesspool?

How clean is your public pool?  How about that hot tub?  With summer here, time to think about the sanitary quality of your pool or hot tub and how that can impact you and your family's health.  Have you considered testing the water in your community pool...maybe it is time to start.  Nothing wrong with a little paranoia.   In a summary report, CDC found that most pools surveyed (about 80%) had at least one violation.  And if that violation is a low sanitizer level, fecal oral transmission just became a lot easier.  Especially in that kiddie pool. Here are some things CDC suggests:

• Check for inspection results online or on site before using public pools or hot tubs  [Also, ask the pool staff...if they seem disgruntled or clueless, that is not a good sign].
• Use a test strip (available at most superstores or pool-supply stores) to determine if the pH and free chlorine or bromine concentration are correct. CDC recommends:
• Free chlorine concentration of at least 1 ppm in pools and at least 3 ppm in hot tubs/spas.
• Free bromine concentration of at least 3 ppm in pools and at least 4 ppm in hot tubs/spas.
• pH of 7.2–7.8.
• Make sure the drain at the bottom of the deep end is visible. Clear water allows lifeguards and other swimmers to see swimmers underwater who might need help.
• Check that drain covers appear to be secured and in good repair. Swimmers can get trapped underwater by a loose or broken drain cover.
• Confirm that a lifeguard is on duty at public venues. If not, check whether safety equipment like a rescue ring with rope or pole is available.

Norovirus Infection from Swimming in Lake (2014) - CDC Report

Last summer, approximately 70 people contracted Norovirus infection after swimming in a lake.  The lake, located close to Portland OR was shut down for 10 days following the outbreak which occurred on July 12, 2014.

It is always nice to be reminded of these swimming related outbreaks now that summer approaches.  I have always preferred pools with a dash of chlorine and plenty of sunlight to that of some oversized pond with imported sand and plenty of stuff floating in the water.  I will gladly accept chlorine induced red eyes over the possibility of swallowing some viral or bacterial pathogen, or even worse, a parasite such as Giardia or Cryptosporidium.  But even chlorine has limitations.  CDC has a publication on recreational water (below).

CDC - Morbidity and Mortality Weekly Report (MMWR)
http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6418a2.htm?s_cid=mm6418a2_e
Norovirus Outbreak Associated with a Natural Lake Used for Recreation — Oregon, 2014
Weekly
May 15, 2015 / 64(18);485-490
Amy Zlot, MPH1, Maayan Simckes, MPH1,2, Jennifer Vines, MD1, Laura Reynolds, MPH1, Amy Sullivan PhD1, Magdalena Kendall Scott, MPH3, J. Michael McLuckie1, Dan Kromer, MPA4, Vincent R. Hill, PhD5, Jonathan S. Yoder, MPH5, Michele C. Hlavsa, MPH5 (Author affiliations at end of text)
In July 2014, Multnomah County public health officials investigated a norovirus outbreak among persons visiting Blue Lake Regional Park in Oregon. During the weekend of the reported illnesses (Friday, July 11–Sunday, July 13) approximately 15,400 persons visited the park. The investigation identified 65 probable and five laboratory-confirmed cases of norovirus infection (70 total cases). No hospitalizations or deaths were reported. Analyses from a retrospective cohort study revealed that swimming at Blue Lake during July 12–13 was significantly associated with illness during July 13–14 (adjusted relative risk = 2.3; 95% confidence interval [CI] = 1.1–64.9). Persons who swam were more than twice as likely to become ill compared with those who did not swim in the lake. To control the outbreak, Blue Lake was closed for 10 days to prevent further illness. This investigation underscores the need for guidance for determining when to reopen untreated recreational water venues (e.g., lakes) associated with outbreaks, and communication tools to inform the public about the risks associated with swimming in untreated recreational water venues and measures that can prevent illness.