Infectious baths

Proven content

Sun, beach and water are associated with carefree and relaxation. Also in the winter season, various types of swimming pools and water parks offer water relaxation. The use of the bath relaxes you, and the swimming itself has a very positive effect on the cardiovascular system, allows you to exercise all parts of the muscles and greatly relieves the spine. The use of water attractions is highly recommended at all ages, starting from the day of birth.

Water provides life on Earth and is essential not only for us humans, but for all organisms. While enjoying the benefits of bathing areas, we should remember that we are not the only ones who can use them. Of course, on most properly prepared and guarded beaches, it is unlikely that pets, such as dogs, swim next to people swimming – in the pools it is inconceivable at all. However, as we well know, apart from animals and plants visible to the naked eye, there is also a world of microorganisms that live and reproduce, although they are invisible. Wherever water, there is moisture, and even a layman knows that in such conditions all kinds of microbes feel good. And if we add warmth and the lack of proper hygiene to it, we can say that “the germs have found their way in the Caribbean or Hawaii” and they can use it at will. Here, it is also very important to involve the administrator of a bathing beach or swimming pool and implement appropriate procedures by him. Of course, there are sanitary and epidemiological stations (SANEPID) that are obliged to control such places, but let’s face it – they are not able to be everywhere and constantly. Therefore, a lot in this respect depends on ourselves: do we want and know how to protect ourselves. The most important is proper hygiene and prophylaxis as well as paying attention to messages about the cleanliness of a given bathing site. Theoretically, it is better in swimming pools due to the obligation to use properly chlorinated or ozonated water, which allows the elimination of the vast majority of pathogens. But let’s not forget that the swimming pool is not only a basin with water, but also showers and the floor we walk on.

Microbes in the pool – fungus

If you ask a random passer-by what kind of microorganism is waiting for you in the swimming pool, he will most likely answer that it is a fungus. He will be right, because pathogenic fungi like warm and humid places, and there are plenty of them in the joints of floor tiles in changing rooms, shower cabins and saunas. Most often, the fungus attacks the feet, because they are in direct contact with the surfaces on which these microorganisms can live. Mycosis of the feet is usually manifested by troublesome itching of the skin, mainly between the toes, where the fungus finds the best conditions for development. The skin turns red and peels. A person with athlete’s foot can spread the infection to other people by using the same bathroom or by leaving fungus spores on the swimming pool locker room floor. In order to prevent infection, it is enough to put on the foot flaps so that the skin does not come into contact with the floor. Fungicides available in pharmacies may help a person with athlete’s foot, but they may as well prove ineffective, so the best solution is to visit a dermatologist. The more so because the “blind” use of antifungal drugs may spread the resistance of fungi to drugs known to medicine.

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Bacteria in public bathing areas – E. coli

The main group of pathogenic microorganisms, apart from fungi, which we can encounter in public bathing areas, are, of course, the ubiquitous bacteria. The most common water contamination is caused by coliform bacteria, i.e. fecal bacteria. These bacteria are nothing but Colon bacilli (Escherichia coli), which in large numbers inhabit the digestive tract (mainly the large intestine) of humans and animals – hence the name coli group. Usually together with them, bacteria of the genus Enterococcus, i.e. fecal streptococci, also present in the intestines. As long as they are in the lower digestive tract, these bacteria pose no threat, but if swallowed in large quantities, they can cause health problems such as diarrhea, fever, vomiting, or food poisoning. The number of coliforms in the water is an indicator of its purity. The parameter called coli is determined, i.e. what is the smallest volume of water in which Escherichia coli bacteria are still present. The more of these bacteria in the water, the smaller the volume of the tested water will be detected. Most strains of E. coli are not pathogenic, but contamination of the water with this bacterium always indicates that sewage contaminated with faeces, which may contain much more dangerous bacteria, has entered the water body (water supply). For this reason, detection of exceeding the norms for the number of coliforms in water is always a signal to take steps to purify the water and find the source of contamination.

Among E. coli bacteria there are very virulent strains, such as e.g. EPEC (enteropathogenic Escherichia coli), EHEC (enterohemorrhagic Escherichia coli) or ETEC (enterotoxic Escherichia coli). They all produce toxins that can lead to, for example, damage to the kidneys and blood vessels and, consequently, even death. In addition to these bacteria, they can appear in the water Shigella sticks responsible for causing dysentery, which is manifested by the frequent passing of small amounts of stool along with blood and mucus.

Bacteria in public bathing areas – golden staph and legionnaires’ disease

Another common bacterium that can be found in contaminated water is Staphylococcus aureus (Staphylococcus aureus). Its presence can be dangerous for bathers due to the possibility of causing skin infections (mainly in people with reduced immunity or with abrasions of the epidermis). In such cases, it can cause abscesses and skin boils. It can also cause conjunctivitis if contaminated water gets into the eyes. Staphylococcal staph is uneven and some may be more virulent than others. Enterotoxic staphylococci produce toxins that cause severe digestive disorders with severe diarrhea and vomiting, which can be life-threatening. Symptoms appear very quickly if you choke on water containing this type of staphylococcus.

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When it comes to the microbiological dangers of bathing, the gracefully named bacteria cannot be ignored Legionella pneumophilaIt is responsible for causing Legionnaires ‘disease – the name derives from the first case of pneumonia reported in 1976 during the American Legionnaires’ congress in Philadelphia. This bacterium can cause pneumonia with fever, chills, headache and cough. Sometimes watery diarrhea may be present. Mortality can be as high as 20%, which is high despite treatment. Pontiac fever is a milder form of the disease, which produces flu-like symptoms without lung involvement and is often self-limiting. L. pneumophila bacteria occur in humid environments, e.g. in air-conditioning systems, in shower nozzles or in taps. For this reason, infections most often occur in air-conditioned rooms or in swimming pools or saunas. Usually, the disease affects the elderly, people with chronic lung diseases or heavy tobacco smokers. To prevent exposure to this bacterium, keep sanitary facilities clean and regularly service air conditioning equipment.

Bacteria in public bathing places – chlamydia and vaginal trichomoniasis

In bathing waters, you can come across a microorganism called Chlamydia trachomatis. It is a bacterium that is an intracellular parasite, that is, it enters the host’s cells and there it grows and multiplies. Most often, this species of chlamydia is rightly associated with diseases of the genital organs and causes venereal granuloma, non-nongonococcal urethritis or mucopurulent cervicitis. Most often, the microorganism is transmitted through sexual contact with an infected person. There is another type of infection caused by C. trachomatis – it is trachoma, or chronic vesicular keratitis, an eye disease. It is the leading cause of blindness in low-developed countries. The most common infection is during labor, when the baby squeezes through the birth canal of a carrier mother or is infected with the bacterium. However, there is also the possibility of infecting the eyes while swimming in the water in which the so-called elementary bodies (infectious extracellular form of chlamydia). These can come from the genitals of dripping carriers.

In addition to bacterial factors, the waters of the swimming pools may hide other microorganisms that pose a threat. One of them is a parasite called Trichomonas vaginalis (vaginal trichomoniasisIt is a microscopic, single-celled protozoan that causes genital infections in women (in men it usually does not cause symptoms, but the man is then a carrier of the protozoan). In women, 1-4 weeks after infection, abundant, foamy, foul-smelling yellowish discharge appear. The infection most often occurs through sexual contact and through the use of shared towels, bedding or bathing utensils. The protozoan can survive in insufficiently chlorinated water and cause infection in bathers.

Dangerous microorganisms in natural waters

Many microorganisms live in natural open waters, incl. cyanobacteria, i.e. bacteria capable of photosynthesis, i.e. sugar production under the influence of sunlight, as it is in plants. Some species of these microorganisms are capable of producing dangerous toxins: hepatotoxins (damaging the liver), neurotoxins (damaging the nervous system, including the brain), dermatotoxins (irritation of the skin and mucous membranes). When a large amount of nutrients are supplied to the water reservoir with cyanobacteria (e.g. fertilizers flowing from the surrounding fields), the phenomenon of water over-fertilization, i.e. eutrophication, occurs. Now, a few sunny sunny days are enough for the cyanobacteria to multiply en masse, i.e. to cause the so-called water bloom manifested by its blue-green color, sometimes by thickening of the consistency or formation of a crust on the surface of the water. In such water, the concentration of toxins secreted by cyanobacteria increases dramatically, which may have very serious health consequences for humans and animals in the event of skin contact with water, not to mention drinking it. Sanitary and epidemiological stations control the state of bathing waters and you should pay attention to their messages regarding the cleanliness of specific water reservoirs.

The microbiological threats described above are real and it is only up to us whether we will succumb to them. We follow the rules of hygiene and follow the recommendations of doctors, epidemiologists and institutions monitoring the state of water, and rest by the water and in the water will be a pleasure without any unpleasant consequences.

Text: Tomasz Gosiewski, MD, PhD

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