Control Measures

Swimming continues to be a safe and effective means of exercise. RWI transmission can be prevented by reducing contamination of swimming venues and exposure to contaminated water through adoption of the following practices:

• People with diarrhea should avoid recreational water activities, including swimming.
  
  • After cessation of symptoms, all people who had diarrhea attributable to Cryptosporidium species also should avoid recreational water activities for an additional 2 weeks. This is because of prolonged excretion of Cryptosporidium organisms after cessation of symptoms, the potential for intermittent diarrhea that may cause infected people to think symptoms have stopped, and the increased transmission potential in disinfected venues (eg, swimming pools) because of the parasite's high chlorine tolerance.
  
  
  • After cessation of symptoms, children who had diarrhea attributable to other potentially waterborne pathogens (eg, Shigella species, Giardia species, and norovirus) and who have not been toilet trained should avoid recreational water activities for 1 additional week.
  
  


• Avoid ingestion of recreational water.


• Practice good swimming hygiene by:
  
  • Showering, using soap and water, before entering recreational water.
  
  
  • Washing children thoroughly, especially the perianal area, with soap and water before allowing them to participate in recreational water activities.
  
  
  • Taking young children for regular bathroom breaks or checking diapers often.
  
  
  • Washing hands with soap and water after toilet use and diaper-changing activities. These should occur at a distance from the recreational water source.
  
  
  • Washing hands with soap and water before and after consumption of food and drink.
  
  

Revised recommendations for responding to fecal accidents in disinfected swimming venues have been published.¹