Large numbers of recreational water-related outbreaks are documented annually, which is a significant increase over the past several decades.
Since 1978, the number of recreational water-associated WATERBORNE DISEASE outbreaks (WBDOs) reported annually has increased dramatically. This increase is probably due to a combination of factors including:
* The emergence of PATHOGENs, especially CHLORINE-tolerant Cryptosporidium,
* Increased participation in aquatic activities,
* Increases in the number of AQUATIC FACILITIES, and
* Increased recognition, investigation, and reporting of outbreaks that may have previously gone undetected.
Over 2009-2010, a total of 81 recreational water-associated WBDOs and 1,366 cases of illness and 62 hospitalizations were reported to the CDC. CDC documented that 57 of these outbreaks and 78% of the cases were associated with disinfected water venues.
Multiple challenges exist for providing adequate cleaning and disinfecting of swimming water. Sunlight, urine, exposure to air, and inorganic and organic matter (i.e. sweat, saliva, and feces) can quickly deplete FREE AVAILABLE CHLORINE, the primary disinfectant used in POOLS. AQUATIC FACILITIES also provide potential exposure to FECAL contamination from other swimmers. These incidents are common in AQUATIC FACILITIES, especially from diaper-aged BATHERS who are not toilet trained (babies and toddlers).