Water dangers: what to know before taking a dip

With summer on the horizon, it’s time to start thinking about water-related activities. Swimming-related illnesses are not uncommon among different bodies of water. Dr. Sara Andrabi, assistant professor in the Henry J.N. Taub Department of Emergency Medicine, cautions swimmers ahead of the summer.


Four children playing in the ocean near sunset.Bacteria count is something to look out for in gulf and ocean water. The main contributors in Texas include buildings and concrete pavement, leakage from sewer systems and large livestock farms, which can cause bacteria to go into the water. Texas Beach Watch provides up-to-date information on bacteria count at the beach you plan to visit, so check the levels online before swimming at the beach, and look for similar state-by-state resources.

Andrabi explains that the stillness of the water at the beach can impact bacteria levels.

“Not every beach is created equal. People usually prefer to swim in areas where the water is calmer. In areas where water doesn’t circulate as well with little movement, bacteria and organisms might not dissipate as quickly as high-energy beaches,” she said.

If the water is not safe at the beach that day, get creative with your beach activities: play volleyball, have a picnic or build sandcastles.

Vibrio is one bacteria of concern. It is an oceanwater bug that appears in water during warmer temperatures that can cause wound infections.

“When you hear reports of flesh-eating bacteria, this is what they are referring to,” Andrabi said. “If you have a cut or scrape on your skin, the bacteria can get underneath your skin, which is your body’s biggest barrier, and cause infection.”

If you feel sick, especially with diarrhea, avoid the water. Small bits of fecal matter can get into the water, and if someone accidentally swallows that water, they can get sick as well.


Naegleria fowleri is a brain-eating amoeba that typically lives in fresh and warm water sources, such as lakes, ponds, rivers, springs and unchlorinated swimming pools. Swimming, diving, jumping or splashing will typically expose you to this because of facial contact with the water. Exposure to naegleria fowleri is more common than contracting the actual disease. The risk of infection is low (2.5 cases per million exposures). Despite low prevalence of disease and frequent exposure, mortality is high once you contract the disease.

The disease is an infection of the brain, and symptoms include:

  • Fever
  • Headache
  • Photophobia (sensitivity to light)
  • Nausea
  • Vomiting
  • Seizures
  • Smell and taste abnormalities

Swimming pools

Swimming pools have a lot of chlorine, so they typically are safe for swimming. Diarrheal illnesses can occur while swimming. The most common is cryptosporidium, which can cause gastrointestinal illness. If you feel sick, refrain from getting in the water because if fecal matter gets in the water and someone swallows it, they can get sick. Norovirus and giardia are other bugs that can cause gastrointestinal illnesses.

Legionella is another bug that lives in water and soil, and it can lead to lung infection through inhalation. According to Andrabi, historical outbreaks of legionella include contaminated mists like cooling towers, showers, faucets, decorative fountains and mist machines.

Swimmer’s ear is common during summer months and occurs when water stays in the ear for a long time, providing an opportunity for bacteria to thrive in the moist environment in your ear. Patients will feel pain when tugging on the ear, experience redness or swelling or have drainage. Antibiotic drops can treat swimmer’s ear. You should see a doctor who can examine your ear and prescribe the appropriate course of treatment.

Hot tub rash, or folliculitis, is caused by bacteria, and it appears a few days after you sit in a hot tub that is not maintained or cleaned well. The rash is itchy, red and bumpy all over your hair follicles, and medication can treat the rash.

By Homa Shalchi

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