Recreational Water and Infection: A Review of Recent Findings

Fewtrell, Lorna; Kay, David

doi:10.1007/s40572-014-0036-6

Cited by 128 publications

(93 citation statements)

References 41 publications

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“…However, some outbreaks were reported even when recreational water showed normal levels of intestinal enterococci and E . coli [1, 5, 6]. Additionally, high levels of intestinal enterococci and E .…”

Section: Introductionmentioning

confidence: 99%

Risk factors for gastroenteritis associated with canal swimming in two cities in the Netherlands during the summer of 2015: A prospective study

et al. 2017

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Urban canal swimming events are popular in the Netherlands. In 2015, two city canal swimming events took place, in Utrecht (Utrecht Singel Swim, USS) and in Amsterdam (Amsterdam City Swim, ACS). This prospective study characterizes the health risks associated with swimming in urban waters. Online questionnaires were sent to 160 (USS) and 2,692 (ACS) participants, with relatives of participants who did not swim completing the questionnaire as a control. Swimming water specimens and stool specimens of diarrheic participants in the ACS group were analysed. A total of 49% of USS and 51% of ACS swimmers returned their questionnaires. Nine percent of USS swimmers and 4% of non-swimmers reported gastrointestinal complaints (aRR 2.1; 95% CI: 0.3–16), while a total of 31% of ACS swimmers and 5% of non-swimmers reported gastrointestinal complaints (aRR 6.3; 95% CI: 4.1–9.5). AGI risk among ACS participants was directly related to increasing number of mouthfuls of water swallowed. Various norovirus genotypes were detected in five out of seven stool specimens taken from ACS participants and in all three tested ACS water samples. We conclude that the AGI risk among open-water swimmers in urban areas depends on the circumstances around the event. The epidemiological curve, the statistical association between swimming and AGI, and the microbiological evidence for norovirus in stool and water specimens suggest that AGI outbreak after the ACS event was due to water contamination by multiple norovirus strains, which is possibly linked to sewage overflow due to prior heavy rainfall. There is need for more targeted preventive measurements and recommendations for organizers, municipal authorities and participants to prevent this reoccurring in the future.

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Section: Introductionmentioning

confidence: 99%

Risk factors for gastroenteritis associated with canal swimming in two cities in the Netherlands during the summer of 2015: A prospective study

et al. 2017

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“…Nonetheless, sampling in August coincided with a period of systemic severe fires in the surrounding unplanted forests, which might explain the noticeable decrease in water abiotic parameter quality, namely, dissolved oxygen and turbidity, owing to the deposition of ash and other debris. Concomitantly, the number of beachgoers also increased, contributing to the re-suspension of bottom fine particles and turbidity, a process that tends to increase IE in the water [8], but not noticed at Zebreiros (see below).…”

Section: Bathing Water Qualitymentioning

confidence: 98%

“…Two decades before, EPA [7] recommended the use of intestinal enterococci as the sole indicator for ocean water bacterial monitoring. Recently, Fewtrell & Kay [8] reviewed epidemiological studies and quantitative microbial risk assessments of infection risk from recreational water use. Again, the selection of enterococci and/or E. coli as the most suitable water quality indicators was questioned, and the use of models and more locally customized approaches have been proposed, not in line with the current European BWD.…”

Section: Introductionmentioning

confidence: 99%

Urban Estuarine Beaches and Urban Water Cycle Seepage: The Influence of Temporal Scales

Costa-Dias

Machado

Teixeira

et al. 2018

Water

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Abstract:Temperate estuarine beaches are an asset to coastal cities. Being located within the transition zone where the river meets the sea can provide several environmental benefits such as warm water temperature during the summer, flat waters, protection from coastal upwelling-induced morning fog, as well as additional recreational and cultural values. In this study we address a major question-can the urban water cycle impair the water quality dynamics during a bathing season in a temperate Atlantic estuary (Douro, Northwest Portugal)? Water quality was assessed according to the EU legal criteria at different time scales. No daily, weekly, or monthly patterns for microbiological descriptors were found, which rather followed the hourly tidal dynamics. Quality decreased during high tide, affecting potentially 800+ beach-users during mid-summer weekends (4 m 2 per person). Low water quality was transported upstream from highly populated urban areas. Therefore, the understanding of the dynamics of estuarine systems is essential to adapt the standard official approach, and the obtained results can be used to draw policy recommendations to improve the sampling strategy, aiming for more accurate assessment of the water quality to reduce the risk hazard of estuarine beaches.

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“…Previous studies have reported that levels of fecal indicator bacteria (FIB) in recreational waters are associated with gastrointestinal illness and that a dose-response relationship exists between FIB concentrations and levels of illness in recreational water impacted by sewage discharge (Prüss, 1998;World Health Organization (WHO), 2003;Fewtrell and Kay, 2015). A meta-analysis of epidemiology studies found that enterococci were associated with an increase in gastrointestinal illness in marine waters, with a one log increase in Enterococcus correlating with a 1.34 increase in relative risk (Wade et al, 2003).…”

Section: Introductionmentioning

confidence: 99%

Water quality and antibiotic resistance at beaches of the Galápagos Islands

Overbey

Hatcher

Stewart

2015

Front. Environ. Sci.

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Tourism and residential population growth are increasing on the Galápagos Islands, yet the effects of this growth on environmental quality are not well understood. The goal of this study was to characterize recreational water quality on one of the inhabited islands of the Galápagos (Isla San Cristóbal). Five beaches were sampled to allow a comparison between beaches with and without discharge of human sewage, and to help elucidate the effects of human activities in this unique environment. Enterococcus concentrations were quantified using IDEXX Enterolert ® and antibiotic resistance testing was performed on Escherichia coli isolated by membrane filtration. All study beaches sometimes exceeded international guidelines for recreational water quality, and significantly higher Enterococcus concentrations were found near sites subjected to sewage discharge (p < 0.01). These sewage-impacted sites also had higher levels of antibiotic resistant E. coli, suggesting that human activities are increasing the levels of resistance that would occur naturally. Future studies should characterize the extent of this impact both spatially and temporally. The results of this study demonstrate that sewage can contribute antibiotic resistant bacteria to marine waters and suggest that human impacts in the Galápagos Islands extend to the environmental resistome. This impact is likely common in areas across the globe wherever tourists frequently carry and use antibiotics.

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Recreational Water and Infection: A Review of Recent Findings

Cited by 128 publications

References 41 publications

Risk factors for gastroenteritis associated with canal swimming in two cities in the Netherlands during the summer of 2015: A prospective study

Risk factors for gastroenteritis associated with canal swimming in two cities in the Netherlands during the summer of 2015: A prospective study

Urban Estuarine Beaches and Urban Water Cycle Seepage: The Influence of Temporal Scales

Water quality and antibiotic resistance at beaches of the Galápagos Islands

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