The association between marine bathing and infectious diseases– a review

Abstract

Worldwide, infectious diseases represent a leading cause of death and disability. Exposure to the ocean, whether through recreation or occupation, represents a potentially significant, but poorly understood, source of infectious diseases in man. This review describes the potential mechanisms whereby marine bathing could lead to infectious diseases in man. Sources of pathogens in the marine environment are described, including human sewage, animal sources, fellow bathers and indigenous marine organisms. The epidemiological evidence for the association between marine bathing and infectious disease is presented, including a consideration of the differing relationship between faecal indicator bacteria levels and illness at point source compared with non-point source settings. Estimating the burden of infectious disease is reliant on public health surveillance, both formal and informal, which is described from a UK perspective in this review. Potential emerging threats at the marine–human interface are discussed, including infections caused by Shewanella and Vibrio bacteria, and the presence of human pathogens in the marine environment that are resistant to antimicrobials.

Occurrence, antifungal susceptibility, and virulence factors of opportunistic yeasts isolated from Brazilian beaches

“…For years, faecal indicator bacteria (typically coliforms, Escherichia coli , as well as faecal Streptococci and Enterococci ) have been used to assess the water and sand quality of beaches. Their association with diseases is often described in areas with known sources of pollution 5 . However, it has been shown the persistence and growth of these microorganisms in the environment, which is an undesirable feature for a good faecal indicator 3 .…”

The seaweed fly (Coelopidae) can facilitate environmental survival and transmission of E. coli O157 at sandy beaches

“…Management of diffuse and point sources of E. coli O157:H7 in the environment can help to reduce 627 E. coli O157:H7 inputs into beach environments, and farm-level strategies to reduce direct 628 defecation by livestock and diffuse agricultural runoff to the coastal zone are important to mitigate 629 the transfer of pathogens and nutrients to coastal environments [Young, 2016]. Excessive nitrogen 630 loading of coastal waters is a major cause of accelerated seaweed production, resulting in 631 unnaturally high levels of wrack biomass accumulating along coastlines [Anderson et.…”

“…78 al., 2011. Hence, our incomplete understanding of the survival capacity of E. coli O157:H7 in hostile 79 secondary environments, together with a lack of accurate quantification tools, hampers efforts to 80 manage its public health risk [Quilliam et al, 2011, Young, 2016. 81…”

“…Identification of all possible modes of direct and indirect transmission of human microbial 120 pathogens in the coastal zone will enable more effective management of the potential public health 121 risk in that environment [Young, 2016, Caron et. al., 2015.…”

Assessment of local and regional strategies to control bacteria levels at beaches with consideration of impacts from climate change

“…In a prospective cohort study among beachgoers, swimmers in beaches near contaminated sources were more likely to develop waterborne illness (Arnold 2013; Dorevitch et al 2015). Quite alarmingly, children account for the largest burden waterborne illness (Arnold et al 2016; Ford et al 1996, Young 2016; Wade et al 2008). The most recent statistics on U.S. waterborne diseases were reported in a June 2015 Morbidity and Mortality Weekly Report (MMWR) (MMWR, 2015), which states that during 20011–2012, public health officials from 32 states and Puerto Rico reported 90 recreational water–associated disease outbreaks.…”