Last summer, while my 3-year-old daughter was learning to swim, we were frequent visitors to the neighborhood pool. But after 45 minutes in the water, my little one would have to run to the bathroom, always with a bad case of diarrhea. Every time we left the pool, I would watch my child closely to see if any other symptoms or signs of illness followed. They never did.

Because this puzzled me, I began to retrace our steps. My daughter wore a swim diaper that was supposed to protect against leaking, as did the other toddlers. Yet she was still getting sick. What was behind it?

Each summer people are exposed to germs in swimming pools, lakes, oceans and interactive water fountains that can cause a variety of illnesses. The Centers for Disease Control and Prevention refers to these as recreational water illnesses, or RWIs. The most common are diarrhea, swimmer’s ear and swimmer’s itch.

How are such waterborne illnesses transmitted?

Anytime someone enters a swimming pool after experiencing diarrhea, the water can become contaminated. This occurs because children and sometimes adults go to the bathroom and fail to properly clean themselves of fecal matter before returning to the pool. As children swim and splash, they swallow water. It only takes two or three tablespoons of contaminated water to contract diarrhea.

You might think that the chlorine in the water kills these germs. It does and it doesn’t. Germs such as crypto (KRIP-toe, short for cryptosporidium), giardia (gee-ARE-dee-uh), E. coli 0157:H7 and shigella (Shi-GE-luh) cause RWIs. The E. coli germ is usually killed within seven minutes of the chlorine level being raised in a pool. But the crypto germ can live in the pool for days after treatment because it is resistant to chlorine. This means even the best-maintained pools can lead to RWI illnesses.

“To avoid putting people at risk, don’t allow your child to swim if they have diarrhea,” says Dr. Landon B. Pendergrass, founding partner of Pediatric Consultants. “You wouldn’t take your child to school if they were running a fever. The same thing applies with diarrhea and swimming. Swim diapers give a false sense of security. Be smart and use common sense.”

If your child experiences diarrhea while at the pool, take him or her home and watch your youngster closely for 24 hours before returning to the pool. “It is hard to tell if the child is sick with a bacterial infection or if it is a one-time isolated case where they just swallowed too much water,” adds Kim Moore, aquatics director at Shilling Farms YMCA.

Pendergrass agrees: “If the diarrhea is persistent and it is associated with fever, vomiting, abdominal cramping and blood in their stool then you need to seek medical attention.”

Other Recreational Water Illnesses

Swimmer’s Ear

Cause: Water gets trapped in the ear canal after swimming, making the ear sore to the touch.
Solution: Mix together three-quarters tablespoon of rubbing alcohol with one-quarter tablespoon of vinegar. Add to ear after swimming. Take Tylenol or Motrin for the pain.

Swimmer’s Itch

Cause: Skin gets irritated from pool chemicals that can cause burns, tingles and small blisters.
Solution: Shower immediately after swimming. Use an anti-itch cream to soothe skin.

Be a Savvy Swimmer

  • Take children to bathroom or change diapers often.
  • Tend to diapers in the bathroom, not poolside.
  • Wash your children thoroughly with soap and water before entering the pool.
  • Don’t allow children to swim with diarrhea.
  • Teach kids to avoid swallowing pool water.
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  • April Smith Carpenter

    April Smith Carpenter of Mississippi is a freelance writer, speaker and author. She covers a variety of topics with a particular focus on parenting, sports and women’s health issues. Smith Carpenter is also a devoted wife and mother of two children. Check out her website at or contact Smith Carpenter at [email protected]. If you are interested in learning more about RWIs, visit To shop for swim diapers that help prevent messy poolside accidents, visit