Germs in the Pool: A Survival Guide for Swimmers

Her advice? Older adults may want to avoid hot tubs completely. “Not only not getting in, but staying away from the area of the hot tub,” she said.

Other common ailments linked to pools and hot tubs are skin rashes, ear pain, cough or congestion, eye pain and other infections.

If you think you’ve gotten sick from a pool, seek medical attention and notify your local health department. If health officials start making connections between people who are getting infected, they may launch an investigation to identify a potential outbreak, Hlavsa said.

10 ways to stay safe from a pool-related illness

1. Stay out of the water if you have diarrhea. If you have been diagnosed with cryptosporidiosis, the illness caused by the parasite, don’t go back into the water until two weeks after diarrhea has completely stopped.

2. Shower before you swim. Rinsing off in the shower for 1 minute removes most of the dirt or anything else on your body that uses up pool chemicals to kill germs. Most people have about 0.14 grams of feces — comparable to a few grains of sand — on their body at any given time, according to the CDC.

3. Don’t swallow the water. The number one way you can protect yourself from crypto is to avoid swallowing the water, Hlavsa said. Chlorine kills most germs within minutes; it doesn't kill germs instantly.

4. Have kids? Take frequent bathroom breaks. For those who are very little, check diapers every hour and change them away from the water to keep germs from contaminating it.

5. Beware of red eyes and a strong “chlorine” smell. The smell comes from a chemical irritant called chloramine that occurs when chlorine combines with what washes off swimmers’ bodies. Chloramine also causes red, blood-shot eyes. An abundance of chloramine likely means there is an excess of urine, feces or sweat in the pool. It also means there’s less chlorine remaining in the water to kill germs.

6. Protect open cuts or wounds. It’s best to stay out of the water, especially if the cut or wound is the result of a recent surgery or piercing. If you do go in, use waterproof bandages to completely cover the cut or wound.

7. Mind your ears. Dry ears thoroughly after swimming or wear a bathing cap or ear plugs to prevent swimmer’s ear, an infection in the outer ear canal. The bacterial infection is more common in children.

8. Shower after with soap. After getting out of water for the day, remove your swimsuit and lather up to kill any germs clinging to your skin. Wash your swimsuit, too — this prevents “hot tub rash,” an itchy red bump that can fill with pus around hair follicles.

9. Conduct your own inspection. If it doesn’t meet proper criteria, talk to the pool operator or go to your local health department to make sure the pool or hot tub is operating properly:

• Make sure the drain at the bottom of the deep end of the pool is visible, secured and in good condition.
• Use test strips that can be purchased at a pool supply or hardware store to check the chlorine or bromine levels and pH in the water.
  • Chlorine should be at least 1 part per million (ppm) in pools and at least 3 ppm in hot tubs.
  • Bromine, an alternative to chlorine, should read at least 3 ppm in pools and 4 ppm in hot tubs.
  • The pH level represents how effectively germs are killed and should be between 7.2 and 7.8.

10. Do your part. “If swimmers and caregivers of young swimmers are doing their part — not swimming with diarrhea, not swallowing the water — I think we can all have a great summer in and around the pool this year,” Hlavsa said. “It's just going to take all of us doing that together.”

Editor's note: This article, originally published May 25, 2021, has been updated with additional information.