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NC Department of Health and Human Services
NC Division of Public Health
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NCDHHS has developed new guidance for fresh water recreational activities involving indirect contact with water. Find the full report here.

Diseases & Topics

Avoiding Recreational Water Illnesses

Swimming pools and natural bodies of water like lakes, rivers and the ocean, may contain organisms that can cause illness in people, especially if the water is warm and still. Illness may range from mild to severe or even life-threatening.

Bacteria, amoebae, parasites and other naturally occurring microorganisms can cause diarrhea; skin, eye and ear infections; respiratory infections; neurologic infections; wound infections and other illnesses. Chlorine in pools does not always kill such organisms. Other contaminants, such as chemicals or other pollution, may also cause illness.

People can take simple precautions to protect themselves and others against water-borne illness when swimming or playing in or on the water.

In pools:

  • People with diarrhea — including children — should not get in the pool.
  • Do not swallow pool water or get pool water in your mouth.
  • Shower before and after swimming (children too!).
  • Wash your hands after using the toilet or changing diapers.
  • Small children should wear tight-fitting swim diapers, and diapers should be checked before entering the water.
  • Take children on bathroom breaks frequently.
  • Change children's diapers often and in a bathroom, not at poolside.

Other swimming areas:

  • Pay attention to signage. Do not swim or play in waters that are under a swimming advisory or that have been closed because of pollution or other risks.
  • Do not swim or play in stagnant water or water with dead fish or algae in it.
  • Do not swim or play in natural waters immediately after a heavy rain, as contaminants in the surrounding area may have washed into the water.
  • Do not swim or play in waters near sewer pipes, discharge pipes, or storm drain outlets.
  • Do not swim in water that is also frequented by livestock or other land animals.

Natural bodies of water:

  • Avoid getting the water in your mouth, and do not drink or swallow the water.
  • Reduce the risk of water going up your nose by holding your nose shut or using nose clips when taking part in water-related activities in bodies of warm freshwater such as lakes, rivers or hot springs.
  • Avoid digging in or stirring up the sediment while taking part in water-related activities in shallow, warm freshwater areas.
  • Do not swim in natural waters, whether fresh or salt water, if you have open wounds or sores.
  • Shower with soap and water after swimming or playing in the water.
  • Promptly tend to any wounds, cuts or abrasions you get while in or near the water: thoroughly wash the wound with clean, potable (drinkable) water and soap, and seek a doctor's care if a rash or swelling develops around the wound or it appears infected.
  • Seek a doctor's care immediately if you become ill or develop symptoms of an infection.