In this summer’s record-breaking scorching heat, a splash of cool, cool water sounds like delicious bliss. Each drop offers energetic relief as it patters across your face, quenching your red-hot skin.
But if you find such a euphoric respite at a kiddie splash area, that calming spray could quickly turn into disgusting puke, as drips and droplets can be laced with diarrheal pathogens. Each tap can deliver a splash of infectious germs that, if accidentally ingested, could transform you into a veritable fecal source for days to come.
That’s the warning from the Centers for Disease Control and Prevention, at least. This week the agency published a report describing two gastrointestinal outbreaks linked to a single recreational platform in Kansas. The two outbreaks, which occurred within days of each other in June 2021, involved two different pathogens:Shigella bacteria and norovirus, and collectively sickened at least 27 people. Although some circumstances are specific to that particular splash pad in Kansas, the outbreaks highlight the common risk of such facilities, which are often unregulated.
Splash pads, popular water features that can include interactive fountains, water sprays and jets, generally do not include areas with standing water. And because of this, “splash pads do not always meet the local, state, territorial, or tribal definition of an ‘aquatic location,'” and may be exempt from public health codes, CDC notes on their website. “This means that they are not always regulated, nor are they always required to disinfect the water with chemicals that kill germs.”
In other words, the water gushing out of those tempting jets could have been filtered through a poopy diaper instead of a proper sanitation system. This is not just a horrible hypothetical, but a disgusting reality. The CDC has counted a number of such outbreaks over the years and listed the risks for more. The most obvious is that young children generally have poor hygiene and potty skills and enjoy sitting and standing in spouts, which, as the CDC bluntly warns, “can rinse poop out of your butt.” Young children are also more likely to have such water in their mouths, thus completing the fecal-oral route in record time.
The authors of the new report, written by the CDC and Kansas health officials, referenced a 2010 study that documented children’s splash behavior and found that “children wore diapers, sat in water and put their mouths open in the water”.
Also, the jets and sprinklers themselves pose a risk because when the water is aerosolized, it depletes the concentration of free chlorine, making it difficult to consistently maintain the concentration needed to prevent the spread of disease.
If all that wasn’t nauseating enough, the report on the two Kansas outbreaks notes that the splash pad involved was at a wildlife park where people visited animal exhibits, including lemurs, before getting into the water sprinklers. . One of the outbreaks, which occurred on June 11, involved the spread of Shigella bacteria that cause a diarrheal disease called shigellosis.
Non-human primates, such as lemurs, are the only known animal reservoir of Shigella. But the outbreak, which sickened at least 21 children and teens ages 1 to 15, was not related to touching or feeding lemurs, outbreak investigators found. Instead, the illnesses were associated with playing on the splash pad and having water in the mouth. Three sick children had to be hospitalized and fortunately they recovered.
A week later, on June 18, another outbreak broke out, this time with norovirus. Investigators identified six cases in this outbreak, affecting people between the ages of 1 and 38. All of the sick people were playing in the splash pad and all reported having water in their mouths.
But that was not all. In the days between the two outbreaks, the researchers identified more cases of acute gastrointestinal illness in people who visited the park, but lacked laboratory data to link them directly to any of the identified outbreaks. With additional cases identified on June 19, investigators tallied 63 gastrointestinal illnesses, and the splash pad was closed on June 19.
When local health officials investigated how splash pads work, they found some concerning features that could explain the outbreaks, including:
The water remained in the collection tank (into which the water is drained after spraying users and before it is filtered, disinfected, and re-sprayed) overnight instead of continually being recirculated, filtered, and chlorinated. The splash pad did not have an automatic controller to measure and help maintain the free chlorine concentration needed to prevent pathogen transmission. Additionally, no staff member had documentation of completing standardized operator training.
CDC testing found gastrointestinal bacteria in three of the seven pumps used to deliver water to the splash pad features.
After the splash pad was closed on June 19, the wildlife park addressed the health investigator’s findings, adding continuous circulation, filtration, disinfection; add an automated chlorine controller and train staff on it. The splash pad reopened on July 24, and no additional illnesses were identified on the splash pad.
“As the use of splash pads increases, there is a need to reconsider the exemption of splash pads from regulation under public health codes,” the report authors concluded.
For now, however, simple messages can also help prevent splash outbreaks, such as signs telling splashers and caregivers: “Stay out of the water if you have diarrhea,” “Do not stand or sit on the jets.” ” and “Don’t swallow the water.”