This week's Morbidity and Mortality Weekly Report had a timely article summarizing outbreaks associated with treated recreational water over the time period 2000 - 2014. I'll share a few take home points.
A total of 493 outbreaks were reported over this time period, and 363 (74%) had a confirmed infectious etiology. Any guesses as to the number 1 identified infectious cause? If you said Cryptosporidium, you win the prize. Second place wasn't even close, more or less a tie between Legionella and Pseudomonas, with the latter manifest mostly by folliculitis and otitis externa. Hotels were implicated in about 1/3 of the outbreaks.
The report included a little informational poster with some fairly obvious but still important messages to the public:
1. Don't swim with diarrhea
2. Check the pool or hot tub inspection score (more on this below)
3. Don't swallow the water
I had never really looked into how public pools or hot tubs were regulated, but not surprisingly there are rules governing this with oversight by county/state health departments. I decided to try to find out pool inspection scores for some area hotels, and I had a lot of difficulty. Montgomery County Health Department's web page listed a bunch of regulations, but I couldn't see anything there about individual hotel reports. Needless to say, going to a hotel's website isn't likely to help anyone find out when the pool was last inspected, or how it scored. This seems to be true for most of the country. So, I guess if you're really concerned about your vacation spot's pool or hot tub health rating, you'd need to ask the hotel specifically. The CDC does help if you wanted to look at the sites responsible for outbreaks in the past, via this site.
My only swimming possibility this summer is a lake, not covered by the treated recreational water regulations. I'll just have to take my chances.