In this record-breaking summer heat, a splash of cool, ice-cold water sounds like delicious bliss. Each drop tingles your face, soaks your skin, and provides instant relief.
However, if you find that euphoric breath at a children’s splash pad, that soothing spray can quickly turn into a pathogen, as drips and drips can be washed away with diarrheal pathogens. Every potter can offer infectious germs that, if accidentally swallowed, can turn into a veritable fecal fountain in the days to come.
At least that’s the warning from the Centers for Disease Control and Prevention. This week, the agency released a report detailing two gastrointestinal illnesses linked to a Kansas resort. The two outbreaks in June 2021 involved two different pathogens –Shigella bacteria and norovirus and sickened at least 27 people in total. While some of the circumstances are specific to that Kansas spray site, the outbreak underscores the general dangers of such facilities, which are often unregulated.
Splash pads — popular water features that can include interactive fountains, water sprays and jets — typically don’t include areas with water. Because of this, the CDC notes on its website, “splash sites do not always meet local, state, regional, or tribal definitions” and may be exempt from public health codes. disinfection with substances is not required.”
In other words, the water coming out of those tempting jets could have been filtered with a diaper instead of a sanitary system. This is not just a scary hypothetical, but rather a revolting reality. The CDC has counted the number of such outbreaks over the years and listed more risks. Most obviously, young children have poor hygiene and toilet skills and love to sit and stand on airplanes, which, as the CDC bluntly warns, “can shake your bum.” Even small children swallow that water, thus completing the fecal-oral route in record time.
The authors of the new report, written by the CDC and Kansas state health officials, cite a 2010 study that documented children’s behavior and found that “children were wearing diapers, sitting at the water’s edge, and putting their mouths in the water.”
Furthermore, jets and sprays themselves pose a risk because when the water is aerosolized, it loses its concentration of free chlorine, making it difficult to maintain a consistent concentration necessary to prevent the spread of disease.
Diversity in water
If all that wasn’t enough, the two outbreak reports in Kansas involved a splash pad at a wildlife park where people visited animal exhibits, including lemurs, and used water sprinklers. One of the outbreaks on June 11th is related to the spread of pneumonia Shigella bacteria that cause diarrhea called shigellosis.
Non-human primates such as lemurs are the only known animal reservoirs Shigella. However, investigators have determined that the outbreak, which has afflicted at least 21 children and adolescents between the ages of 1 and 15, was not linked to touching or feeding the lemurs. Instead, illnesses are associated with playing on splash pads and mouthing water. Three sick children had to be admitted to the hospital, and luckily they recovered.
A week later, on June 18, another outbreak of norovirus broke out. Investigators found six cases of the disease affecting people between the ages of 1 and 38. All those who were sick said that they played in the sprinkler and got water in their mouths.
But that was not all. In the days between the two outbreaks, investigators found more cases of acute gastrointestinal illness in people visiting the park, but there was no laboratory data to directly link them to either of the identified outbreaks. As additional facts were revealed on June 19, investigators identified 63 gastrointestinal diseases, and sprinklers were closed from June 19.
revision of regulations
When local health officials investigated the sprinklers’ performance, they discovered some characteristics that may explain the outbreak, including:
The water sat overnight in a holding tank (after being sprayed on users and before being filtered, disinfected and sprayed again) instead of being constantly recirculated, filtered and chlorinated. The spray pad does not have an automated controller to measure and maintain the free chlorine concentration necessary to prevent pathogen transmission. In addition, none of the employees had documents confirming that they had completed standardized operator training.
CDC testing found enteric bacteria in three of seven pumps used to feed water to sprinkler features.
After the splash pad was closed on June 19, the wildlife park addressed the health inspector’s report, adding regular circulation, filtration and disinfection; adding an automated chlorine controller and training its staff. The splash pad reopened on July 24 and no additional splash pads were identified.
“As the use of splash pads increases, the exemption from regulation of splash pads under the Public Health Code should be reconsidered,” the report’s authors concluded.
For now, simple messages can help prevent splash outbreaks, such as to sprayers and caregivers: “Do not swim if you have diarrhea,” “Do not stand or sit on airplanes,” and “Do not swallow water.”