Infections Acquired via Fresh Water: From Lakes to Hot Tubs.

This chapter is unique in its focus on infections that are acquired in water. For those who like to swim and spend time in water parks and pools, the exposure to water and therefore the risk of infection is higher. Recreational water illnesses are illnesses related to recreation in water. Of these recreational water illnesses, infections are the most common because water laden with microorganisms or contaminated by human activity gains access to healthy tissue through the skin and body orifices. Infection occurs by inhalation, ingestion, or direct invasion of the respiratory and gastrointestinal tract. Gastrointestinal infections are the most common. This chapter discusses skin and soft tissue infections, ocular infections, urinary tract infections, pulmonary infections, central nervous system infections, and disseminated infections that can occur as people come into contact with natural nonmarine water bodies as well as manmade aquatic environments. Most of these infections are mild but can occasionally be life threatening. There is a focus on the latest methods to treat these infections. Pseudomonas aeruginosa is a very common pathogen in water. The chapter discusses P. aeruginosa dermatitis at length and also looks at keratitis and pneumonia caused by this organism. The chapter also discusses the latest treatments for primary amoebic meningoencephalitis, a severe life-threatening illness with a high mortality, caused by Naegleria fowleri. Finally, there is an in-depth discussion of the notorious gastrointestinal illnesses such as norovirus and Cryptosporidium parvum that can affect large numbers of people at a time.