Faecal fountains: CDC warns of poop-related diarrhea

A two-year-old enjoys a spray of water in Los Angeles on June 20, 2022.
Increase / A two-year-old enjoys a spray of water in Los Angeles on June 20, 2022.

In this summer’s record heat, splashing the crisp, cool water sounds like delicious bliss. Each drop provides crisp relief as it taps your face, extinguishing sizzling skin.

But if you find such a euphoric respite with a baby shower cap, this soothing spray can quickly turn into disgusting sputum as drops and drops can be drenched with diarrheal pathogens. Each patter can offer a plague of infectious microbes that, if accidentally ingested, can turn you into a veritable fountain of feces in the days to come.

That’s at least a warning from the Centers for Disease Control and Prevention. This week, the agency released a report describing two gastrointestinal outbreaks related to one recreational welcome platform in Kansas. Two outbreaks that split in June 2021 affected two different pathogens –Shigella bacteria and noroviruses – and at least 27 people fell ill together. While some circumstances are specific to this particular Kansas rainfall, outbreaks indicate a widespread risk of such facilities that are often unregulated.

Great fun

Splash pads – popular water spots where interactive fountains, water jets, and jets can be found – typically don’t include stagnant areas. For this reason, “splash pads do not always meet the local, state, territorial or tribal definition of a” water spot “and may be exempt from public health regulations, the CDC notes on its website. “This means they are not always regulated and not always required to disinfect water with germ-killing chemicals.”

In other words, the water gushing from these tempting jets could have been filtered through a dirty swim diaper and not through a proper sanitation system. This is not only a terrifying hypothetical, but a disgusting reality. The CDC has recorded many such epidemics over the years and listed the risk for more. The most obvious is that young children generally have poor hygiene and toilet skills, and like to sit and stand in jets which, as the CDC bluntly warns, “can wash the poop off your butt.” Young children are also likely to get this water in their mouths, making them complete the fecal-oral route in record time.

The authors of a new report, written by CDC and Kansas health officials, cited a 2010 study that documented children’s behavior in the paddles and found that “babies wear diapers, sit on jets of water, and put their mouths open in the water.”

Moreover, the jets and sprays themselves are a risk because when the water is aerosolized it depletes the concentration of free chlorine, making it difficult to maintain the concentration needed to prevent the spread of disease at all times.

Water diversity

If all this wasn’t boring enough, the report of two outbreaks in Kansas notes that flat splashes were found in a wildlife park where people visited exhibits of animals, including lemurs, before entering the water. One of the epidemics on June 11 was about spreading Shigella bacteria that cause a diarrheal disease called shigellosis.

Non-human primates such as lemurs are the only known reservoir of animals Shigella. But the outbreak, which affected at least 21 children and adolescents between the ages of 1 and 15, was not related to touching or feeding lemurs, epidemic researchers found. Instead, sickness was associated with splash fun and splash water getting into the mouth. Three sick children had to be hospitalized and fortunately recovered.

A week later, on June 18, another epidemic broke out, this time with norovirus. Investigators identified six cases in this epidemic, affecting people between the ages of 1 and 38. All sick people played splash water and all reported that they were getting water in their mouths.

But it is not everything. In the days between the two outbreaks, researchers identified more cases of acute gastrointestinal disease in people who visited the park but lacked the laboratory data to link them directly to any of the identified outbreaks. With additional cases identified on June 19, investigators found 63 gastrointestinal diseases and the enclosure was closed on June 19.

Reconsider the rules

When local health officials investigated the operation of the covers, they found some disturbing features that could explain the outbreaks, including:

Stagnant water in the reservoir (into which the water flows after the users are sprinkled and before filtration, disinfection and re-sprinkling) overnight, instead of being constantly recirculated, filtered and chlorinated. The splash pad did not have an automatic controller to measure and maintain the concentration of free chlorine needed to prevent the transmission of pathogens. In addition, no staff members had documentation of completion of standardized operator training.

CDC tests detected gastrointestinal bacteria in three of the seven pumps used to deliver water to the splash elements.

After the protector was closed on June 19, the wildlife park took on the health researcher’s discoveries, adding continuous circulation, filtering, disinfection; adding an automated chlorine controller and training its staff. The welcome panel reopened on July 24 and no additional welcoming panel diseases were identified.

“As the use of guards increases, exempting washers from regulation under public health codes should be reconsidered,” concluded the authors of the report.

For now, however, simple messages can also help prevent splashes, such as signs telling sprayers and caregivers: “Do not enter the water if you have diarrhea”, “Do not stand or sit over the nozzles” and “Do not swallow the water.”

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