Estudio de Validación

including U50Cinted pipes and air-conditioning units 21

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Atypical m)cobacteria are ubiquitous in the aqueous environment and proliferate in and around swimming pools and sim1lu environments (Leoni ^{et al..} 1999) In pool environments. MycobocJeriu. n,ar/1111111 is responsible for skin and son tissue infections in

healthy people The organism is probably picked up from the pool edge by bathers as they climb in and out of the pool (Collins ^et al. 1984) Rcspimory illnesses associated with hot tub use in nomllllly healthy individuals ^ha\-c been linked to other atypical mycobactcria (Kahana ^et al. 1997, Grimes ^{et al.} 2001, Lumb ^{et al,} 2004) Thorough cleaning of surfaces and materials around pools and hot tubs where the organism may pcnist is necessary, supplemented by the maintenance of disinfection at appropnatc levels

Humans arc the only knO\YTI reservoir of Slaphylococcus aurrus, and it is found on the anterior nasal mucosa ^and skin as well as in the faeces of a substantial ponion of healthy individuals Stapl,ylococcus aureus in swimming pools could cause a host of infections including skin and ^wound infections, otitis extcma, impetigo and eye infections. Adequate inactivation of potentially pathogenic S. ^aurrus in S\vimming pools can be a11ained by maintaining free chlorine levels greater than I mg/I (ruvcrn and Adcru, I 99 I)

2.9.2 Protozoan PatbogcnJ

Protozoan pathogens found in S\Yimming pools and similar environments include Cryp1ospond111m, G1ard10, Narglt-11afo,,.Jer, and />lasmad111n1 Sf)JJ Crypto5TJOr1d111m and

Giarcl,a are s1nglcxellcd pro101..01 that mny be �cretcd by infcacd humans into SW1mming poolJ through fcac:al accidents. ^G,arwa has caused outbreaks of giardiasis in poolJ and \Wier slides {1 lancr ^{et al,} 198'1; Pon er ^et al. I 988, Grccnsmith ^{et al} , I 988) A number of outbreaks of cryptosporidiosis have been linked to swimming pools The sources of Cryp1os110nd111m coouaminaung the pools '"'ere believed to be eith ^er SC\Yllgc or the swimmers themselves (CDC, 1990, Joyce ^et o/, 1991, Hunt el al. 1994) Chlonoauon at recommended rcs1duaJ levels has limllcd effect on Glorci,o and ^IS completely ineffective 1ga1ns1 Cryptorpond,um oocysts UV and Ozone arc more clfcctivc in i ^na cth ^"8 tlng Giardia cysts and cryptosporidium oocysts Regula, "dumping" and tilu.tion using

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11occulation and coagula1ion agents aid 1n the removal or these parasites Regular super chlonnation also aid m control or these organisms (NSW Health, 1996)

Naegler,a fowleri is a free-living amoeba prcscnl in fresh water and soil It docs not require the infection or n host organism to 00mplcte its life cycle N. /011/cn is thennophilic, preferri ng ,varm Wlltcr and reproducing suc;ccssfully nl temperatures up to 46 ^° C N. JOU;/er, causes Primary Amoebic �feningocnccphalit1s (PM1) Infection is

usually acquired by eq,osurc 10 waler in ponds, na1ural spas and lll'tific1al lakes �1artincz Md Visvcsvara.. 1997, Szenasi ^{ct al,} 1998) Infection occurs ,vhen ,vo1cr con1ainin8 the organisms is forcefully inhaled or splashed onlo the olfactory cp11hchum. For those infected, death usuttlly occur 3-IOdnys a.flcr onse1 or syn1p1oms (\VHO, 2006) Although PM1 1s nn extremely rare disease; cases have been associated with pools and natural spas Risk of 1nfcct1on can ^be reduced by minimizing the occum:ncc of the causative agenl

through appropriate choice of source waler, proper cleaning. main1cnancc_ e04gula1ion­

filtra1ion :ind disinfection

S,vimmin8 pools ore nssocia1cd ,vith anophclinc mosquilo larvae, the insect -.cc1ors or P/a<;n1oJ111m ,,pp To crrectivcly manage this risk. pools should be drained every S-7days

during rainy scasori 10 avoid mosqui10 larvae dcvc.loping in10 adults Treatment or the pools with larvicidcs may also ^be carried oul when pools arc no1 in use for long periods

2.9.3 rnthogcnic fungi

Ep1d.:rmoplryto11jlocco.fl1m and vanow species or fungi in the gcnw Tncl,op/

1011 cause superficial fungal infections of Lhc hair. finger nails or skin Infection of the skin of I.be foot (usually bcl\ve1:n the toes) is described as 7i11ea peths or, more commonly as athletes foot (Aho & Him. 1981) , The sole source of these fungi 1n swimming pool and simil ^ar fi1cili1ics 1s infected balhcn. hcnec, ^the most imponant means or controlling Lhc spraid of the fungus is to educate the public oboul the <l•u:ase. limning contact bch�-ccn infected and non-,nfcctcd balhc:rs and medical treatment Rou1inc disinfection appcan 1o control the

SJ>rcad of these fungi in swimming pools and similar environments

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2.9.4 Viral patbogeDJ

Vi ^ruses f ^ou nd in S\vimming pools and similar environments include mo/111sapor ^VlNS, JJOpill ^oma virus. cntcro viruses and adcoo viruses. M ^o /111.sc,por virus causes M ^o l/uscum

co11tag1os11n1, an innocuous cutaneous disease limited to ^humans. II is spread by direct

person-to-person contact or indi ^rec tly through physical cooU1ct ,vith contaminated

surfaces. S\vimming pool-related cases cx:cur more frequently in children ^than in adults

Lesions are most often found on the anns. back of the legs nnd back. suggesting

transmission through physical contact ,vith the edge of the poo� benches around the pool,

S\Vimming aids carried into the pool or shared towels (Castilla ^{ct al.,} 199S). ^The only

source of Al/oll11sr:ipor virus in S\Vimming pool and similar facilities is infected bathers

(Oren & \Vcndc, ¹⁹⁹¹⁾ Public education. limiting conlllct bcrwcen infected and non

infected people, medical treatment and frequent cleaning of surfaces in facilities are all