Splash Pads Are Fun but Can Spark Waterborne-Disease Outbreaks, CDC Finds

The Washington Post / Sabrina Malhi

13:07 JST, December 5, 2024

Splash pads found in public parks across the United States are linked to thousands of cases of waterborne diseases that leave a calling card of diarrhea, fever and vomiting, the Centers for Disease Control and Prevention reported this week.

More than 10,000 children became ill from 1997 to 2022 after using splash pads, and most of those outbreaks were attributed to cryptosporidium, a parasite that causes diarrhea and spreads through contaminated water.

No deaths were blamed on the infections, but the CDC said families need to be more vigilant about the proper use of splash pads. The agency also encouraged parents to avoid using public aquatic centers if their children have diarrhea.

Cryptosporidium is spread by infected people or animals, and when children carrying the parasite use splash pads the nozzles can spray the pathogen broadly. Children sometimes sit or stand on top of the water jets, leading to an increased risk of water becoming contaminated with fecal material. Kids also can ingest the contaminated water – a perfect storm for exposure to waterborne pathogens.

Splash pads use nozzles to spray water recirculated through a filtration system and treated with chlorine to minimize transmission of pathogens. But chlorine is not especially effective against cryptosporidium, so the amount of chlorine needed to kill this parasite would be harmful if ingested, according to the CDC.

CDC epidemiologist Hannah Lawinger, lead author of the paper, said splash pads have been growing in popularity, leading the agency to investigate these outbreaks. She said the paper released this week can serve as a guide for public health officials involved in building and operating water recreation centers.

Lawinger urges officials to voluntarily adopt the CDC’s model aquatic health code, which provides public health guidance to prevent injury and illness linked to pools, hot tubs and splash pads. It includes building, plumbing and electrical codes. But she said these measures prove effective only if proper splash pad usage is followed.

“If your kid had cryptosporidium-based diarrhea, they shouldn’t be in a [splash pad] for two weeks after they had an infection,” said Natalie Exum, an environmental health scientist at Johns Hopkins Bloomberg School of Public Health who was not involved in the study.

“It’s really good information for parents to understand the risks when taking their children to the splash pads,” Exum said. “If you have a trip planned to France for your summer vacation and you don’t want anyone to get sick before you go, maybe you’re not sending them a week before you leave.”

Most illnesses related to splash pads did not require hospitalization, the CDC report concludes, and children recovered on their own. Some may need additional fluids while recovering, so offering electrolytes may be sufficient for those with mild symptoms.

“With prompt rehydration and fluid support, they should recover within 10 days,” said Alexandra Brugler Yonts, a pediatric infectious-disease physician at Children’s National in D.C. But she said if children are younger than 1 and unable to maintain adequate fluid intake, they may need an IV.

In rare instances, antiparasitic medications are administered, but the treatment is typically reserved for people with weakened immune systems, such as those living with HIV.