The purification of the water of swimming baths.

  • Great Britain. Ministry of Health.
Date:
1929
Catalogue details

Licence: Public Domain Mark

Credit: The purification of the water of swimming baths. Source: Wellcome Collection.

    30/72 (page 20)
    from the water a sufficiently massive dose of sticky mucus from: another bather to infect him with a catarrh or a tonsilitis, yet it is probably a more usual sequence for the sufferer himself to be carrying the infecting organism already, and for the attack of catarrh or tonsilitis to be brought on by the abnormal state of the mucous membrane, or by the lowered resistance induced by unaccus- tomed and prolonged immersion, exertion, and chill. This is especially likely to be the case with tonsilitis, for we have seen how unusual it is to swallow any appreciable quantity of water. When we remember that the tonsils are constantly bathed in saliva, which contains normally some hundred million streptococci per c.c., and often contain in their crypts a multitude of pathogenic or potentially pathogenic germs (e.g., streptococci both of the haemolytic,* and of the viridans type), it seems unlikely that an infecting dose of another person’s haemolytic streptococci would ever reach the tonsils. No epidemic of diphtheria has, to our knowledge, been ascribed to swimming bath infection, though waterborne diphtheritic nasal infection might seem theoretically possible. Otitis.—But it is the ear infections which give the chief grava- men to the charge of disseminating disease against swimming baths. There are numerous recorded instances of middle ear disease undoubtedly following upon and obviously due to swimming, and in several*cases recorded in the medical press of this country (and in one case known personally to one of us) mastoid disease, menin- gitis, and death have speedily followed the otitis media. The questionnaire of the American Special Committee on Bathing Places issued to 2,000 practitioners elicited details of 129 cases of otitis, 19 of mastoid disease, and 5 of meningitis, whilst the records of two epidemics of middle ear disease were considered by the Committee to be “‘reasonably authentic.’’ It must be remembered, however, that there are estimated to be 15,000 swimming pools and places in the United States, so that the numbers of cases reported seem comparatively small. In this country aurists have described epidemic waves of middle ear disease following swimming, occurring in hot summers such as 1921} and 1928, and have ascribed the disease to swimming bath infection. Such cases are more likely to occur in persons who bathe infre-- quently and so run the maximum risk of infection for the following reasons. The bather who bathes infrequently is out of training for the particular exercise involved in swimming, and so becomes soon and greatly fatigued. His heat-regulating mechanism and his skin are alike unused to immersion in cool water, and he is very apt to chill. He is probably neither an expert diver nor * Normal populations in cities may show a carrier rate of haemolytic streptococcus of 10 per cent., and carrier rates of 33 per cent. have been found in certain section of school populations. } Dr. Dan Mackenzie, Lancet, 1921, ii, Sept. 10th, p. 589.