Can You Get Sick from a Hot Tub?

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Possibly. You should be cautious when using a public hot tub, since these can be VERY unhealthy.

Soaking in a hot tub after a long day of skiing or an intense workout is an ideal way to warm up and unwind. It can relax your mind and body, loosen tense muscles and has even been known to boost the immune system. But, you may need to think twice about taking that serene dip.

Can-You-Get-Sick-Hot-Tub-Featured-Image

You might have heard the flu that is sweeping the country this cold season seems to be more widespread than normal. But what about the diseases you can get from a hot tub? Lately Legionella’s Disease has been a popular subject in the news headlines. The most recent case in January 2018 found a hot tub in Tennessee as a source of an outbreak of this disease that spread to 92 people, one which has died.

Do you know when to avoid the hot tub? I’ll explain what Legionella’s Disease is plus other diseases you can get from a hot tub and help you decide if you should enjoy that soak or skip it.

Already sick? Using the hot tub is one of the best tools to help relieve cold & flu symptoms! Read more about how your hot tub can help.

Proper-Hot-Tub-Disinfection

Hot tubs are generally safe when:

  • The walls of the spa are smooth and clean
  • The water is clean, clear and a slight blue tint
  • There is no strong smell
  • You can hear the hot tub equipment

See-Feel-Smell-Listen

Knowing if a spa is properly sanitized can help prevent the spread of disease.

Ask your hotel or gym what the most recent health inspection score was, what their daily maintenance schedule is like, and how often they change the hot tub water. If you don’t feel comfortable asking how they maintain their spa or pool water you can bring your own test strips or use your senses to tell if it’s safe to bathe.

Properly maintained hot tubs have the recommended amount of disinfectant (also known as sanitizer) in them. For recreational hot tubs, the CDC suggests free chlorine levels should be 2-4 parts per million (ppm), bromine should be between 4-6 ppm and pH levels should be between 7.2-7.8. You are more than welcome to use your own test strips at these public watering holes. Test strips can be purchased here or your local hardware store.

Your Nose Knows!

When spas are not properly sanitized, your nose will know! If you smell strong chlorine or other chemical odors, that means the hot tub is not being properly sanitized (or overly sanitized which can be just as bad).

This might seem odd or wrong to those who believe the smell usually means there’s too much chlorine in the water. In fact, when you smell the disinfectant it means the chlorine has combined with urine, feces, sweat and dirt from soaker’s bodies to produce chloramines. Chloramines use up the disinfectant faster to create that strong chemical odor.

The job of sanitizers or disinfectants is to kill germs. When dissolved solids (urine, feces, sweat, etc) rinse off our bodies and into the water, the chemicals break these down instead of killing the germs. This uses up the disinfectant’s power, leaving less to kill infectious bacteria.

Common-Waterbourne-Diseases

Legionnaire’s Disease

This bacteria has been in the news quite a few times recently. It is a waterborne illness that is transmitted mainly by contact with the mucous membranes or inhalation of a mist or aerosolized water particles (CDC, 2018). Making a hot tub a prime breeding & thriving ground.

It’s a bacteria that causes one of two respiratory illnesses. First, Legionnaire’s disease causes a severe pneumonia and the second is a less severe Pontiac fever that causes an influenza-like illness.

Legionnaire’s Disease Coughing Man

Proper maintenance and disinfection of hot tubs can prevent the proliferation of Legionella in public water systems.

Cryptosporidium

More commonly known as Crypto, this parasite is spread through swallowing water. On average, adult swimmers swallow up to 1 ounce of pool water per swim, and children typically swallow twice that amount. The good news is you are less likely to swallow water on accident in a hot tub than from using the pool.

Crypto causes severe diarrhea, stomach cramps, fever, nausea and vomiting. This parasite is present in 1-4% of the total North American population, or over 12 million in the United States alone can be carriers of Crypto.

Crypto-Biofilm-bacteria

In addition to pools, this infectious disease is spread through contaminated water from water parks, interactive fountains, water play areas, hot tubs, lakes, rivers, springs, ponds, streams and oceans.

Crypto can be chlorine-resistant, leading to an infectious spread in the water, six to seven days following exposure to this parasite.

The signs posted around public pools and hot tubs that say to not enter the water if you’ve had diarrhea are up for a reason! Even if you feel better, it could take weeks before you stop shedding diarrhea-causing pathogens. Fear of missing out is better than feeling guilty when all your friends end up with your illness.

Hot Tub Skin Rash

This type of dermatitis is an infection on the skin. It is caused by the germ Pseudomonas aeruginosa which can be found in a hot tub environment.

Hot-tub-rash

Hot tub rash is spread through long skin exposure to contaminated water. The symptoms include itchy spots on the skin that become a bumpy red rash, and can appear to be worse in the areas that a swimsuit previously covered. This infection can spread faster in hot tubs.

This hot tub rash is also referred to as Folliculitis, read more about it here.

Shower-Before-and-After

Practicing healthy hygiene at home and before using any public hot tub is very important.

Keep in mind, a clean, showered adult swimmer can introduce 0.1 gram of fecal material into hot tub water. Kids can introduce 100 times that amount in the water. (We don’t want to mention or think about how much an unshowered swimmer can introduce…)

Shower-Head

Don’t forget to rinse your swimsuit with water after the hot tub, pool or other recreational water exposure. This can reduce the risk of reinfection at your next soak if any germs are present.

Personal-Hot-Tubs-and-Spas

The value of owning your own spa can substantially outweigh the benefits of using a public water source found at the local gym or your vacation resort. There is certainly less of a risk contracting any waterborne diseases when you are using your own spa at home without guests. However, keeping proper maintenance and cleaning schedules is vitally as important.

Sometimes private home spas can become more dangerous than using a heavily occupied gym hot tub because owners become careless in cleaning or maintaining a private home spa when it’s just friends and family using it.

Personal-Hot-Tub

Maintaining the disinfectant or sanitizer is very crucial to prevent the possible transmission of infections. Ensuring you have high water quality is the first line of defense in preventing the spread of bacteria.

To reduce the possibility of having guests infect your water, follow these steps:

  • Prevent the water temperature from exceeding 104° F
  • Ask guests to shower for at least 1 minute and to rinse their suits with regular water prior to entering your hot tub and remind them to do so again after
  • Don’t allow children under the age of 5 to enter the spa
  • When the hot tub is not in use, always lock the cover

How-to-super-clean-hot-tubs

If you’re concerned that someone or yourself had exposure to an infection and visited your hot tub, here are some CDC recommended best practices you can follow to disinfect a contaminated hot tub.

Bucket, sponge, microfiber towel

How to Super Clean a Hot Tub:

  • Close the hot tub immediately
  • Collect water samples and contact your state or local public health agency
  • Drain water as directed by the local regulatory authority
  • Vigorously scrubbing all surfaces, skimmers, and circulation components
  • Remove and replace filters
  • Refill spa and hyperchlorinate by maintaining 20 ppm of free chlorine in the system for 10 hours, regardless of disinfectant type.
    • Keep jets off for first hour, then turn jets on to circulate hyperchlorinated water for 9 additional hours.
  • Flush system with a product such as Spa System Flush to remove all hyperchlorinated water
  • Refill and at least 24 hours after, resample until lab tests confirm infectious diseases are no longer present
  • Check and maintain water quality to make sure sanitizer and pH levels are meeting local and state standards

To recap…

What you can catch from a hot tub:

  • Legionella’s Disease can be transferred by simply breathing in the hot tub steam. It can cause pneumonia or Pontiac fever.
  • Crypto is a parasite that is spread through swallowing water and adults may swallow up to 1 ounce of water during each swim. It causes
  • Hot tub rash is spread by continuous contact with infected water and causes severe diarrhea, stomach cramps, fever, nausea and vomiting.

When spas are not properly sanitized, your nose will know! If you smell strong chlorine or other chemical odors, that means the hot tub is not being properly sanitized.

Personal hot tubs can become more of a cesspool than a public hot tub if the owner disregards proper maintenance.

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