Nemours Doctor Discusses Health Risks in Florida’s Waters

May is National Water Safety Month, so all month we’ll be discussing this topic. We’re starting off the month featuring an article written by Catherine Lamprecht, M.D. She’s a doctor with Nemours in Lake Nona, and has great information to share.

Playing it Safe in Florida’s Waters
The health risks of water activities.
By Catherine Lamprecht, M.D.

Florida’s warm weather and endless sunshine makes water activities a popular pastime. What
many parents forget to think about is the health risks that can stem from water exposure. To
ensure your child remains healthy throughout the swimming season, take the proper precautions
when playing in the water.

Swimmer’s Ear

Swimmer’s ear is an infection of the ear canal, the tubular opening that carries sounds from the
outside of the body to the eardrum, and is caused by different types of bacteria or fungi getting
into the canal. The infection commonly occurs in children who spend a lot of time in the water.
Too much moisture in the ear can irritate and break down the skin in the canal, allowing bacteria
or fungi to penetrate and cause your child to complain of pain.

But children don’t have to swim to get swimmer’s ear. Anything that causes a break in the skin of
the ear canal can lead to an infection. Dry skin or eczema, scratching the ear canal, vigorous ear
cleaning with cotton-tipped applicators, or inserting foreign objects like bobby pins or paper clips
into the ear can all increase the risk of developing swimmer’s ear.

How to Recognize Swimmer’s Ear

  • Increasing ear pain
  • Pain while chewing
  • Itching
  • Swelling of the ear canal
  • Irritation & swelling of the outer ear
  • Swollen/tender lymph nodes around the ear
  • Drainage from the ear canal
  • Hearing trouble
  • Fever is possible but not common

Prevention

Using over-the-counter drops of a dilute solution of acetic acid or alcohol in the ears after
swimming can help prevent swimmer’s ear. These drops are available at pharmacies and should
only be used for children who do not have ear tubes or a hole in the eardrum. After time in the
water, children should gently dry their ears with a towel and help water run out of their ears
by turning their heads to the side. Never put objects into a child’s ear, including cotton-tipped
applicators.

Treatment

Swimmer’s ear should be treated by a doctor. If left untreated, the ear pain will get worse and the
infection may spread. To help relieve the pain until your child sees the doctor, you can place a
warm washcloth or heating pad against the affected ear. Acetaminophen or ibuprofen may also
ease discomfort. For most cases, your doctor may prescribe eardrops that contain antibiotics to
fight the infection and eardrops are usually given several times a day for seven to 10 days.

The Amoeba in Our Water

Florida’s waters are home to a deadly amoeba known as Naegleria fowleri or N. fowleri. The
amoeba causes a rare brain infection that has killed 30 people in Florida including three Central
Florida boys in 2007. Amoebas thrive in warm, fresh water around the world, particularly water
heated to 80 degrees Fahrenheit in temperature. Common places in Florida for the amoeba to be
present are in the waters of lakes, ponds and poorly maintained pools.

When infected water makes its way into the nose, the amoeba finds its entry way into the human
body. The nasal passage permits access to the olfactory nerve, which it follows until reaching
the brain. It is in the brain that the deadly infection begins and spreads at a severely rapid pace.
Victims typically die seven to 10 days after infection although symptoms may not appear for
up to 14 days. Initial symptoms include headache, fever, nausea, vomiting and a stiff neck.

As the infection progresses, symptoms include confusion, inability to pay attention to people
and surroundings, loss of balance, seizures and hallucinations. Death usually follows the first
symptoms by three to seven days. If you or someone you know has any of these symptoms and
has recently participated in water activities, seek immediate medical attention.

Prevention

When you can, try to avoid swimming in warm, fresh water. If you can’t, here are a few tips to
help you and your child prevent infection from these deadly amoebas:

  • Minimize entry of water into the nose by using nose plugs
  • Avoid digging or stirring up sediment while in warm waters
  • Avoid thermally polluted water, such as water near power plants
  • Learn as much about the species as you can

For more information on water safety, visit KidsHealth.org.

Catherine Lamprecht, M.D., is a board certified pediatric infectious disease physician at
Nemours Children’s Clinic and provides services to diagnose and treat children of all ages
with chronic or recurrent infections as well as unusual bacterial, fungal or viral infections.

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