May 27, 2006
 
How to Swim and Stay Healthy
 
By Lee Bowman
Scripps Howard News Service
 
Sometime between now and Labor Day, chances are that you're going to stick your head under water at least once in a pool, pond, river or ocean. But no matter how pristine the water seems or how much chlorine has been added to the pool, the odds are still also pretty good that you'll be swimming with some germs.
 
Water-safety experts say the best way to avoid infections from a dip is to make sure there are no contamination warnings for where you swim, to shower before and after you get in the water, to not swallow water you're swimming in, and to avoid swimming if you have open cuts or scrapes.
 
Yet even with those precautions, waterborne infections are on the rise. According to state reports to the federal Centers for Disease Control and Prevention of disease outbreaks involving groups of people, treated water in swimming pools is just as likely as the natural water in lakes or the ocean to produce gastrointestinal or other types of infection.
 
Chlorine and other pool chemicals don't work instantly, and microbes are quick to jump to a new human host.
 
The most common pathway for a waterborne infection is the ear. It's estimated that one in every 100 to 250 Americans falls victim to an infection of the ear canal commonly known as swimmer's ear each year.
 
Actually, anything that irritates the tubular opening that carries sound from the outer ear to the eardrum can open a pathway to infection from a variety of bacteria and fungi. Lots of things can cause the skin inside the ear canal to break: dry skin, vigorous ear cleaning with a swab, fingernail or objects like paper clips, even a grain or two of sand.
 
The main culprit in otitis externa, however, is water. Too much moisture in the ear can irritate and break down the skin inside and allow infection to gain a foothold. "The skin inside the ear gets pruny, just like the tips of your fingers do when you soak too long, and bacteria have an open gateway,"
 
said Dr. Alan Greene, a California pediatrician and Internet health consultant whose books include a parental guide to dealing with ear infections.
 
Infection from swimmer's ear typically sets in within a few days of exposure, and can last for a week or longer, plenty of time to ruin a vacation. "It's a hot, painful infection that keeps a lot of kids out of the water every summer," Greene said.
 
The first line of defense against swimmer's ear is to keep the ears dry, Greene and others say. That can be as simple as tilting the head to one side and shaking the water out, or aiming the hair dryer down the ear for a few seconds. People whose ear canals are difficult to drain can apply a few drops of an alcohol -- or vinegar-based ear-drying product -- sold over the counter at drugstores.
 
Children with tubes in their ears as a result of frequent middle-ear infections, or anyone with ears prone to stay wet may need to use earplugs or bathing caps when they swim.
 
If an infection does get started, new guidelines issued last month by a special commission of ear specialists, pediatricians and family doctors are in place to help in getting the quickest cure possible.
 
"The most important feature of the new guidelines is that they do not depend on physicians' opinions, but are entirely based on what has been scientifically demonstrated," said Dr. Peter Roland, a member of the panel and chairman of otolaryngology at the University of Texas Southwestern Medical Center in Dallas.
 
The main emphasis is on treating the infections with antiseptic or antibiotic eardrops to inhibit bacterial growth, rather than giving patients oral doses of antibiotics.
 
"Most of the time, there's no reason to swallow a pill for an ear infection. Maybe a thousandth of the dose you take gets to that little patch of skin in the ear where the infection is," Greene said. "You're using less antibiotic, with less side effects, and getting much better results."
 
Roland said the drops relieve ear pain in most patients within a day, and clear up most infections within a week. When patients take pills for ear infections, the pain often lasts for a week.
 
The guidelines recommend that oral antibiotics should only be used if other conditions, such as diabetes or immune-system-compromising illnesses, are present.
 
"I've always been a big proponent of not overusing antibiotics," Greene said, "but swimmer's ear is one situation where just a couple of drops once a day can make a huge difference in recovery."
 
On the Net: www.cdc.gov/healthyswimming/
 
(Contact Lee Bowman at BowmanL@shns.com)