Freshwater sports and infectious diseases: A narrative review

• Published in: Infectious diseases now (Online) 2024-06, Vol.54 (4), p.104883, Article 104883
• Main Authors: Delamare, Hugues, Septfons, Alexandra, Alfandari, Serge, Mailles, Alexandra
• Format: Article
• Language: English
• Subjects: Bacterial Infections - epidemiology; Communicable Diseases - epidemiology; Fresh Water - parasitology; Freshwater; Humans; Infectious diseases; Outbreak; Sports; Virus Diseases - epidemiology; Water sport; Water Sports; Waterborne infections
• ISSN: 2666-9919; 2666-9919
• DOI: 10.1016/j.idnow.2024.104883

•Freshwater sports can expose participants to various infectious risks depending on the geographical place and the type of sport.•Assessing bathing water through Escherichia coli and enterococci levels alone is not sufficient and should be complemented with local environmental observations.•Potential exposure to pathogen should not be a reason to avoid the practice of freshwater sport, but certain precautions should be taken.•Participants should be informed regarding the infectious risk involved and be aware of the types of infection associated. Moreover, in case of symptoms after freshwater activities, they should be advised to consult a healthcare professional. Freshwater sports involve a wide range of practices leading to contact with soil and water that can entail exposure to agents of potential infectious diseases. The pathogens can be multiple (bacteria, parasites, viruses, fungi), and be either well-known or more unfamiliar and exotic. We conducted a literature review to describe various infections contracted following exposure to water and mud during freshwater sport activities. Out of the 1011 articles identified, 50 were finally included. Our findings encompassed bacterial infections (leptospirosis and gastrointestinal infections); parasitic infections (schistosomiasis, cercarial dermatitis); viral infections (norovirus and other gastrointestinal viruses; seaweed contamination; and fungal infections. These infections were reported in various countries worldwide among diverse freshwater sport activities, including swimming, surfing, kayaking, as well as extreme sports such as adventure races and mud runs. Water sports in freshwater can expose participants to infectious risks according to geographical location and type of sport. Because regular sport practice is beneficial for health, freshwater sports should not be avoided due to potential exposure to pathogens; that much said, certain precautions should be taken. In addition to adoption of preventive measures, participants should be informed about infectious risks and seek medical advice if symptoms appear after exposure. Current guidelines for assessment of bathing water quality do not suffice to ensure comprehensive evaluation of freshwater quality. Event organizers are called upon to pay close attention to environmental factors and meteorological events, to conduct timely sensitization campaigns, and to enforce appropriate safety measures.