Infections associated with fresh water exposure

• Acute febrile illness
  • Leptospirosis
  • Schistosomiasis
  • Enteric fever
  • Hepatitis A
  • Burkholderia pseudomallei (melioidosis)
• Skin and soft tissue infections
  • Aeromonas species
  • Vibrio vulnificus (brackish water)
  • Edwardsiella tarda
  • Plesiomonas shigelloides
  • Burkholderia pseudomallei (melioidosis)
  • Mycobacterium marinum
  • Other Gram-negative bacilli
• Gastrointestinal illness
  • Cryptosporidium species
  • Giardia lamblia
  • Escherichia coli O157:H7
  • Shigella species
  • Campylobacter species
  • Salmonella species
• Central nervous system infections
  • Neuroschistosomiasis
  • Primary amoebic meningoencephalitis (PAM)
  • Granulomatous amoebic encephalitis (GAE)
• Respiratory illness
  • Legionella species
  • Burkholderia pseudomallei (melioidosis)

Recreational Water

Organism	Survives Chlorination?
Escherichia coli	no
Giardia lamblia	maybe cysts
Cryptosporidium	yes
Shigella	no
Norovirus	no