Bathers as a possible source of contamination for swimming‐associated illness at marine bathing beaches

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Abstract
The results of a prospective, follow‐up epidemiological study conducted at three Israeli coastal beaches in 1983 showed that enteric, respiratory and ear symptomatology were higher among swimmers than nonswimmers, especially for young children. The enterococcus levels and the swimming‐associated rates for enteric and respiratory symptoms at one of the beaches (Gordon) were at least twice those at another beach (Rishon Lezion). The higher swimming‐associated symptom rates at Gordon Beach, however, were largely attributable to individuals who swam on Saturdays, which are non‐working days in Israel, as opposed to Fridays and Sundays. The absence of extrinsic sources of pollution, the restricted water exchange due to horizontal surf‐breakers, the greater bather density and higher indicator levels (including those of Staphylococcus aureus) on Saturdays and the better correlation of S. aureus than enterococcus (or Escherichia cofi) levels to swimming‐associated enteric and respiratory symptoms, suggests that contamination from the bathers themselves is the source of the indicators and swimming‐associated illness at Gordon Beach.