Viruses in recreational water-borne disease outbreaks: A review

R. G. Sinclair, E. L. Jones, C. P. Gerba

Research output: Contribution to journalReview articlepeer-review

299 Scopus citations


Viruses are believed to be a significant cause of recreationally associated water-borne disease. However, they have been difficult to document because of the wide variety of illnesses that they cause and the limitations in previous detection methods. Noroviruses are believed to be the single largest cause of outbreaks, which have been documented in the published literature 45% (n = 25), followed by adenovirus (24%), echovirus (18%), hepatitis A virus (7%) and coxsackieviruses (5%). Just under half of the outbreaks occurred in swimming pools (49%), while the second largest outbreak occurred in lakes or ponds (40%). The number of reported outbreaks associated with noroviruses has increased significantly in recent years probably because of better methods for virus detection. Inadequate disinfection was related to 69% (n = 18) of swimming pool outbreaks. A lack of required reporting and nonuniform water quality and chlorination/disinfection standards continues to contribute to water-borne recreational disease outbreaks.

Original languageEnglish (US)
Pages (from-to)1769-1780
Number of pages12
JournalJournal of Applied Microbiology
Issue number6
StatePublished - Dec 2009


  • Adenovirus
  • Coxsackievirus
  • Echovirus
  • Enteroviruses
  • Hepatitis A
  • Lake
  • Norovirus
  • Outbreak
  • Pond
  • Recreation
  • River
  • Swimming pool
  • Virus
  • Water-borne

ASJC Scopus subject areas

  • Biotechnology
  • Applied Microbiology and Biotechnology


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