JANE SWIFT
GOVERNOR

WILLIAM D. O’LEARY
SECRETARY

HOWARD K. KOH, MD, MPH
COMMISSIONER	The Commonwealth of Massachusetts
Executive Office of Health and Human Services
Department of Public Health
Division of Community Sanitation
305 South Street, Jamaica Plain, MA 02130-3597
(617) 983-6761 (617) 983-6770 - Fax	

MEMORANDUM

To:   	Local Boards of Health, Pool Operators	
From:    	Division of Community Sanitation	
Regarding:   	Communicable Disease and Public and Semi-Public Swimming Pool Use	
Date:    	September 4, 2001	

This memo is intended to clarify the term “communicable disease” as it is found in 105 CMR 435.00: Minimum Standards For Swimming Pools.  Specifically, 435.22(1) restricts an individual with a communicable disease from working at a swimming, wading or special purpose pool and 435.22(3) requires that a sign be posted at the same locations that states, “ No person with a communicable disease is allowed to use the pool.”

The regulation solely applies to communicable diseases that are transmitted through water.  The following common diseases are known to be transmissible through water and individuals who have one of these diseases are restricted from working at or swimming in a pool:

Bacteria: 	Virus:	Parasite:	
Shigellosis	Hepatitis A	Cryptosporidiosis	
Campylobacteriosis		Giardiasis	
Salmonellosis			
E.coli O157:H7 Infection      			

These microorganisms are shed in the feces of an infected person. Since the disease-causing organisms can survive outside of the host body and may survive in pool water, the swimmer’s health is at risk if contaminated water is ingested.  A properly disinfected and pH controlled pool will kill most, but not all, contagious organisms. The Centers for Disease Control and Prevention reports that cryptosporidia oocysts are resistant to chlorine and may remain infective for days in a sufficiently chlorinated pool. It is important that swimmers observe the no swimming rule if they have been diagnosed with any of the diseases noted above or have symptoms that might be due to organisms that cause these diseases. It is recommended that upon recovery, an infected individual wait an additional fourteen days before using the pool. (If you have a question regarding a disease that is not listed and restrictions on pool use, please contact the Division of Community Sanitation at (617) 983-6766.)

It is important to note that although an individual may have a contagious disease, if that disease cannot be contracted through water, the swimming pool regulation restrictions on pool use are not applicable.  For example, according to the CDC, there is no evidence that HIV/AIDS is transmissible through water. The virus cannot remain infectious outside of the host body, especially in a well-chlorinated pool that would kill the virus. While HIV is a disease that is contagious, it has been proven contagious only through activities that involve the exchange of infected bodily fluids, such as, in sexual contact and sharing needles with an infected individual; therefore individuals with HIV/AIDS are not restricted from pool use.