Splish, Splash - But Please Don’t Take A Bath In A Splash Fountain

It’s hot outside and you live in the city.  Down the street, a fire hydrant has burst and there is refreshing cold water spraying up into the air like a geyser.   Sounds of ecstatic children running, yelling, jumping up and down, having fun and cooling off fill the thick, humid air.  Unfortunately this type of splash fountain, also known as a spray fountain is not a properly functioning fountain, but a malfunctioning piece of city property.  Take the same idea and turn it into a popular form of outdoor commercial fountains and there you have it - splash fountains and spray fountains.

Splash Fountains

Splash fountains are an affordable alternative to the large swimming pool.  These fountains, also known as bathing fountains spray water in all different directions, and usually include non-slip tread for safety.  They may also be called splash pads or “spraygrounds”, and are often located in public playgrounds, parks, or around pools to enhance the surrounding play area.  There is no standing water, thus eliminating drowning hazards and the need for a lifeguard. 

Spray Fountains

A spray fountain is another popular pool alternative.  This type of fountain is reminiscent of water showering out of an open fire hydrant, creating a canopy of water used for cooling and frolicking.  These are more popular in urban areas, where a public pool may not be cost effective, and space is an issue.

Why Water Fountain Cleanliness Is So Important

Splash and Spray fountains can be a great way to cool down on a summer day, but precautions must be taken to reduce to risk of contracting a germ or virus.  Cryptosporidium is a germ that has been found in multiple splash fountains.  In San Jose, California, the Cesar Chavez Fountain is a popular attraction in the downtown area.  However, many children have been sickened and at least one hospitalized due to infection by the germ.  The germ was able to thrive because the filtration system only treated the water with chlorine, which does not make the water safe to ingest.  Still, visitors have observed the homeless bathing in the fountain, dogs running through the spray, and diapered toddlers with their mouths to the water, using the water to drink or spit at their friends.  The fountain was eventually shut down, so a new filtration system could be installed, with a cost of close to $600,000. 

Another outbreak occurred in Sarasota, Florida.  The Steigerwaldt/Jockey Children's Fountain used water that is treated with chlorine and replaced weekly.  The water was pumped through pressure jets so fast that the water didn't receive full treatment during each cycle.  The result was six confirmed cases of Cryptosporidiosis.  The fountain’s filtration system was then replaced with a state-of-the-art water quality system, which brings the water quality to drinking water standards. 

Cryptosporidiosis in the History of Fountains

The largest outbreak of cryptosporidiosis was found to be associated with exposure to a water fountain at the Minnesota Zoo in 1997. The Minnesota Department of Health (MDH) was first notified of a potential problem when four of ten children who attended a birthday party at the zoo were diagnosed with cryptosporidiosis. Zoo officials provided the MDH with a listing of registered groups that had visited the zoo from June 28 through June 30. The MDH interviewed 120 zoo visitors relative to illness and exposure at the zoo. Initial findings indicated cases of vomiting and diarrhea, with three or more loose stools during a 24-hour period. Of the 120 zoo visitors interviewed, 11 (9%) had illnesses that met the initial case definition for cryptosporidiosis. All of the visitors had exposure to the fountain.

The fountain was closed and the MDH issued a public statement requesting that persons who had visited the zoo and developed diarrhea to contact their physicians and the MDH. Persons responded to the public statement and a revised case definition was developed. It was defined as vomiting, diarrhea persisting at least 3 days, with onset 3-15 days after exposure to the fountain. Of the respondents, 369 case patients were identified. Of the 369 cases, 73 (20%) were lab confirmed. This includes the 11 initial cases. The symptoms identified were as follows:

The median age for case patients was 6 years old. The median duration for illness was 7 days. The median number hospitalized was six. Of the respondents, 191 of 332 case patients indicated exposure to the petting zoo. However, all animals in the petting zoo tested negative for Cryptosporidium. In addition to case-patients with fountain exposure, nine laboratory-confirmed cases of cryptosporidiosis were identified among household contacts of case-patients with fountain exposure.

The MDH found that as a matter of routine, water in the fountain was replaced three times a week, but the filter was never flushed. As a result, the fountain was banned as a play area and it was subsequently fenced off and allowed to stand only as a decorative piece. The true source of contamination was never established, but study results suggest that contamination could have stemmed from a baby’s diaper. 

The Center for Disease Control (CDC) concluded that shared filtration systems could have contributed to the contamination of multiple pools within the water park. Pool water disinfection and filtration systems are commonly used to prevent contamination. However, Cryptosporidium is chlorine resistant. Existing chloride concentrations are not able to effectively inactivate Cryptosporidium oocysts. As such, Cryptosporidium may survive in pool water for days. Cryptosporidium oocysts are also not removed by filtration systems that are normally used in recreational water facilities and swimming pools. 

CDC guidelines to reduce the risk of contamination and the transmission of infection include the following: 

• Educating and modifying behaviors of pool managers, staff and patrons.
• Hyperclorination after episodes of facial and diarrhea episodes. Hyperclorination includes free chlorine levels of 20 ppm for 8 hours.
• Having patrons comply with regulations and practices of good hygiene when using pool facilities.
• Modify water park designs to prevent cross contamination.
• Separate toddler/wading pool filtration systems from other swimming pools and water facilities.
• Increase the turnover time of toddler/wading pools to about 30 minutes.
• Include ultraviolet systems to complement existing chlorine disinfection and DE filtration processes. Ultraviolet water treatment is effective in inactivating Cryptosporidium oocysts.
• Avoid swimming while experiencing symptoms of diarrhea.
• Avoid swimming during outbreaks of diarrhea for 2 weeks following resolution.
• Avoid risky behavior such as getting water in the mouth or swallowing water.
• Allow frequent bathroom breaks for children and toddlers.
• Engage appropriate diaper changes and hand washings.
• Early recognition and prompt actions by health officials.
• Early notification of infection or contamination by hospital staff.

Everyone, whether young or old, seems to be drawn to water.  There is something peaceful yet at the same time revitalizing and mesmerizing about water fountains.  It is important to remember that public water fountain sources that are used to supply large tiered commercial fountains, large spray or splash fountains, or any other type of large fountain may have the potential to become contaminated, especially if less than standard filtration systems are used in the fountain system. 

Be aware of your surroundings, observe other participants near or in the fountain area.  Use your best judgment and observe posted usage rules and regulations when enjoying one of these wonderful fountains so that all participants are able to have a safe, enjoyable experience.