Shigellosis associated with recreational water contact in Los Angeles County

An outbreak of shigellosis associated with swimming at a human-made lake during the Labor Day weekend occurred in Los Angeles County in 1985. Sixty-eight persons had onset of diarrheal illness within 1 week following exposure at the recreational site. Thirty-three of these cases were culture-confirmed as shigellosis (29 Shigella sonnei, 4 Shigella boydii). Fifteen persons were hospitalized. Illness was highly associated with water contact, specifically swallowing water while swimming (P less than 0.001) and age less than 15 years (P less than 0.001). Water samples from the swimming area had high fecal coliform counts; however, dye testing showed no evidence of sewage contamination. Direct bather contamination of the swimming area may have occurred in the context of large crowds, inadequate restroom facilities, poor water exchange, and the absence of a mechanism of disinfection.