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Swimming pool-associated viral outbreaks in China: causes and solutions
1Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, State Key Laboratory of Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Objective:
This study aimed to assess the causes of the swimming pool-associated viral outbreaks in China and discuss the possible preventive measures for the outbreaks.
Methods:
A systematic search was performed in 4 Chinese and English databases for studies investigating the swimming pool-associated viral outbreaks in China up to June 2024.
Results:
29 outbreaks were included in the review. A median of 89 cases per outbreak was observed among 29 outbreaks, and most outbreaks (27/29, 93%) were caused by adenovirus. The findings regarding the difference in attack rate of adenovirus between males and females were not consistent. Poor maintenance and management of the pool (26/29, 90%), difficulty in early identification of outbreaks (21/29, 72%), and lack of public awareness of waterborne diseases (7/29, 24%) were the main causes of the outbreaks.
Conclusion:
This review reveals the causes of swimming pool-associated viral outbreaks in China, and possible preventive measures could include improving pool maintenance and management, early recognition of the outbreaks, and increasing public awareness of recreational water illnesses.