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Summer is a time to enjoy life but can also present a series of season-specific health complications, including water-born and sun related illness, according to health experts. (Photo by Kirsten Farmer)

With warmer weather finally here, The Beach Reporter sought advice from Dr. William Kim, chief medical adviser of the Beach Cities Health District in Redondo Beach, to learn how to avoid common summer ailments.

Pool-borne illnesses

With more people flocking to swimming pools and water parks comes an increased risk for certain water-borne parasites such as cryptosporidium.

The intracellular protozoan, which can cause severe gastrointestinal problems, particularly in children, older adults or those with weakened immune systems, according to Kim, who said there were 212 outbreaks in the United States between 2000 and 2014, affecting some 22,000 individuals.

“It lives in the stool of individuals that are infected and that’s how it gets into the water,” Kim explained. “As little as 10 to 50 ingested can cause rather severe symptoms.”

Those symptoms—which can begin two to 10 days after becoming infected and last one to two weeks—may include: severe, watery diarrhea, stomach cramps or pain, dehydration, nausea, vomiting, fever and weight loss, according to the Centers for Disease Control and Prevention. 

“A major source is swimming pools, which can cause community outbreaks,” Kim said. “Basically pools have to be properly cleaned.”

The CDC also recommends proper hygiene as the best defense against crypto fecal parasites, noting frequent hand washing, especially after using the restroom, is crucial.

And if you do have symptoms such as diarrhea, drink plenty of fluids and avoid going into swimming pools or attending water parks until symptoms have subsided for at least two weeks, warns the CDC.

Heat stroke and sunburn

As summer temps rise, so do the number of heat-related illnesses such as sunburn, heat-exhaustion and heat-stroke, according to Kim, who said his office begins to see an influx of patients when temperatures go above 104 degrees.

“Heat stroke is more common in the young and the elderly. It is also found in individuals who take certain types of medications,” Kim said.

He said individuals experiencing heat-related illnesses often have nausea, headaches, shortness of breath, a rapid heart rate, altered mental status, confusion, flushing and redness.

“If you can’t get into air conditioning or a cooler environment, wetting your head and scalp can help lower your temperature,” Kim advised. “And staying well hydrated is key.”

As for sunburn, Kim recommended wearing an SPF of at least 50, avoiding prolonged exposure to the sun and wearing a hat, as well as clothes that help cover the skin.

“SPF creams should be reapplied every couple of hours, especially after bathing or taking a shower,” he added.

If a sunburn should occur, traditional remedies such as aloe vera, moisturizing creams, cool showers and staying hydrated are recommended.

But if an individual has significant blistering that be may be indicative of a more severe burn, it’s time to see a doctor, Kim says.

The CDC says to stay cool, stay hydrated and stay informed of local weather conditions as part of the organization’s heat-related safety tips, which include making sure to avoid leaving children or pets in cars.

Insect bites

Outdoor insects such as mosquitoes and ticks can transmit serious illnesses such as Zika, Dengue and West Nile Virus.

Mosquito season runs from summer to fall, according to the CDC.

While the species of mosquito native to Southern California—the Culex—are larger, easier to spot and typically only bite in the dusk hours, they are no longer the only winged threat to contend with.

Two new, invasive species of mosquito known as the Aedes Aegypti and the Aedes Albopictus have been found across Southern California, according to the California Department of Public Health, and are more likely to bite during the day.

Thus, the traditional wisdom of avoiding being outdoors during early evening hours is no longer effective, Kim explained.

“If you’re going to be doing activities outside, it’s best to put on some form of mosquito repellent,” Kim advised. “There are also mosquito candles and other things that can zap them. The other thing is to make sure there’s no standing water around your home for the mosquitoes to breed in.”

As for mosquito-born illnesses, Kim said it can take three to seven days for symptoms such as fever, chills and myalgias to arise. If they do, a person should see their doctor, he continued.

“I had one poor guy that got West Nile. He’s paralyzed and needs to be on a respirator,” Kim said.

People can also suffer severe allergic reactions—particularly to the invasive species of mosquito they have not yet been exposed to—which can include large areas of swelling, low-grade fever, swollen lymph nodes and hives. Some people may also get short of breath, indicating a systemic reaction.

“For a severe allergic reaction, check with your doctor. It may require more than just an over the counter allergy medication and might warrant a prescription such as prednisone,” he said.

The CDC recommends using a bug repellent that contains active ingredients such as DEET, covering up with long pants and sleeves and keeping mosquitoes outside by using windows and door screens.

Similar measures are also advised to help prevent tick bites, which can spread Lyme disease.

“Avoid wooded and brushy areas with high grass and leaf litter. Walk in the center of trails,” according to the CDC. “Check your clothing and body for ticks and shower soon  after being outdoors. Examine gear and pets.”

If you do find a tick, remove it with fine-nipped tweezers as close to the skin’s surface as possible and pull upward with steady, even pressure, ensuring not to twist or jerk the tick to avoid breaking off its mouth parts. Be certain to thoroughly clean the bite area and hands after removal.

Ocean predators

As the summer season means vacations to the coast for many, beaches everywhere will be packed with sun revelers and tourists.

While most will enjoy a problem-free trip, some unfortunate few will be subjected to beach-related concerns such as shark attacks.

Of the 130 incidents of alleged shark-human interaction that took place in 2018, 66 of those were unprovoked attacks on humans, according to the International Shark Attack File out of the University of Florida Museum of Natural History, which conducts an annual investigation on shark attacks.

“As you might know, in the South Bay, the Santa Monica Bay is an area where great whites actually reproduce,” said Kim. “The ones here are juvenile and smaller sharks. They’re rather skittish and generally don’t attack humans.”

Kim recommended checking in with lifeguards upon arrival to the beach to see if there had been shark, jellyfish or stingray sightings.

The International Shark File advises swimmers to stay in groups, avoid wandering to far from shore or being in the water during darkness or twilight hours and not to enter the water if menstruating or bleeding.

If attacked by a shark, the File says hitting the shark on the nose, ideally with an inanimate object, usually results in the animal curtailing its attack.

“Try to get out of the water at this time. If not possible, repeated blows to the snout may offer a temporary reprieve but the result is likely to become increasingly less effective,” according to the File. “If a shark actually bites, we suggest clawing at its eyes and gill openings...you should not act passively if under attack as sharks respect size and power.”

Flesh-eating bacteria 

Flesh-eating bacteria, or necrotizing fasciitis, is a rare but potentially life threatening infection that can come with exposure to ocean water, lakes and rivers or even swimming pools and hot tubs.

“There are a few types of bacteria that can cause this,” said Kim, noting risk factors are major or minor trauma to the skin, including cuts, scrapes, insect bites or any other skin breach that the bacteria can enter through. “Problems like hemorrhoids or rectal fissures can also be a factor.”

Approximately 700 to 1,200 cases occur each year in the United States with one in every three people dying from the infection, even with treatment, according to the CDC.

Symptoms include: a red or swollen area that spreads quickly, severe pain and fever.

“Redness is seen in more than 72 percent of people with the infection and fever is seen in 60 percent,” Kim added. “It is often extremely painful and out of proportion with the clinical findings.”

If any of these symptoms should arise, Kim advised seeking medical treatment right away.

The CDC said serious complications are common, including sepsis, shock and organ failure, as well as loss of limbs and severe scarring.

Some populations, such as those with diabetes, cancer or weak immune systems, are also more likely to contract such bacteria, according to Kim.

Wound care, such as cleaning all injuries thoroughly with soap and water, as well as avoiding spending time in natural and recreational bodies of water if you have an open wound is advised.

Kim said showering after leaving the beach is recommended, regardless of whether or not you went in the water.

"Upon exiting the beach, use showers provided to wash off sand, dirt and sea water to prevent any sand or water-born illnesses."

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