Health Issue relating to Water/ Forestareas.
1. General
1.1 Participation in activities at waterside locations, on water and in forest areas carries with it a small but significant health risk. Publicity surrounding such risks to health understandably gives parents and all involved in the provision of such activity cause for concern. The DfES produce a document "Group Safety at Water Margins" which is available from http://www.teachernet.gov.uk/wholeschool/healthandsafety/visits/
1.2 The following guidance is provided to enable Party Leaders to give positive advice and assurance to parents. The degree of risk of serious illness in each case is very small indeed, given appropriate precautions, should be strongly emphasised. It is recognised, however, that some parents may, as a result of information, decide against participation in the activity.
1.3 Each school or youth centre will need to decide how best such information is provided for parents. It is recommended that this should be done at a very early stage, preferably at the time of recruitment, and in sufficient detail to describe accurately the chance of contracting the illness and its nature, symptoms and treatment.
2. Blue/green algae
2.1 Blue-green algae inhabit most inland waterways. They are a natural part of the life-cycle of such waters and only create a significant risk to health when a combination of calm conditions and nutrients during the summer months cause the algae to multiply abnormally. On such occasions the water becomes discoloured and a bright green/blue scum may form at the surface.
2.2 On decomposition the algae may release toxins, which can be harmful to those who swim through or swallow affected water. There have been few reports of long term illness affecting humans, but the short-term effects of exposure, including skin rashes, fever and stomach complaints, can be severe.
2.3 The Environment Agency monitors most waters affected by blue-green algae. When doubt exists about a particular water, leaders and instructors should seek and heed the advice of the relevant Environment Agency office.
3. Polluted water
3.1 Some inland waterways, particularly those in lowland areas, show sewage based pollution levels greater than that considered safe for bathing. Such risks are minimised where immersion is avoided or is rare. On waters where pollution levels are high, activities likely to lead to immersion e.g. deliberate canoe capsizes should be avoided.
3.2 Illness arising through such pollution is not likely to be severe. Where illness does occur following activity in or on waters, parents should inform the provider of the activity who may decide to inform the appropriate authorities below and will then determine whether future activity should proceed.
3.3 The appropriate office of the Environment Agency or the Environmental Health Department of the local District Council can give advice on pollution levels of water in their local area.
4. Lyme Disease
4.1 In many forest and moorland areas where deer and other animals run wild, ticks are quite common. Some areas are more badly affected than others are, the ticks are most active between April and October. They are normally carried on animals and on vegetation and are transferred to humans by contact with vegetation.
4.2 Though the tick bites are usually unnoticed and quite common, the incidence of the disease is rare.
4.3 Symptoms are that the bite develops a red patch or circle which expands around the infected area. Flu-like symptoms may develop and, in extreme cases meningitis like symptoms may ensue.
4.4 There are, however, a number of cases each year in Britain and the following guidance is given to raise awareness and identify preventative measures.
4.5 Basic precautionary measures will reduce the number of bites:
- avoid tick habitats where possible,
- wear long trousers tucked into socks,
- light coloured clothing will help you spot ticks,
- brush off clothing before entering accommodation,
- undress and check for ticks, they usually crawl about for several hours before attaching themselves to your skin,
- remove any attached ticks by gently tugging with tweezers and/or by the application of surgical or methylated spirits,
- save the tick for future reference.
Diagnosis and treatment
4.6 The likelihood of infection following bites is very rare but the bites should be monitored. Check for any rash or red patch, especially one that expands over several days. The patch can be quite large and it may be ring shaped.
4.7 Flu like symptoms often occur early in the disease. Meningitis like symptoms, such as a stiff neck, difficulty in concentrating, remembering and fatigue, can occur later in the disease. If you have any of these symptoms, especially after a tick bite, visit your doctor. Explain where you have been and mention LYME DISEASE.
4.8 The disease is treatable with antibiotics at any stage, the earlier the easier the treatment.
5. Weil's disease
5.1 Weil's disease is caused by an organism, carried in rat's urine, which is present in and on the banks of many rivers and lakes. Participation in all forms of water-based outdoor activity carries with it a very small risk of contracting the disease.
5.2 Precautions can be taken by participants to reduce further the risk of infection. Though rare it can be a serious illness requiring hospital treatment, but if diagnosed early, responds well to antibiotics.
5.3 The following guidance is given to inform all involved of the existence of this rare disease. Its very rarity, particularly amongst water-sports participants carries the risk of misdiagnosis.
5.4 Party Leaders may wish to copy the notes overleaf in full for parental notification.
Weil's disease
INFORMATION FOR YOUNG PEOPLE, PARENTS, TEACHERS, YOUTH WORKERS AND INSTRUCTORS.
Participation in any water activity carries with it a very small risk of bacterial infection, which may give rise to a condition known as Weil's Disease. The purpose of this note is to identify;
i) The precautions to be taken to reduce the chance of being infected
ii) The symptoms,
iii) The treatment.
Weil's Disease is caused by bacteria present in rat's urine, and which may contaminate waterways and river or canal bank sides, particularly where there is slow moving or stagnant water. The bacteria do not survive for long in dry conditions or in salt water. The bacteria may be absorbed through the mucous membranes of the eyes and mouth, and particularly via skin cuts or abrasions.
It is a serious illness and can be fatal. It is a 'notifiable disease' and responds well to early treatment.
PRECAUTIONS TO REDUCE THE CHANCE OF INFECTION
Simple protective and hygiene procedures can further reduce the already small chances of infection:
i) Avoid intentional immersion, particularly in slow moving or stagnant waters
ii) Wear protective footwear so as to reduce the chance of accidental cuts or abrasions
iii) Cover any existing cuts with a waterproof plaster, before participation
iv) Wash or shower as soon as possible after the activity.
SYMPTOMS AND TREATMENT
Early symptoms, normally appearing within 3 - 19 days after the activity, are:
i) A temperature, flu-like illness, often with a severe and persistent headache, joint and muscle pain. Pain in the calf muscles is often particularly noticeable.
ii) Jaundice and conjunctivitis may develop.
Having any of the above symptoms does not necessarily mean that you have Weil's Disease, but if you become unwell or such symptoms develop a few days to three weeks after participation:
- Visit your doctor promptly
- Tell the doctor that you have been involved in water activities and where
- Mention Weil's Disease and the Elisa blood test below.
The doctor should then administer penicillin or another antibiotic and arrange for an urgent ELISA blood test. If your local laboratory is not equipped to perform the test, the sample should be sent direct to:
The Leptospirosis Reference Unit, Public Health Laboratory, County Hospital. Hereford, HR1 2ER.
REMEMBER - THE CHANCES OF CONTRACTING THE DISEASE ARE REMOTE - BUT IF YOU DO, EARLY TREATMENT IS ESSENTIAL.