Americans are being warned to be careful when swimming in lakes this summer, after several children suffered kidney failure after taking a dip in freshwater.
The patients fell ill days after playing in Lake Anna, Virginia, over the Memorial Day weekend, with symptoms including diarrhea, dehydration and stomach cramps.
In total, 20 people, mostly children, fell ill after swimming in the lake and several were hospitalized. No deaths have been reported.
Tests show that many of the patients are infected with E. coli, a bacteria that can infest lakes and rivers, usually when sewage is dumped into them.
However, authorities are testing for other viruses, including the deadly brain-eating amoeba Naegleria fowleri, which kills more than 97 percent of the people it infects.
Ava Inglett, 15, is among those who fell ill with kidney failure after contracting E. coli in a freshwater lake in Virginia.
The infections have been linked to Lake Anna, which is about 70 miles south of Washington, DC.
Amoebas appear to be increasingly common in freshwater, as the warmer climate warms lakes and streams.
Families who have lost loved ones to the amoeba are raising awareness about the organism this year, including the mother of 10-year-old Lily Avant, who died in 2019 after contracting the disease in a local river.
Most people contract E. coli by eating foods such as salads, which may have been sprayed with water contaminated with the bacteria.
But it is also possible to contract bacteria from lakes and rivers if someone swallows contaminated water. Three to five percent of patients die from the disease.
Fifteen-year-old Ava Inglett was among those hospitalized by the E. coli outbreak in Virginia.
His mother Judy told him local news her daughter fell ill a few days after visiting the lake for a weekend boating trip, before she was rushed to the hospital.
He has now received at least four rounds of dialysis and three blood transfusions as he fights the infection.
“She’s going through all these things that I never in a million years would have imagined my daughter would have to deal with,” Mrs. Inglett said.
“There’s something in the water that’s making all these kids sick.”
She added: “I want people to know that and think twice before letting their child swim in that water, because I would hate for anyone else to go through what my daughter went through.”
The lake, about 70 miles south of Washington, DC, is popular with families and for boating activities, as well as swimming and kayaking. Around 3 million visitors enjoy days at the lake each year.
Ava has been on dialysis due to kidney failure, where a machine is used to filter her blood.
I had swam in the lake with friends on Memorial Day. Several others are also ill, local journalists said.
Virginia Department of Health officials disclosed the increase in illnesses in an alert and said they were testing water to determine the cause.
All patients are also being interviewed to ensure that E. coli does not come from food, a common way people become infected.
Ten of the patients are confirmed to be infected with E. coli.
Chief Health Officer Dr Olugbenga Obasanjo said: “As we head to swimming pools, lakes and beaches to enjoy the warmer weather and spend time with our families, it is important to remember that we must take precautions to prevent illness.”
‘Showering before and after swimming, washing your hands before eating, and making sure you don’t drink lake water are some of the ways to stay healthy this summer.
“It’s also important not to swim if you have diarrhea.”
He added: “Children may need extra monitoring and reminders to follow these precautions.”
E. coli often enters lakes through leaking sewer pipes or animal feces, as well as through storm drain runoff.
Swimmers can become infected if they accidentally swallow contaminated water or handle food after swimming without washing their hands.
The bacteria can survive stomach acid and travel to the small intestine, where they trigger an infection that causes typical gastrointestinal symptoms.
But they also release toxins in the intestine that can enter the bloodstream and destroy red blood cells.
Debris from destroyed cells can build up in the kidneys, leaving them unable to filter blood properly, leading to kidney failure.
Doctors treat the condition with dialysis, which filters the blood when the kidneys cannot do so, giving the kidneys time to heal.
To treat an E. coli infection, doctors prescribe antibiotics, such as ciprofloxacin and azithromycin, which kill the bacteria.
According to the World Health Organization, about three to five percent of patients who contract E. coli die from the disease.
It is particularly dangerous for children under five years old, adults over 65 years old, and anyone with a weakened immune system.